Journal of Hypertension最新文献

{"title":"Treatment of early hypertensive renal damage with Quanduzhong capsules: two case reports.","authors":"Gao-Yu Zhang, Jia-Rong Fan, Zi-Han Wang, Qing He, Xue-Fei Gao, Xiao-Feng Li, Zhi-Gang Zhou, Yu Cui, Lin Li","doi":"10.1097/HJH.0000000000003966","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003966","url":null,"abstract":"<p><strong>Background: </strong>Hypertensive nephropathy is increasingly prevalent and a leading cause of end-stage renal disease. Current treatment strategies for hypertensive nephropathy focus on blood pressure control and reducing urinary albumin. However, the use of angiotensin-converting enzyme inhibitor (ACEI)/angiotensin receptor blocker (ARB) medications carries risks, including a potential decrease in glomerular filtration rate (GFR). This report aims to assess the clinical effectiveness of Quanduzhong capsules (QDZCs) in early-stage hypertensive kidney damage, contributing to the evidence base for their use in traditional Chinese medicine for hypertension treatment.</p><p><strong>Methods: </strong>The patients, two middle-aged gentlemen with over a decade of hypertension in their medical history, were currently in the early phase of grade 1 hypertension. Notably, their blood pressure readings consistently exceeded the normal parameters. Furthermore, they exhibited signs of microalbuminuria and proteinuria in their clinical presentations. Based on these symptoms, they received a diagnosis of hypertensive kidney damage, specifically at the microalbuminuria stage.</p><p><strong>Results: </strong>After admission, the two patients took QDZCs for treatment. The medication method was: 2 times a day, 3 capsules each time. The results showed that the microalbuminuria of case 1 and the proteinuria of case 2 were reduced within 12 weeks after taking the medicine, and the average 24-h blood pressure was also reduced. Case 2 experienced a slight decrease in creatinine clearance and glomerular filtration rate after treatment, but the difference was not significant. During the 12-week follow-up period, there were no significant abnormalities in serum creatinine, blood urea nitrogen, creatinine clearance, and estimated glomerular filtration rate.</p><p><strong>Conclusion: </strong>This case report shows that Quanduzhong capsule can lower blood pressure and improve symptoms of microalbuminuria and proteinuria in patients with early hypertensive renal damage, and may provide a promising treatment option for the management of early hypertensive renal damage. However, the evidence is preliminary and larger, controlled studies are needed to determine its efficacy and potential advantages.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure measurement at kiosks in public spaces: systematic review and consensus statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability endorsed by the International Society of Hypertension and the World Hypertension League.","authors":"George S Stergiou, Konstantinos G Kyriakoulis, Anastasios Kollias, Richard J McManus, Ariadni Menti, Gianfranco Parati, Aletta E Schutte, Jiguang Wang, Kei Asayama, Roland Asmar, Grzegorz Bilo, Niamh Chapman, Takeshi Fujiwara, Geoffrey Head, Nadia Kahn, Kazuomi Kario, Yan Li, Efstathios Manios, Dimitrios Mariglis, Anastasia S Mihailidou, Paul Muntner, Martin Myers, Teemu Niiranen, Takayoshi Ohkubo, Stefano Omboni, Athanasios Protogerou, Francesca Saladini, James Sharman, Daichi Shimbo, Alejandro De La Sierra, Paolo Palatini","doi":"10.1097/HJH.0000000000003965","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003965","url":null,"abstract":"<p><p>Kiosk devices for unsupervised self-measurement of blood pressure (BP) are being used in public spaces and healthcare settings in several countries. This statement by the European Society of Hypertension (ESH) Working Group on BP Monitoring and Cardiovascular Variability provides a review of the published evidence on kiosk BP devices and consensus recommendations for their requirements and clinical use. A systematic literature search identified 54 relevant studies. Kiosk BP measurements appeared to be close to office BP [mean difference systolic 0.2 mmHg (95% confidence intervals -1.3 to 1.8); diastolic -0.4 mmHg (-3.5 to 2.7)], and higher than daytime ambulatory and home BP [mean difference 6.0 mmHg (1.6-10.4)/5.0 (2-8) and 8.1 mmHg (-2.6 to 18.9)/0.2 (-9.6 to 10.0), respectively]. Randomized or observational studies using kiosk BP measurements