Journal of Hypertension最新文献

{"title":"Effect of aerobic exercise on endothelial function in hypertensive and prehypertensive patients: a systematic review and meta-analysis of randomized controlled trials.","authors":"Cui Li, Shang Wu, Bingkai Lei, Weidong Zang, Xifeng Tao, Laikang Yu","doi":"10.1097/HJH.0000000000003980","DOIUrl":"10.1097/HJH.0000000000003980","url":null,"abstract":"<p><p>Our objective was to explore the effect of aerobic exercise on endothelial function in hypertensive and prehypertensive patients, and to ascertain the optimal duration and intensity of aerobic exercise. Data were synthesized using a random effects model to calculate the weighted mean difference (WMD) and 95% confidence interval (CI). Fifteen studies met the inclusion criteria. Aerobic exercise was found to significantly improve flow-mediated dilation (FMD) in prehypertensive and hypertensive patients (WMD, 2.23; 95% CI, 1.20-3.26; P  < 0.0001; I2  = 90%). Aerobic exercise, undertaken at a moderate or, even better, vigorous intensity, and lasting no less than 12 weeks, is an effective approach to improve flow-mediated dilation (FMD) in prehypertensive and hypertensive patients. The effect of aerobic exercise on endothelial function is influenced by participant characteristics: a better health status, a younger age, a larger basal body mass index, and a larger basal FMD were associated with larger improvement in FMD.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"727-738"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624940","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":"Nocturnal hypertension represents an uncontrolled burden in patients with metabolic dysfunction-associated steatotic liver disease.","authors":"Anna Martin, Sonja Lang, Felix Schifferdecker, Gabriel Allo, Seung-Hun Chon, Christoph Neumann-Haefelin, Münevver Demir, Hans-Michael Steffen, Philipp Kasper","doi":"10.1097/HJH.0000000000003977","DOIUrl":"10.1097/HJH.0000000000003977","url":null,"abstract":"<p><strong>Backgroundaims: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is an independent risk factor for cardiovascular morbidity and mortality. Another critical risk factor in these patients is arterial hypertension (AH). Although it is estimated that 50% of MASLD patients are suffering from AH, 24-h ambulatory blood pressure monitoring (24-h-ABPM), the gold standard for diagnosing hypertension, is often neglected. However, only 24-h-ABPM can identify hypertension subtypes, particularly nocturnal hypertension (NH), which is a stronger predictor of cardiovascular mortality than daytime or 24-h blood pressure. The aim of this study was to investigate the prevalence of NH in MASLD patients and to identify associated risk factors.</p><p><strong>Methods: </strong>To this end, 226 MASLD patients with or without known AH were prospectively recruited in an outpatient liver department and underwent 24-h-ABPM together with repeated office-blood-pressure measurements.</p><p><strong>Results: </strong>24-h-ABPM datasets from 218 patients were included in the final analysis. NH was observed in 112 patients (51.3%), of whom 54 (48.2%) were receiving antihypertensive treatment (uncontrolled hypertension). Univariable regression analysis showed that age, increased waist-to-hip ratio, a waist-to-height ratio ≥0.5, type 2 diabetes mellitus (T2DM), dyslipidemia, a lower estimated glomerular filtration rate and increased liver stiffness were significantly associated with a higher risk of NH. In multivariable regression analysis, T2DM [odds ratio (OR) 2.56; 95% confidence interval (CI) 1.09-6.23; P  = 0.033], dyslipidemia (OR 3.30; 95% CI, 1.67-6.73; P  = 0.001) and liver stiffness (OR 1.09; 95% CI, 1.02-1.18; P  = 0.021) were identified as independent risk factors.</p><p><strong>Conclusions: </strong>In conclusion, particularly MASLD patients with accompanying T2DM, dyslipidemia, and increased liver stiffness should undergo 24-h-ABPM to detect and treat NH, as they are at the highest risk of adverse cardiovascular events.</p><p><strong>Clinical trial: </strong>NCT-04543721.