Journal of Human Hypertension最新文献

{"title":"Diagnosis and management of primary hyperaldosteronism in patients with hypertension: a practical approach endorsed by the British and Irish Hypertension Society","authors":"Luca Faconti, Spoorthy Kulkarni, Christian Delles, Vikas Kapil, Philip Lewis, Mark Glover, Thomas M. MacDonald, Ian B. Wilkinson","doi":"10.1038/s41371-023-00875-1","DOIUrl":"10.1038/s41371-023-00875-1","url":null,"abstract":"Alongside the lack of homogeneity among international guidelines and consensus documents on primary hyperaldosteronism, the National UK guidelines on hypertension do not provide extensive recommendations regarding the diagnosis and management of this condition. Local guidelines vary from area to area, and this is reflected in the current clinical practice in the UK. In an attempt to provide support to the clinicians involved in the screening of subjects with hypertension and clinical management of suspected cases of primary hyperaldosteronism the following document has been prepared on the behalf of the BIHS Guidelines and Information Service Standing Committee. Through remote video conferences, the authors of this document reviewed an initial draft which was then circulated among the BIHS Executive members for feedback. A survey among members of the BIHS was carried out in 2022 to assess screening strategies and clinical management of primary hyperaldosteronism in the different regions of the UK. Feedback and results of the survey were then discussed and incorporated in the final document which was approved by the panel after consensus was achieved considering critical review of existing literature and expert opinions. Grading of recommendations was not performed in light of the limited available data from properly designed randomized controlled trials.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-023-00875-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"107591461","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":"Improving the accuracy of blood pressure measuring devices in Australia: a modelled return on investment study","authors":"Zachary Desson, James E. Sharman, Andrew Searles, Aletta E. Schutte, Christian Delles, Michael Hecht Olsen, Pedro Ordunez, Alexis Hure, Rachael Morton, Gemma Figtree, Jacqui Webster, Garry Jennings, Julie Redfern, Stephen J. Nicholls, Martin McNamara, Simon Deeming, Kerry Doyle, Shanthi Ramanathan","doi":"10.1038/s41371-023-00866-2","DOIUrl":"10.1038/s41371-023-00866-2","url":null,"abstract":"The VALID BP project was initiated to increase the availability of validated blood pressure measuring devices (BPMDs). The goal is to eliminate non validated BPMDs and minimise over- and underdiagnosis of hypertension caused by inaccurate readings. This study was undertaken to assess the potential return on investment in the VALID BP project. The Framework to Assess the Impact of Translational Health Research was applied to the VALID BP project. This paper focuses on the implementation of the cost benefit analysis aspect of this framework to monetise past research investment and model future research costs, implementation costs, and benefits. Analysis was based on reasoned assumptions about potential impacts from availability and use of validated BPMDs (assuming an end goal of 100% validated BPMDs available in Australia by 2028) and improved skills leading to more accurate BP measurement. After 5 years, with 20% attribution of benefits, there is a potential $1.14–$1.30 return for every dollar spent if the proportion of validated BPMDs and staff trained in proper BP measurement technique increased from 20% to 60%. After eight years (2020–2028) and assuming universal validation and training coverage, the returns would be between $2.70 and $3.20 per dollar spent (not including cost of side effects of unnecessary medication or downstream patient impacts from unmanaged hypertension). This modelled economic analysis indicates there will be positive downstream economic benefits if the availability of validated BPMDs is increased. The findings support ongoing efforts toward a universal regulatory framework for BPMDs and can be considered within more detailed future economic analyses.