Journal of Human Hypertension最新文献

{"title":"When the sum isn't the whole - The vascular status score and its components in hypertension identification: The African PREDICT study.","authors":"Marizelle Vermeulen, Wayne Smith, Yolandi Breet, Annemarie Wentzel","doi":"10.1038/s41371-026-01156-3","DOIUrl":"https://doi.org/10.1038/s41371-026-01156-3","url":null,"abstract":"<p><p>The vascular status score (VSS) is an emerging composite index, developed to investigate early vascular changes by integrating pulse wave velocity (PWV), augmentation index (AIx), and carotid intima-media thickness (cIMT). Although prior studies have linked the VSS to inflammatory and metabolic dysfunction, its association with hypertension remains unexplored. This study compared the ability of the VSS and its individual components in identifying hypertension, regardless of phenotype, among young South African adults. We included 1,019 participants aged 20 - 30 years from a community-based cohort. Office and ambulatory blood pressures were measured, and hypertension phenotypes were defined according to the 2024 ESC guidelines. Carotid-femoral PWV, Aix, and cIMT were assessed and combined to calculate the composite VSS. Receiver operating characteristic (ROC) analyses determined optimal cut points for VSS and its components relative to normotensive and hypertensive classifications, and odds ratios were adjusted for relevant covariates. Among the indices examined, only PWV demonstrated consistent sensitivity and specificity across hypertension phenotypes. While a VSS above 4 modestly increased the odds of masked, sustained, and white-coat hypertension (odds ratios ranging from 1.74 to 2.35, all P < 0.05), only PWV accurately identified masked and sustained hypertension (odds ratios 2.25-2.70, all P < 0.01). Neither AIx nor cIMT achieved comparable diagnostic utility. Despite the promise of a composite vascular index, PWV independently outperformed the VSS and its other components in detecting hypertension in young adults. These findings suggest that PWV may be the most reliable individual biomarker for early hypertension identification in young adults.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertensive heart disease attributable to high BMI: global trends, gender disparities, and SDI-based inequalities (1990-2021).","authors":"Yiming Zhou, Yukang Mao, Minshan Zhong, Yuxuan Lou, Yang Hua, Wei Sun, Tingting Wu","doi":"10.1038/s41371-026-01157-2","DOIUrl":"https://doi.org/10.1038/s41371-026-01157-2","url":null,"abstract":"<p><p>In order to provide insights crucial for achieving UN Sustainable Development Goal 3.4, this study attempts to evaluate the global burden of hypertensive heart disease (HHD) owing to high BMI, stratified by gender and SDI, from 1990 to 2021 and projects trends to 2051. Leveraging Global Burden of Disease 2021 data, we assessed HHD mortality and DALYs attributable to high BMI via DisMod-MR 2.1. Health inequalities were quantified using SII and CI, with Bayesian age-period-cohort modeling enabling gender-stratified projections. Global HHD deaths attributable to high BMI showed a relative change of 1.48 from 1990-2021, corresponding to an approximately 148% increase. Females experienced disproportionately higher mortality (relative change +1.4) and DALYs (relative change +1.12) than males. Southern sub-Saharan Africa recorded the steepest ASMR increase (relative change +0.54), while East Asia saw mortality surge (relative change +1.14). The escalating HHD burden from high BMI is a health inequality crisis, disproportionately affecting females and low-resource regions. This demands urgent tiered interventions and requires reconciling economic growth with health system resilience to address the underlying socioeconomic paradox.