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"814-821"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408748","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":"Validity and reliability of the 6-min stepper test in hypertensive individuals.","authors":"Beyza Nur Durukan, Emine Burcu Ozcan, Melda Saglam, Yusuf Ziya Sener, Naciye Vardar-Yagli, Deniz Inal Ince, Lale Tokgozoglu, Ebru Calik-Kutukcu","doi":"10.1097/HJH.0000000000003996","DOIUrl":"10.1097/HJH.0000000000003996","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a common public health problem characterized by high blood pressure (BP) and associated with complications such as coronary artery disease, stroke, and renal failure. Physical activity and exercise regulate BP, and assessment of exercise capacity is a cornerstone of exercise training.</p><p><strong>Objective: </strong>The aims of this study were to evaluate the validity and reliability of the 6-min stepper test (6MST) in hypertensive individuals and compare their physiological responses during the 6MST and 6-min walk test (6MWT).</p><p><strong>Methods: </strong>Forty individuals with hypertension were included. Participants performed the 6MWT and 6MST in separate morning and afternoon sessions. In each session, the test was repeated twice with a 30-min rest interval. Heart rate (HR), BP, perceived dyspnea, general fatigue, and leg fatigue were measured pre and posttest. Intraclass correlation coefficient (ICC), Bland-Altman plots, and standard error of measurement (SEM) were used to assess reliability. Pearson correlation analysis was used for convergent validity.</p><p><strong>Results: </strong>There was a strong and significant correlation between 6MWT distance and 6MST score ( r  = 0.689, P  < 0.001). Physiological responses during the 6MST had ICC values ranging from 0.70 to 0.89, suggesting good to excellent test-retest reliability. The SEM and minimum detectable difference (MDD) indicated the 6MST had low measurement error and high sensitivity.</p><p><strong>Conclusion: </strong>The 6MST is a valid and reliable tool for assessing exercise capacity in people with HTN. Its practicality and ease of use make it a suitable alternative to the 6MWT for this population.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"880-886"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624949","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":"Nighttime blood pressure-targeted antihypertensive treatment.","authors":"Tatsuya Maruhashi, Yoshihiko Kinoshita, Ryoji Ozono, Mitsuaki Nakamaru, Masanori Ninomiya, Jiro Oiwa, Takuji Kawagoe, Osamu Yoshida, Toshiyuki Matsumoto, Yasuo Fukunaga, Kotaro Sumii, Hironori Ueda, Nobuo Shiode, Kosuke Takahari, Yasuhiko Hayashi, Yujiro Ono, Yukiko Nakano, Masakazu Takahashi, Yasuki Kihara, Yukihito Higashi","doi":"10.1097/HJH.0000000000003998","DOIUrl":"10.1097/HJH.0000000000003998","url":null,"abstract":"<p><strong>Objectives: </strong>Nocturnal hypertension is increasingly recognized as a significant risk factor for cardiovascular events. However, there is limited information on whether antihypertensive treatment directly targeting nighttime blood pressure (BP) improves cardiovascular outcomes in medicated patients with hypertension. In this prospective multicenter study, we investigated whether aggressive adjustments in antihypertensive drug treatment targeting nighttime BP can effectively normalize nocturnal hypertension and assessed the safety of this approach.</p><p><strong>Methods: </strong>Nighttime BP was measured using a home BP monitoring device at baseline and at 6 months in 264 medicated patients with hypertension (161 men and 103 women; mean age, 68.5 ± 9.9 years) between October 2015 and March 2019. All patients with nocturnal hypertension, defined as mean nighttime SBP at least 120 mmHg, at baseline received aggressive adjustments in antihypertensive drug treatment targeting nighttime BP. Morning and evening measurements were taken in some patients.</p><p><strong>Results: </strong>Of the 264 patients, 90 had nocturnal hypertension at baseline. After 6 months of medication adjustments, nocturnal hypertension was normalized in 48 (53.3%) of the 90 patients, with values decreasing from 127.8 ± 6.6 to 112.5 ± 6.6 mmHg. Normalization of nocturnal hypertension was accompanied by significant reductions in both morning BP (135.9 ± 12.7 to 126.4 ± 10.8 mmHg, P  < 0.001) and evening BP (130.8 ± 10.9 to 121.9 ± 10.3 mmHg, P  < 0.001). The incidence of nonserious adverse events was higher in patients with nocturnal hypertension, but these events were not deemed specific to the treatment targeting nighttime BP.</p><p><strong>Conclusion: </strong>Aggressive adjustments in antihypertensive drug treatment directly targeting nighttime BP can safely normalize nocturnal hypertension in over half of medicated patients with hypertension within a 6-month period.