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-023-00866-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482375","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":"High prevalence but lack of awareness of hypertension in South Africa, particularly among men and young adults.","authors":"Angela J Woodiwiss,&nbsp;Ane Orchard,&nbsp;Catharina M C Mels,&nbsp;Aletta S Uys,&nbsp;Benedicta N Nkeh-Chungag,&nbsp;Andrea Kolkenbeck-Ruh,&nbsp;Lisa J Ware,&nbsp;Samantha Yates,&nbsp;Erika S W Jones,&nbsp;Vernice R Peterson,&nbsp;Neil R Poulter","doi":"10.1038/s41371-023-00873-3","DOIUrl":"https://doi.org/10.1038/s41371-023-00873-3","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) is a leading cause of death in South Africa (SA) and high blood pressure (BP) is the primary risk factor. However, hypertension prevalence is high, BP control is poor and CV events occur at a younger age than in Europe or America. Increasing screening, raising awareness and improving management of hypertension are critical to prevent CVD in SA. May Measurement Month (MMM) is a global initiative of the International Society of Hypertension aimed at raising awareness of high BP. As part of the MMM campaign, in SA (2017, 2018, 2019 and 2021), BP measurements and a cross-sectional survey of volunteers aged ≥ 18years were performed. Of 11,320 individuals (age 36.6 ± 16.8years) screened, 29.7% had hypertension (systolic BP/diastolic BP ≥ 140/90 mmHg or antihypertensive medication use) and the prevalence was higher (p < 0.0001) in men (35.6%) than in women (26.3%). Of those with hypertension, only 54.3% were aware and 46.8% were receiving antihypertensive medication, and 53.7% of these had controlled BP. In men with hypertension, awareness (45.2%, treatment (38.2%) and controlled BP on antihypertensive medication (45.2%) were lower (p < 0.0001) than in women (awareness: 60.8%; treatment: 53.5%; controlled BP: 58.3%). In young participants (age < 40years), 15.6% had hypertension, 18.6% of these were on treatment but 76.0% were not aware, and only 57.7% had controlled BP. The high prevalence of hypertension, but low levels of awareness, treatment, and BP control in SA, especially in young adults and men, highlight the need for systematic BP screening programmes and improvements in education and management of hypertension.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50161861","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":"Knowledge and practices related to salt consumption in China: findings from a national representative cross-sectional survey","authors":"Wenrong Zhang,&nbsp;Dinesh Neupane,&nbsp;Zhenping Zhao,&nbsp;Bo Jiang,&nbsp;Mei Zhang,&nbsp;Xiao Zhang,&nbsp;Zhengjing Huang,&nbsp;Chun Li,&nbsp;James E. Sharman,&nbsp;Caihong Hu,&nbsp;Pengpeng Ye,&nbsp;Limin Wang","doi":"10.1038/s41371-023-00861-7","DOIUrl":"10.1038/s41371-023-00861-7","url":null,"abstract":"There is limited information on the knowledge and practice of salt-reduction in China. The purpose of this study was to describe the status of the knowledge and practice of salt-reduction among the Chinese population from a nationally representative survey stratified according to hypertension status. The association between hypertensive status and salt-reduction knowledge and practice was calculated using multivariate hierarchical logistic regression adjusting for related confounders. The study included 179,834 participants; 51.7% were women, and the mean age was 44 years. The levels of overall salt-reduction knowledge (7.9%) and practice (37.1%) were low. The percentage of the use of salt-control spoons and low-sodium salt was 10.7% and 12.2%. The aging population (≥60 years) had the lowest levels of salt-reduction knowledge (5.7%) than other age groups (P &lt; 0.0001). People living in rural areas (OR = 0.64; 95% CI: 0.51, 0.81) had lower odds of using salt-control spoons. Females (OR = 1.23; 95% CI: 1.10, 1.36) had higher odds of using salt-control spoons. People living in rural areas (OR = 0.48; 95% CI: 0.36, 0.63) had lower odds of using low-sodium salt. Females (OR = 1.26; 95% CI: 1.13, 1.41) and people living in the southern region (OR = 1.43; 95% CI: 1.11, 1.83) had higher odds of using low-sodium salt. Our work highlights the need to promote education related to hypertension, salt-reduction knowledge and methods among the public and the need to strengthen strategies for the popularization of salt-reduction knowledge and practices among males, people living in rural areas, people living in the northern region and the aging population in China.