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of individual hemodynamic thresholds during exercise (Hem-TRex): relationship with blood pressure.","authors":"Fabian Spahiu, Max Hagemann, Michelle Ottlik, Moritz Lampkemeyer, Christopher J A Pugh, Martin G Schultz, Eric J Stöhr","doi":"10.1038/s41371-026-01155-4","DOIUrl":"https://doi.org/10.1038/s41371-026-01155-4","url":null,"abstract":"","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Need to take action for hypertension: insights from primary care blood pressure practices in Greece.","authors":"Vasileios Gkolias, Nikolaos Evangelidis, Magda Gavana, Ioannis Staikos, Styliani Ouzouni, Maria Moirasgenti, Anna-Bettina Haidich, Michael Doumas, Emmanouil Smyrnakis, Areti Triantafyllou","doi":"10.1038/s41371-026-01151-8","DOIUrl":"https://doi.org/10.1038/s41371-026-01151-8","url":null,"abstract":"<p><p>Primary healthcare (PHC) physicians play a pivotal role in the diagnosis and management of hypertension. While guidelines suggest that blood pressure (BP) should be measured in every patient visit at PHC units, the few studies conducted among PHC physicians report a low ratio of BP measurements in PHC settings. Data on PHC physicians' practices concerning BP measurement in Greece are lacking. This study aimed to investigate the practices of PHC physicians regarding BP measurement in Greece. A cross-sectional web-based survey was conducted among PHC physicians across Greece. A total of 284 PHC physicians completed the questionnaire and 282 responses were included in the analysis, 42.9% male, 92.9% General Practitioners, 89.4% working in the public sector, with a median of 25 (17 - 30) daily patient visits. PHC physicians reported measuring BP in 33.3% (20-50%) of their patients and recommending home BP measurements in 31.1% (SD: 24.3%) of them. Among those who measured BP, 22.3% measured it once, 44.7% measured it twice, and only 21.3% measured it three times, while 54.6% used an electronic upper arm BP monitor. The main barriers reported were high daily patient volume (60.5%), together with limited time available with patients (69.5%), while only 1.3% declared insufficient training. This is the first study in Greece investigating the practices of PHC physicians regarding BP measurements. Our findings underscore the need for targeted interventions to improve BP monitoring practices. Education and motivation of physicians and other primary care team members would be fundamental in addressing the challenge of implementing BP measurement recommendations in clinical practice.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus on the management of hypertension in individuals with diabetes by Asian-Pacific Society of hypertension (APSH) & Diabetes Asia Study Group (DASG).","authors":"Anuj Maheshwari, Banshi Saboo, Boon Wee Teo, Ji-Guang Wang, Narsingh Verma, Amit Kumar Gupta, Apichard Sukonthasarn, Nadima Shegem, Bishwajit Bhowmik, Ashraf P Valappil, Antonia Anna Lukito, Abdul Basit, Sumerah Jabeen, Hae-Young Lee, Abdulla O Al Hamaq, Akira Nishiyama, Asher Fawwad, Jam Chin Tay, Deborah Ignacia D Ona, Eid Elsayed A, Yen-Hung Lin, Rohana Abdul Ghani, Mesbah Sayed Kamel Mohamed, Shubhashree Patil, Raghunath Dantu","doi":"10.1038/s41371-026-01150-9","DOIUrl":"https://doi.org/10.1038/s41371-026-01150-9","url":null,"abstract":"<p><p>Hypertension and diabetes commonly coexist, sharing mechanisms such as insulin resistance, obesity, and endothelial dysfunction, which together amplify cardiovascular, renal, and cerebrovascular risk. This dual burden is particularly pronounced in the Asia-Pacific region, where rapid demographic and lifestyle transitions have led to a surge in non-communicable diseases. The Asian-Pacific Society of Hypertension (APSH) and the Diabetes Asia Study Group (DASG) have jointly developed this consensus to provide region-specific, evidence-based recommendations for managing hypertension in individuals with diabetes. A multidisciplinary panel from 15 countries formulated these recommendations using a modified Delphi approach, incorporating evidence from randomized controlled trials, meta-analyses, and international and regional guidelines published between 2015 and 2025, graded according to the GRADE framework. The consensus underscores lifestyle modification as the cornerstone of therapy, emphasizing sodium restriction, weight control, regular physical activity, and avoidance of tobacco and alcohol. Pharmacologic management should be individualized, prioritizing renin-angiotensin-aldosterone system inhibitors, calcium channel blockers, and thiazide-like diuretics