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"887-896"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624910","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":"Local release of renin unveils intrarenal arterial fibromuscular dysplasia.","authors":"Cristiano Fava, Chiara Dal Pont, Andrea Sartorio, Alberto Contro, Giancarlo Mansueto, Pietro Minuz","doi":"10.1097/HJH.0000000000003987","DOIUrl":"10.1097/HJH.0000000000003987","url":null,"abstract":"<p><p>A previously healthy young man developed severe hypertension requiring triple antihypertensive therapy. Initial evaluation identified hyperreninemic hyperaldosteronism, mild hypokalaemia, hypodensity within the right kidney at computed tomography (CT), normal renal arteries at echography. He was referred to Verona ESH Centre were angio-CT revealed significant stenosis of an aberrant branch artery of the right kidney with hypo-perfused area colocalizing with a hypo-oxygenated area, as assessed by BOLD-MR imaging. Super-selective sampling found high plasma renin concentrations only in the vein draining the lower pole of the right kidney. Renal angiography confirmed tightened stenosis of an aberrant branch artery supplying the lower arterial segments, consistent with unifocal medial fibromuscular dysplasia, successfully treated with angioplasty. Investigating extra-renal sites, angio-MR found an S-shaped loop of extracranial left internal carotid artery, consistent with multisite fibromuscular dysplasia. This clinical case underscores the importance of comprehensive functional and imaging tests to identify elusive causes of secondary hypertension.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"909-913"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624908","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":"Central pulse pressure, carotid artery remodeling and coronary artery calcifications.","authors":"Michaela Kozakova, Carmela Morizzo, Giuli Jamagidze, Sara Chiappino, Dante Chiappino, Michele Emdin, Carlo Palombo","doi":"10.1097/HJH.0000000000003968","DOIUrl":"10.1097/HJH.0000000000003968","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to evaluate the role of central pulse pressure (PP) in carotid wall thickening and coronary artery calcification (CAC).</p><p><strong>Methods: </strong>In an asymptomatic general population ( N  = 396, 163 men, 47-89 years), central PP was measured by applanation tonometry, CAC by computed tomography, and common carotid artery intima-media thickness (cIMT), pulse wave velocity (cPWV) and the power of the signal reflected from carotid media (cMP) by radiofrequency-based carotid ultrasound. High cIMT was defined as cIMT equal to or greater than the 75th percentile for given sex and age, and CAC presence as a CAC score greater than 0.</p><p><strong>Results: </strong>In the entire population, luminal diameter and cMP increased with increasing central PP ( r  = 0.32 and 0.25; P  < 0.0001). One hundred and ninety-seven individuals had high cIMT; individuals with high cIMT had higher central PP, luminal diameter, cMP and cPWV ( P  = or <0.0001), but comparable wall tensile stress ( P  = 0.23). In a logistic regression model, high cIMT was independently associated with luminal diameter and central PP. One hundred and fifty-two individuals had CAC score greater than 0; in a logistic regression model, CAC score greater than 0 was independently associated with sex, age, central PP, LDL-cholesterol, triglycerides and T2DM.</p><p><strong>Conclusion: </strong>Our findings indicate that high central PP contributes both to an increase in cIMT and the development of CAC. However, while central PP was the only risk factor linked to high cIMT, multiple atherosclerotic risk factors were associated with CAC. Therefore, both high cIMT and CAC reflect the adverse impact of high pulsatile load on the vascular system, yet only CAC can be considered a marker of atherosclerosis.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"774-780"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399345","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":"Extracellular matrix dynamics in a rat model of pulmonary arterial hypertension: unveiling the role of hyaluronan in disease pathology.","authors":"Pinar Altin Çelik, Metin Aytekin","doi":"10.1097/HJH.0000000000003967","DOIUrl":"10.1097/HJH.0000000000003967","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to investigate the feasibility of conducting extracellular matrix studies within this rat model.