for hypertension screening or for assessing hypertension control were also included, as well as studies investigating users' and healthcare professionals' opinions, acceptability, and perspectives regarding kiosk BP measurements, and validation studies of kiosk BP devices. These studies had considerable heterogeneity in design, setting, methodology, measurement protocol, and sample size. Thus, at present, the clinical utility of kiosk BP measurements is uncertain. This ESH consensus statement acknowledges the potential of kiosk BP measurement as an emerging method for unsupervised self-measurement in the context of opportunistic screening for hypertension in apparently healthy people and the long-term monitoring of people with diagnosed hypertension. Requirements for the design, validation, function, and use of kiosk BP monitors are provided, together with the pending research questions on their optimal implementation in clinical practice.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Formulas to estimate dietary sodium intake from spot urine lead to misleading associations with cardiovascular disease risk and mortality.","authors":"Jing Song, Changqiong Wang, Sonia Pombo-Rodrigues, Graham A MacGregor, Norm R C Campbell, Feng J He","doi":"10.1097/HJH.0000000000003959","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003959","url":null,"abstract":"<p><strong>Objectives: </strong>To test the hypothesis that the association of formula-estimated sodium intake from spot urine with cardiovascular disease is independent of spot urinary sodium concentration.</p><p><strong>Methods: </strong>We included 435 336 participants in the UK Biobank whose sodium intake was estimated from spot urine using INTERSALT, Kawasaki, and Tanaka formulas. Hazard ratios for cardiovascular disease (CVD) events and deaths were estimated using Cox proportional-hazard model adjusted for multiple covariates. Penalized Cox regression was used to assess nonlinear relations. Hazard ratios were recalculated after replacement of the sodium concentration term with sex-specific mean values (women: 67.5 mmol/l; men: 89.8 mmol/l) to assess how other components of the formulas influenced these associations.</p><p><strong>Results: </strong>Forty-four thousand two hundred and sixty-eight CVD events and 3251 CVD deaths occurred during a median follow-up of 12 years. The mean estimated sodium intake was 143 (SD = 35), 178 (52), and 147 (33) mmol/day based on INTERSALT, Kawasaki, and Tanaka formulas, respectively. For CVD incidence, linear inverse associations were observed for INTERSALT and Tanaka estimates [hazard ratios (95% CIs) for every 50 mmol reduction in estimated sodium intake: 0.9 (0.83-0.97) and 0.93 (0.89- 0.97); P-linear = 0.0047 and 0.0021], and a U-shaped association for the Kawasaki estimates (P-nonlinear = 0.0026). When the sodium concentration term was fixed, inverse associations were seen for all formulas [0.86 (0.77-0.95), 0.96 (0.93-0.99) and 0.94 (0.89-0.99) for INTERSALT, Kawasaki, and Tanaka; P linear = 0.0054, 0.0166 and 0.0188]. For CVD mortality, no association was observed, but a nonlinear association was identified for the INTERSALT equation (P-nonlinear = 0.0287) after fixing the sodium concentration.</p><p><strong>Conclusion: </strong>These formula-estimated sodium intakes were associated with CVD incidence and mortality independently of spot urinary sodium concentration. We recommend these formulas not be used in studies associating sodium intake with CVD outcomes to avoid generating misleading evidence.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Aktiia cuffless blood pressure monitor across 24-h, daytime, and night-time measurements versus ambulatory monitoring: a prospective, single-centre observational study.","authors":"Tiago P Almeida, David Perruchoud, Jérémy Alexandre, Pascale Vermare, Josep Sola, Jay Shah, Luisa Marques, Cyril Pellaton","doi":"10.1097/HJH.0000000000003960","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003960","url":null,"abstract":"<p><strong>Objectives: </strong>Cuffless blood pressure (BP) monitors represent an innovative approach to BP assessment, overcoming the traditional episodic nature of readings obtained from cuff-based, oscillometric modalities. Nonetheless, the comparison of these cuffless devices against their cuff-based counterparts remain debated.