as first-line options, with single-pill combinations preferred for adherence. Emerging therapies such as sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, angiotensin receptor-neprilysin inhibitors, and mineralocorticoid receptor antagonists offer added cardio-renal protection and are recommended where appropriate. A target blood pressure of <130/80 mmHg is advised for most, with ≤140/90 mmHg for older or frail individuals. Home blood pressure monitoring is preferred for ongoing management. This consensus offers a practical, patient-centered framework to optimize cardiovascular and renal outcomes in people with diabetes and hypertension across the Asia-Pacific region.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving mortality trends in hypertension-associated ischemic heart disease among U.S. adults over two decades: a CDC wonder analysis (2000-2023).","authors":"Muhammad Hamza Dawood, Tahira Mukhtar, Jibran Ashraf, Faisal Ahmed, Muhammad Adeel Qamar, Rizwana Yasmin","doi":"10.1038/s41371-026-01154-5","DOIUrl":"https://doi.org/10.1038/s41371-026-01154-5","url":null,"abstract":"<p><p>This study aimed to evaluate national, demographic, and geographic trends in mortality associated with hypertension and ischemic heart disease (IHD) among U.S. adults from 1999 to 2023. Mortality data were extracted from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database. Adults aged ≥15 years with hypertension (ICD-10: I10-I15) listed as a contributing cause and IHD (ICD-10: I20-I25) as the underlying cause of death were included. Age-adjusted mortality rates (AAMRs) per 100,000 population and annual percent change (APC) were calculated using Joinpoint regression, stratified by year, sex, race/ethnicity, U.S. Census region, and urban-rural classification. Between 1999 and 2023, 3,575,793 hypertension-associated IHD deaths were recorded. The overall AAMR rose modestly through 2018 (APC = 0.4%; 95% CI, 0.1-0.6), sharply increased from 2018-2021 (APC = 10.3%; 95% CI, 7.7-11.9), and declined thereafter till 2023 (APC = -4.4%; 95% CI, -7.3 to -1.7). Men consistently exhibited nearly twice the mortality rate of women, and Black Americans experienced the highest AAMRs across racial/ethnic groups. Regionally, the South showed the greatest burden, while rural areas had approximately 20% higher mortality than metropolitan regions. Hypertension-associated IHD mortality in the U.S. demonstrates a U-shaped temporal pattern declining until the late 2010s, surging during the COVID-19 era, and only partially improving thereafter. Persistent disparities by sex, race, and geography underscore the urgent need for renewed, equitable prevention strategies targeting hypertension control and cardiovascular risk reduction nationwide.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From daily burden to scheduled protection: the “vaccine-like” shift in hypertension","authors":"Lucas Maciel de Almeida Corrêa,&nbsp;Gabriel Rian Mazur,&nbsp;Clara Belo Gamon Santiago,&nbsp;Alexandre de Assis Barbosa,&nbsp;Luiggi Kevin Virgino Brandão,&nbsp;Gabriel Costa de Santana,&nbsp;Letícia Esteves Dante","doi":"10.1038/s41371-026-01149-2","DOIUrl":"10.1038/s41371-026-01149-2","url":null,"abstract":"","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"40 5","pages":"417-420"},"PeriodicalIF":3.4,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41371-026-01149-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmasking primary aldosteronism after kidney transplantation: a case series","authors":"Mario Funes Hernandez,&nbsp;Colin Lenihan,&nbsp;Vivek Bhalla,&nbsp;Vivek Charu,&nbsp;Xingxing S. Cheng","doi":"10.1038/s41371-026-01153-6","DOIUrl":"10.1038/s41371-026-01153-6","url":null,"abstract":"Primary aldosteronism is characterized by excess aldosterone production leading to hypertension and hypokalemia. We report three cases of unilateral primary aldosteronism after kidney transplantation. Each patient presented with elevated blood pressure and hypokalemia early posttransplant. Diagnosis was established through elevated aldosterone-to-renin ratios and positive aldosterone suppression tests, and lateralization was determined with selective adrenal venous sampling. Ipsilateral adrenalectomy improved hypokalemia and blood pressure control for all. Notably, two patients with biopsy-confirmed glomerular pathology after kidney transplantation exhibited proteinuria reduction following adrenalectomy.