</p><p><strong>Materials and methods: </strong>This study involved 24 Sprague Dawley rats, divided into two groups. Group 1 served as the normoxia control, while Group 2 is SU-5416 pulmonary arterial hypertension (PAH) model. Pulmonary artery pressure (PAP) was measured in both groups using a micro-catheter Power Lab device. Hyaluronan (HA) plasma level was quantified through ELISA, and HA levels were determined via lung tissue immunostaining. Western blotting detected protein levels, and real-time RT-PCR assessed mRNA expressions for HAS1, HAS2, and HAS3 and hyal1 and hyal2.</p><p><strong>Results: </strong>HA plasma levels were markedly higher in PAH rats compared to controls (HA ng/ml, mean ± SD: PAH 3.8 ± 0.41, control 1.96 ± 0.31, P  < 0.0015). Protein analysis showed no detection of HAS1 and HAS3 proteins in both groups, while HAS2 protein expression was notably higher in PAH rats than controls (HAS2 levels, mean ± SD: PAH 2.0 ± 0.5, control 0.86 ± 0.07, P  = 0.0493). Hyal2 protein expression remained consistent between groups (Hyal2 levels, mean ± SD: PAH 1.41 ± 0.18, control 1.05 ± 0.14, P  = 0.214). No mRNA expression of HAS1, HAS3, and Hyal1 were detected in both groups, Hyal2 expression was identified in both without differences. HAS2 mRNA expression was present in both groups, with a significantly higher increase observed in the hypoxia SU-5416 PAH rat model compared to controls.</p><p><strong>Conclusion: </strong>Establishing an extracellular matrix profile in the rat model, resembling human PAH under hypoxia SU-5416 conditions, highlights the model's suitability for matrix studies.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"768-773"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624941","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":"Carotid-femoral pulse wave velocity progression in hypertensive patients is associated with subsequent cardiovascular outcomes.","authors":"Alessandro Maloberti, Paola Rebora, Giuseppe Occhino, Anita Andreano, Rita Cristina Myriam Intravaia, Chiara Tognola, Giorgio Toscani, Gabriele Peraro, Martina Morelli, Magda Rognoni, Luca Cavalieri d'oro, Antonio Russo, Cristina Giannattasio","doi":"10.1097/HJH.0000000000003973","DOIUrl":"10.1097/HJH.0000000000003973","url":null,"abstract":"<p><strong>Objective: </strong>Pulse wave velocity (PWV) is associated with cardiovascular events and mortality. However, little is known on the relationship of its progression (ΔPWV) over time with cardiovascular outcomes. The aim of our study was to evaluate the relationship between ΔPWV and all-cause mortality and cardiovascular events in hypertensive patients.</p><p><strong>Methods: </strong>We enrolled 402 consecutive hypertensive outpatients. At baseline, anamnestic, clinical, blood pressure (BP), laboratory data and PWV were assessed. PWV examination was repeated after 3.8 (I-III quartiles 3.5-4.2) years. Patients were subsequently followed for a median time of 10.1 (I-III quartiles 9.5-10.5) years recording all-cause mortality and cardiovascular events.</p><p><strong>Results: </strong>At baseline, mean age was 53.2 ± 13.0 years, SBP and DBP were 141.8 ± 17.5 and 86.8 ± 10.5 mmHg and PWV was 8.5 ± 1.9 m/s. Despite an improvement in BP control (-9.2 ± 19.5 and -8.0 ± 12.3 for SBP and DBP, respectively), at follow-up, the population showed a PWV increase (ΔPWV +0.6 ± 1.9 m/s). Progressors (ΔPWV ≥0.5 m/s, 204 patients, 50.7%) had a significantly lower survival probability and higher cumulative incidence of composite events, while no differences were seen for cardiovascular events (unadjusted analysis). At Cox multivariable analysis, neither ΔPWV at least 0.5 m/s (progressors) nor ΔPWV (as a spline function) were associated with cardiovascular events and with all-cause mortality. However, the association with survival probability and cumulative incidence of cardiovascular events, as a composite outcome, was significant (hazard ratio = 2.33, 95% CI 1.34-4.05, P  = 0.003).</p><p><strong>Conclusion: </strong>Our study shows that PWV progression at least 0.5 m/s is frequent in hypertensive patients and is associated with a significantly higher risk of developing cardiovascular events or dying (composite outcome).