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-023-00861-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49678336","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":"A single session of aerobic exercise reduces systolic blood pressure at rest and in response to stress in women with rheumatoid arthritis and hypertension","authors":"Tatiane Almeida de Luna,&nbsp;Diego Augusto Nunes Rezende,&nbsp;Leandro Campos de Brito,&nbsp;Rafael Yokoyama Fecchio,&nbsp;Fernanda Rodrigues Lima,&nbsp;Ana Lúcia de Sá Pinto,&nbsp;Ana Cristina de Medeiros Ribeiro,&nbsp;Karina Rossi Bonfiglioli,&nbsp;Bruno Gualano,&nbsp;Hamilton Roschel,&nbsp;Tiago Peçanha","doi":"10.1038/s41371-023-00869-z","DOIUrl":"10.1038/s41371-023-00869-z","url":null,"abstract":"Rheumatoid arthritis (RA) is an autoimmune inflammatory disease characterized by increased risk of cardiovascular disease and hypertension (HT). A single session of aerobic exercise may reduce blood pressure (BP) in different clinical groups; however, little is known about the acute effects of exercise on BP in RA patients. This is a randomized controlled crossover study that assessed the effects of a single session of aerobic exercise on resting BP, on BP responses to stressful stimuli, and on 24-h BP in women with RA and HT. Twenty women with RA and HT (53 ± 10 years) undertook sessions of 30-min treadmill exercise (50% VO2max) or control (no exercise) in a crossover fashion. Before and after the sessions, BP was measured at rest, and in response to the Stroop-Color Word Test (SCWT), the Cold Pressor Test (CPT), and an isometric handgrip test. After the sessions, participants were also fitted with an ambulatory BP monitor for the assessment of 24-h BP. A single session of exercise reduced resting systolic BP (SBP) (−5 ± 9 mmHg; p &lt; 0.05), and reduced SBP response to the SCWT (−7 ± 14 mmHg; p &lt; 0.05), and to the CPT (−5 ± 11 mmHg; p &lt; 0.05). Exercise did not reduce resting diastolic BP (DBP), BP responses to the isometric handgrip test or 24-h BP. In conclusion, a single session of aerobic exercise reduced SBP at rest and in response to stressful stimuli in hypertensive women with RA. These results support the use of exercise as a strategy for controlling HT and, hence, reducing cardiovascular risk in women with RA. Clinical Trial Registration: This study registered at the Brazilian Clinical Trials ( https://ensaiosclinicos.gov.br/rg/RBR-867k9g ) at 12/13/2019.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-023-00869-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49678335","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":"High versus low measurement frequency during 24-h ambulatory blood pressure monitoring - a randomized crossover study","authors":"Martin B. Thomsen,&nbsp;Jakob Nyvad,&nbsp;Kent L. Christensen,&nbsp;Mark Reinhard,&nbsp;Niels Henrik Buus","doi":"10.1038/s41371-023-00868-0","DOIUrl":"10.1038/s41371-023-00868-0","url":null,"abstract":"Ambulatory blood pressure monitoring (ABPM) may be stressful and associated with discomfort, possibly influenced by the number of cuff inflations. We compared a low frequency (LF-ABPM) regimen with one cuff inflation per hour, with a high frequency (HF-ABPM) regimen performed according to current guidelines using three cuff-inflations per hour during daytime and two cuff-inflations during night time. In a crossover study, patients underwent ABPMs with both frequencies, in a randomized order, within an interval of a few days. Patients reported pain (visual analogue scale from 0 to 10) and sleep disturbances after each ABPM. The primary endpoint was the difference in mean 24 h systolic BP (SBP) between HF-ABPM and LF-ABPM. A total of 171 patients were randomized, and data from 131 (age 58 ± 14 years, 47% females, 24% normotensive, 53% mildly hypertensive, and 22% moderately-severely hypertensive) completing both ABPMs were included in the analysis. Mean SBP was 137.5 mmHg (95% CI, 134.8;140.2) for HF-ABPM and 138.2 mmHg (95%CI, 135.2;141.1) for LF-ABPM. The 95% limits of agreement were −15.3 mmHg and +14.0 mmHg. Mean 24 h SBP difference between HF-ABPM and LF-ABPM was −0.7 mmHg (95%CI, −2.0;0.6). Coefficients of variation were similar for LF-ABPM and HF-ABPM. Pain scores (median with interquartile range), for HF-ABPM and LF-ABPM were 1.5 (0.6;3.0) and 1.3 (0.6;2.9) during daytime, and 1.3 (0.4:3.4) and 0.9 (0.4;2.0) during nighttime (P &lt; 0.05 for both differences). We conclude that LF-ABPM and HF-ABPM values are in good agreement without any clinically relevant differences in BP. Furthermore, LF-ABPM causes a relatively modest reduction in procedure-related pain.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-023-00868-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41203276","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":"Exploration of patients’ practices related to home blood pressure monitoring","authors":"C. N. Behnke,&nbsp;C. B. Litvin","doi":"10.1038/s41371-023-00871-5","DOIUrl":"10.1038/s41371-023-00871-5","url":null,"abstract":"Despite guidelines and calls to action for home blood pressure monitoring (HBPM) from organizations including the American Heart Association, little is known about the extent to which patients are knowledgeable about how to conduct accurate HBPM. Our study highlights several gaps in knowledge that exist among patients who monitor blood pressure (BP) at home and highlights the need for better patient education to ensure accurate HBPM.