</p><p><strong>Methods: </strong>This study evaluated BP readings from a cuffless, continual BP monitor (Aktiia monitor, Neuchâtel, Switzerland) and a standard 24-h ambulatory BP monitor (ABPM; Dyasis 3, Novacor, Paris, France) in 54 patients undergoing a 12-week cardiac rehabilitation program in Neuchâtel, Switzerland. Comparisons encompassed 24-h, daytime (9 a.m.-9 p.m.), and night-time (11 p.m.-7 a.m.) systolic and diastolic BP (SBP, DBP) using a 7-day average from Aktiia overlapping a 1-day average from ABPM. Nocturnal dip analysis was performed with 1-day average from Aktiia coinciding with ABPM measurements.</p><p><strong>Results: </strong>No significant differences emerged between the Aktiia and ABPM monitors for 24-h and daytime SBP (24-h: 2.6 ± 12.3 [-0.2, 5.4] mmHg, r = 0.57, P = 0.06; daytime: 1.2 ± 12.4 [-1.6, 4.0] mmHg, r = 0.60, P = 0.38). Night-time SBP showed more evident differences (12.5 ± 14.4 [9.3, 15.8] mmHg, r = 0.39, P < 0.001). DBP were within clinical range across 24-h and daytime (24-h: -2.9 ± 7.9 [-4.7, -1.1] mmHg, r = 0.63, P = 0.002; daytime: -3.1 ± 8.2 [-5.0, -1.3] mmHg, r = 0.64, P = 0.001), and showed significant differences for night-time (4.1 ± 8.5 [2.2, 6.0] mmHg, r = 0.57, P < 0.001). The concordance rate with ABPM's nocturnal dip was 79% for 1-day average from Aktiia.</p><p><strong>Conclusions: </strong>These results demonstrate that the Aktiia monitor yields BP measurements consistent with an ABPM monitor despite some systematic differences during night-time readings. The Aktiia monitor holds potential for future use in continual BP monitoring.</p><p><strong>Clinical trial registration: </strong>NCT04548986. URL: https://clinicaltrials.gov/study/NCT04548986?tab=results.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of renovascular hypertension due to polyarteritis nodosa.","authors":"Diana Ferrao, Luis Nogueira-Silva, Sofia Tavares, Maria J Lima, Jorge Almeida","doi":"10.1097/HJH.0000000000003963","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003963","url":null,"abstract":"<p><p>In renal vasculitis, luminal narrowing can reduce blood flow and activate the renin-angiotensin-aldosterone system, causing renovascular hypertension. We present the case of a 47-year-old man with previous intestinal tuberculosis and episodes of lumbar pain, tender erythematous nodules and arthralgias. He had grade 3 hypertension, unresponsive to treatment, with left ventricular concentric hypertrophy and chronic kidney disease. He was admitted to the ICU due to a hypertensive emergency, with acute kidney failure and a large peri-renal hematoma. The computed tomography and angiography showed bilateral renal scarring, intrarenal pseudoaneurysms and irregularities in the renal, common hepatic and mesenteric arteries, suggesting a medium-vessel vasculitis, namely polyarteritis nodosa. Cyclophosphamide and corticosteroids were started. His blood pressure was controlled, and his kidney function remained stable. Renovascular hypertension is, in infrequent cases, caused by an inflammatory systemic disease. When this is the case, the diagnosis must be considered and appropriately addressed.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor necrosis factor-α inhibitors and preeclampsia: assessing the evidence for risk reduction.","authors":"Wei-Zhen Tang, Wei-Ze Xu, Tai-Hang Liu","doi":"10.1097/HJH.0000000000003880","DOIUrl":"10.1097/HJH.0000000000003880","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 1","pages":"181-182"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revolutionizing LVH detection using artificial intelligence: the AI heartbeat project.","authors":"Zafar Aleem Suchal, Noor Ul Ain, Azra Mahmud","doi":"10.1097/HJH.0000000000003885","DOIUrl":"10.1097/HJH.0000000000003885","url":null,"abstract":"<p><p>Many studies have shown the utility and promise of artificial intelligence (AI), for the diagnosis of left ventricular hypertrophy (LVH). The aim of the present study was to conduct a meta-analysis to compare the accuracy of AI tools to electrocardiographic criteria, including Sokolow-Lyon and the Cornell, most commonly used for the detection of LVH in clinical practice. Nine studies meeting the inclusion criteria were selected, comprising a sample size of 31 657 patients in the testing and 100 271 in the training datasets. Meta-analysis was performed using a hierarchal model, calculating the pooled sensitivity, specificity, accuracy, along with the 95% confidence intervals (95% CIs). To ensure that the results were not skewed by one particular study, a sensitivity analysis using