</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"797-806"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624783","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":"Cardiovascular effects after five nights without continuous positive airway pressure for obstructive sleep apnea: a randomized controlled trial.","authors":"Carin Sahlin, Magnus Hedström, Martin Claesson, Eva Lindberg, Johan Svensson, Anders Blomberg, Karl A Franklin","doi":"10.1097/HJH.0000000000003990","DOIUrl":"10.1097/HJH.0000000000003990","url":null,"abstract":"<p><strong>Objectives: </strong>Although continuous positive airway pressure (CPAP) effectively prevents sleep apnea and reduces blood pressure, many patients do not use CPAP every night. This trial investigates cardiovascular effects after sleeping five nights without CPAP.</p><p><strong>Methods: </strong>We randomized 100 patients (67 men and 33 women with a mean age 64 ± 9 years) using CPAP treatment for moderate-to-severe sleep apnea to either withdraw treatment for five nights ( n  = 50) or to continue with CPAP ( n  = 50). The primary outcomes were arterial stiffness and 24 h blood pressure.</p><p><strong>Results: </strong>The 24 h SBP increased by a mean of 2.8 mmHg [95% confidence interval (CI) 0.2-5.4 mmHg] ( P  = 0.035) and DBP increased by a mean of 1.7 mmHg (95% CI 0.1-3.3 mmHg) ( P  = 0.032) in the group without CPAP compared to the CPAP group. There was a significant effect on blood pressure in women but not in men. In women, SBP increased by 5.1 mmHg (95% CI 1.0-9.5 mmHg) ( P  = 0.017) and DBP by 2.9 mmHg (95% CI 0.4-5.6 mmHg) ( P  = 0.029). Arterial stiffness remained unaffected. Secondary outcomes that worsened in patients without CPAP included apnea-hypopnea index, oxygen desaturation index, hemoglobin levels, and daytime sleepiness.</p><p><strong>Conclusion: </strong>Blood pressure is affected after five nights of CPAP interruption, along with a rapid return of sleep apneas, nocturnal hypoxic events, daytime sleepiness and increased hemoglobin levels, but arterial stiffness was not affected. Blood pressure was affected in women only, suggesting a sex-related CPAP effect on blood pressure.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"864-870"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657325","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":"Chronic hypertension in pregnancy: insights into adverse outcomes prevention.","authors":"Rossana Orabona, Rossella Monaci, Sara Branca, Silvia Sartorello, Chiara Tomasoni, Anna Fichera, Francesca Ramazzotto, Adriana Valcamonico, Sonia Zatti, Franco E Odicino","doi":"10.1097/HJH.0000000000003978","DOIUrl":"10.1097/HJH.0000000000003978","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to investigate the role of low molecular weight heparin in the prevention of preeclampsia and/or fetal growth restriction in pregnant women with chronic hypertension.</p><p><strong>Methods: </strong>Women diagnosed with chronic hypertension were retrospectively selected from our electronic database from January 2019 to January 2024. The primary endpoint was the occurrence of adverse pregnancy outcomes described as the onset of preeclampsia and/or fetal growth restriction.</p><p><strong>Results: </strong>A total of 219 pregnant women with chronic hypertension were included. BMI before pregnancy was 27.8 ± 6.4 kg/m 2 and age 36.1 ± 5.4 years. Preeclampsia and fetal growth restriction occurred in 22.9 and 9.6% of patients, respectively. As concerns prophylaxis in the first trimester, 80.1% of patients were administered low-dose aspirin (100 mg), while 16.7% low molecular weight heparin (at prophylactic doses according to BMI), of which 86.1% aspirin + heparin. The rate of preeclampsia was similar in patients taking aspirin or not (21.3 vs. 25%), while it significantly differed in those administered with heparin as thromboprophylaxis (8.8 vs. 25%, P  = 0.04). Fetal growth restriction occurrence did not differ according to the use of prophylaxis. High resistance at uterine arteries Doppler velocimetry at 24-25 weeks of gestation was confirmed to be associated with the onset of preeclampsia (51 vs. 11.9%; P  < 0.001) and fetal growth restriction (18.2 vs. 6.9%; P  = 0.04).</p><p><strong>Conclusion: </strong>Thromboprophylaxis with low molecular weight heparin reduces the onset of superimposed preeclampsia, independently from aspirin intake.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"822-826"},"PeriodicalIF":3.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624936","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}