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41203275","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":"Impaired artery elasticity predicts cardiovascular morbidity and mortality- A longitudinal study in the Vara-Skövde Cohort","authors":"Gábor Szaló,&nbsp;Margareta I. Hellgren,&nbsp;Matthew Allison,&nbsp;Ying Li,&nbsp;Lennart Råstam,&nbsp;Karin Rådholm,&nbsp;Entela Bollano,&nbsp;Daniel A. Duprez,&nbsp;David R. Jacobs Jr,&nbsp;Ulf Lindblad,&nbsp;Bledar Daka","doi":"10.1038/s41371-023-00867-1","DOIUrl":"10.1038/s41371-023-00867-1","url":null,"abstract":"It is still debated whether arterial elasticity provides prognostic information for cardiovascular risk beyond blood pressure measurements in a healthy population. To investigate the association between arterial elasticity obtained by radial artery pulse wave analysis and risk for cardiovascular diseases (CVD) in men and women. In 2002–2005, 2362 individuals (men=1186, 50.2%) not taking antihypertensive medication were included. C2 (small artery elasticity) was measured using the HDI/Pulse Wave CR2000. Data on acute myocardial infarction or stroke, fatal or non-fatal, was obtained between 2002–2019. Cox- regression was used to investigate associations between C2 and future CVD, adjusting for confounding factors such as age, sex, systolic blood pressure, heart rate, HOMA-IR (Homeostatic Model Assessment for Insulin Resistance), LDL- cholesterol, CRP (C-Reactive Protein), alcohol consumption, smoking and physical activity. At baseline, the mean age of 46 ± 10.6 years and over the follow-up period, we observed 108 events 70 events in men [event rate: 5.9%], 38 in women [event rate: 3.2%]. In the fully adjusted model, and for each quartile decrease in C2, there was a significant increase in the risk for incident CVD by 36%. (HR = 1.36, 95% CI: 1.01–1.82, p = 0.041). The results were accentuated for all men (HR = 1.74, 95% CI: 1.21–2.50, p = 0.003) and women over the age of 50 years (HR = 1.70, 95% CI: 0.69–4.20). We showed a strong and independent association between C2 and CVD in men. In women after menopause, similar tendencies and effect sizes were observed.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-023-00867-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41129830","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":"Prescribing the optimal dialysate sodium concentration for managing hypertension and volume overload in hemodialysis: one size does not fit to all patients","authors":"Christodoula Kourtidou,&nbsp;Panagiotis I. Georgianos,&nbsp;Vasilios Vaios,&nbsp;Vassilios Liakopoulos","doi":"10.1038/s41371-023-00870-6","DOIUrl":"10.1038/s41371-023-00870-6","url":null,"abstract":"","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41176444","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":"Maternal smoking during pregnancy links to childhood blood pressure through birth weight and body mass index: NHANES 1999–2018","authors":"Shengxu Li,&nbsp;Chao Cao,&nbsp;Dave Watson,&nbsp;Lin Yang,&nbsp;Elyse O. Kharbanda","doi":"10.1038/s41371-023-00865-3","DOIUrl":"10.1038/s41371-023-00865-3","url":null,"abstract":"Maternal smoking during pregnancy (MSDP) is associated with lower birth weight, childhood obesity, and elevated blood pressure (BP) in offspring. We aimed to examine whether birth weight and body mass index (BMI) mediate the effect of MSDP on BP in children. The study included 14,713 children aged 8 to 15 years from the National Health and Nutrition Examination Surveys from 1999 to 2018. General third-variable models were used to examine the mediating effects of birth weight and BMI on the association of MSDP with BP. A total of 1928 (13.1%) children were exposed to MSDP. MSDP was associated with reduced birth weight (p &lt; 0.001), increased BMI (p &lt; 0.001), and elevated systolic BP (p = 0.005). MSDP was not associated with systolic BP after adjustment for birth weight and BMI z-score (p = 0.875), with 95.0% of the effect of MSDP on BP mediated by birth weight (39.1%) and BMI (55.9%). In conclusion, lower birth weight and increased obesity measures mediate the adverse effects of MSDP on BP in children. These findings provide novel mechanistic insight into the adverse effect of MSDP on BP in children and have implications for preventing hypertension in later life.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41129831","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}