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"40 5","pages":"413-416"},"PeriodicalIF":3.4,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthostatic hypotension without co-existent supine hypertension is associated with impaired cerebral oxygenation: findings from the Irish Longitudinal Study on Ageing (TILDA).","authors":"Louise Newman, John D O'Connor, Richard B Reilly, Rose Anne Kenny","doi":"10.1038/s41371-026-01125-w","DOIUrl":"https://doi.org/10.1038/s41371-026-01125-w","url":null,"abstract":"<p><p>Hypertension and orthostatic hypotension (OH) are common in older age, with both conditions recognized as risk factors for cardiovascular disease and end organ damage. Cerebral hypoperfusion is postulated to play a role in these adverse effects. For those with both hypertension and OH the effects on the cerebrovasculature are unclear, but there may be a risk of a higher hypotensive burden. We measured cerebral oxygenation utilizing near infrared spectroscopy, during an active stand challenge, and continuous blood pressure (BP), in The Irish Longitudinal Study on Ageing (TILDA) population. There was no difference in baseline oxygenation with supine hypertension (SH) or OH, but those with SH-OH had a higher supine BP, increased arterial stiffness and more cardiovascular conditions. Participants with SH-OH exhibited the largest BP drop and most impaired BP recovery on standing, yet the oxygenation response was not different to those with no SH and no OH. Those with OH only had the lowest BP values, lowest oxygenation values and most impaired oxygenation recovery, suggesting this group are at risk of cerebral hypotension when BP drops to low absolute values, whereas if BP is maintained at higher values as in those with SH-OH sufficient cerebral flow may be maintained.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure determinants of target organ damage among adults with white coat hypertension with a focus on nocturnal hypertension and blood pressure dipping.","authors":"Ionas Papasotiriou, Sotiria Spiliopoulou, Gerasimos Barlas, Damianos Dragonas, Konstantinos Rizogiannis, Efstathios Manios","doi":"10.1038/s41371-026-01152-7","DOIUrl":"https://doi.org/10.1038/s41371-026-01152-7","url":null,"abstract":"<p><p>White coat hypertension (WCH) is still a grey zone regarding its management by clinicians, while its link to target organ damage (TOD) is still understudied. The aim of this study was to explore the impact of non-dipping status and nocturnal hypertension on TOD in untreated WCH subjects. A cross-sectional study of 547 individuals with WCH was conducted at a single institution. Patients underwent a thorough clinical examination, including medical history, office BP measurements, echocardiography, carotid artery ultrasonography, serum creatinine level measurements, and ambulatory blood pressure monitoring. Left ventricular hypertrophy (LVH), intima-media thickness of the common carotid artery (IMT-CCA) and estimated Glomerular Filtration Rate (eGFR) were used as TOD indices. The patients were divided into dippers and non-dippers, as well as nocturnal hypertensives and normotensives. Among WCH patients, 49.9% were non-dippers and 33.6% had nocturnal hypertension. Dippers had a significantly lower risk of left ventricular hypertrophy (OR: 0.68, 95%CI: 0.48 - 0.97) and higher mean expected eGFR values (b = 7.03, 95%CI: 3.12 - 10.94) than non-dippers. For IMT-CCA, office systolic and diastolic BP were the only significant predictors (b = 0.02, 95%CI: 0.00 - 0.03 and b = -0.03, 95%CI: -0.05 - -0.01). Office systolic BP was also significantly associated with eGFR (b = -1.68, 95%CI: -2.84 - -0.52). The results of this study indicate that non-dipping status is a significant risk factor for LVH and renal function in WCH subjects. Therefore, nighttime BP patterns, especially non-dipping, should be examined in patients with WCH.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}