the 'leave-out-one approach' was adopted for all three outcomes. AI was associated with greater pooled estimates; accuracy, 80.50 (95% CI: 80.4-80.60), sensitivity, 89.29 (95% CI: 89.25-89.33) and specificity, 93.32 (95% CI: 93.26-93.38). Adjusting for weightage of individual studies on the outcomes, the results showed that while accuracy and specificity were unchanged, the adjusted pooled sensitivity was 53.16 (95% CI: 52.92-53.40). AI demonstrates higher diagnostic accuracy and sensitivity compared with conventional ECG criteria for LVH detection. AI holds promise as a reliable and efficient tool for the accurate detection of LVH in diverse populations. Further studies are needed to test AI models in hypertensive populations, particularly in low resource settings.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"66-77"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic total occlusion of renal artery in symptomatic young patient with resistant hypertension: is a revascularization necessary or redundant?","authors":"Wojciech Stecko, Piotr Wańczura, Adam Wajhajmer, Mateusz Wiśniowski, David Aebisher","doi":"10.1097/HJH.0000000000003846","DOIUrl":"10.1097/HJH.0000000000003846","url":null,"abstract":"<p><p>Renal artery stenosis (RAS) can be described as a narrowed vessel lumen at least 60% which hemodynamic significance may be subsequently confirmed by the pressure gradient measuring with endovascular methods. Frequency with which a disease appears in a population is 5-10% and its dominant cause is the occurrence of atherosclerotic plaque. Infrequent causes include fibromuscular dysplasia and vasculitis such as Takayasu arteritis. Diagnostic gold standard of RAS is digital subtraction angiography (DSA) with pressure measurements. Nevertheless, Doppler ultrasonography (DUS), magnetic resonance angiography (MRA) and computed tomography angiography (CTA) may also play a key role during diagnostics process. Revascularization of narrowed or occluded vessel consists of percutaneous transluminal angioplasty (PTA) with balloon, drug-coated balloon or stent implantation. Surgical procedures are rare and dedicated only to treatment-resistant cases. We reported a 19-year-old patient with resistant arterial hypertension, left ventricular hypertrophy and stenosis of the proximal segment of the right renal artery, confirmed in angio-CT examination. Subsequent follow-up endovascular diagnostic procedure after 12 months revealed complete occlusion of renal artery with angiographic features of chronic total occlusion (CTO). Additionally, laboratory tests showed increase of creatinine level, with an estimated eGFR of 32.9 ml/min/1.73 m2. Considering the whole case - history of fibromuscular dysplasia, deterioration of renal function and the presence of resistant hypertension in a young patient - the invasive treatment was decided. Revascularization with paclitaxel-coated balloon was performed leading to renal perfusion improvement and normalization of the creatinine level. The patient was discharged from hospital with significantly reduced doses of antihypertensive drugs. There are few publications on opening CTOs of renal arteries. The method is rarely used and research in this field should be extended. While routine revascularization is not recommended, in some cases, we should take under consideration that early restoration of normal renal perfusion can bring benefits to the patient both clinical and related to the number of drugs taken and quality of life.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 1","pages":"163-167"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of thiazide-induced hypertension treatment: insights from gene expression and histological analysis in malignant stroke-prone spontaneously hypertensive rats.","authors":"Saad Khan, Bilal Ahmad, Malik W Z Khan, Syeda Mashal Fatima, Muhammad Usama Nawaz","doi":"10.1097/HJH.0000000000003881","DOIUrl":"10.1097/HJH.0000000000003881","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 1","pages":"180-181"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to 'TNF-α inhibitors and preeclampsia: assessing the evidence for risk reduction'.","authors":"Motohiko Adomi, Thomas F McElrath, Sonia Hernández-Díaz, Krista F Huybrechts","doi":"10.1097/HJH.0000000000003895","DOIUrl":"10.1097/HJH.0000000000003895","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"43 1","pages":"182"},"PeriodicalIF":3.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}