Journal of Human Hypertension最新文献

{"title":"Impact of moderate to vigorous physical activity on systemic vascular resistance in Danish adults with recently diagnosed type 2 diabetes: a cross-sectional study","authors":"Son Bao Nguyen, Thomas Bastholm Olesen, Sidsel Louise Domazet, Sofie Frigaard Kristoffersen, Jens Steen Nielsen, Michael Hecht Olsen, Jacob Volmer Stidsen","doi":"10.1038/s41371-025-01049-x","DOIUrl":"10.1038/s41371-025-01049-x","url":null,"abstract":"Strenuous physical activity alleviates the risk of elevated blood pressure (BP) presumably through a reduction in systemic vascular resistance (SVR). Using logistic multivariate regression models, we investigated whether moderate to vigorous physical activity (MVPA) was negatively associated with high SVR among adults with Type 2 Diabetes (T2DM). Additionally, we assessed associations between other cardiometabolic risk factors and SVR. SVR was assessed using thoracic electrical bioimpedance; high SVR was defined as ≥20% above normal. Time spent on MVPA was calculated using accelerometer data and age-specific cut points. In fasting blood samples, we measured plasma glucose and c-peptide and used the Homeostasis Model Assessment 2-Insulin Resistance (HOMA2-IR) to estimate Insulin resistance. Results are adjusted for age, sex, BP, body mass index (BMI), HOMA2-IR, medication, and smoking. We included 824 adults (mean age = 61.6 years) with recently diagnosed T2DM (interquartile range for diabetes duration = 4.9 years). 41% were females. Median MVPA was 10.7 min/day, and 50.5% had high SVR. Increments of 14.4 min/day in MVPA were independently associated with a lower risk of high SVR (OR = 0.69, [0.57;0.83]). Other risk determinants of high SVR were female sex (OR = 2.06, [1.49;2.86]), each increase in BMI of 6.16 kg/m2 (OR = 2.20, [1.76;2.73]), and HOMA2-IR of 1.79 (OR = 2.33, [1.09;4.96]). BMI had a notably greater impact on explained variability of SVR than MVPA when comparing the coefficient of determination (pseudo-R2, 35.0% vs. 7.9%). Although increased levels of MVPA are associated with a reduced risk of high SVR, BMI appears to have a more pronounced effect on SVR.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 10","pages":"701-708"},"PeriodicalIF":3.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799353","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":"Associations between cardiovascular health metrics in life’s essential 8 and incident hypertension: The LIFE Study","authors":"Kumi Sagara, Kenichi Goto, Megumi Maeda, Haruhisa Fukuda","doi":"10.1038/s41371-025-01059-9","DOIUrl":"10.1038/s41371-025-01059-9","url":null,"abstract":"The American Heart Association’s Life’s Essential 8 is a set of modifiable lifestyle habits and risk factors used to assess cardiovascular health (CVH). However, little is known about the potential impact of non-ideal statuses in these metrics on hypertension risk. This study aimed to clarify the associations between the total number of non-ideal CVH metrics and incident hypertension in a Japanese population. This retrospective cohort study was conducted using data from 10 Japanese municipalities participating in the LIFE Study. We identified National Health Insurance enrollees who had undergone health checkups between April 2017 and March 2018. Participants were categorized into 7 groups (0, 1, 2, 3, 4, 5, and 6–7 metrics) based on their total number of non-ideal CVH metrics (excluding blood pressure). The hazard ratio of each group (reference: 0 metrics) for new-onset hypertension was estimated using Cox proportional hazards models. During a mean follow-up period of 1405 days, 22 826 (24.5%) participants developed hypertension. Hypertension risk significantly increased with higher numbers of non-ideal CVH metrics (hazard ratios ranged from 1.067 for 1 metric to 1.609 for 6–7 metrics). Additionally, all non-ideal CVH metrics except for blood lipids were found to be significant predictors of hypertension. Higher numbers of non-ideal CVH metrics in Life’s Essential 8 were consistently associated with a higher incidence of hypertension. Multicomponent lifestyle modification strategies that improve overall CVH status may help to prevent hypertension.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 10","pages":"716-722"},"PeriodicalIF":3.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789318","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":"A systematic review and meta-analysis of digital interventions targeting lifestyle factors in patients with hypertension","authors":"Alexandra Lindsay-Perez, Rebecca Jurdon, Thomas King, Lydia Koffman, Nia Roberts, Richard J. McManus, David McCartney","doi":"10.1038/s41371-025-01051-3","DOIUrl":"10.1038/s41371-025-01051-3","url":null,"abstract":"Hypertension is a major risk factor for cardiovascular disease, for which the management involves both lifestyle modification (diet, exercise etc) and medication. Digital interventions (mobile applications, websites, and SMS messages) are being developed to facilitate lifestyle change, but their effectiveness remains uncertain. This review aimed to establish whether digital interventions targeting lifestyle factors are effective in reducing blood pressure in individuals with hypertension. A systematic search was run through MEDLINE, EMBASE and the Cochrane Library. 5302 records were screened for eligibility and data on the primary outcome (systolic blood pressure (SBP)) and secondary outcomes (diastolic blood pressure (DBP) and change in lifestyle factors) were extracted from eligible papers. Where sufficient data were available, meta-analysis was undertaken using a random effects model. 17 randomised controlled trials were eligible for inclusion (3040 patients). 12 studies were suitable for meta-analysis. Lifestyle change mediated by digital interventions were associated with a larger SBP reduction than controls (mean difference (MD) −2.91 mmHg; 95% confidence interval (CI) −4.11, −1.71; p value (p) <0.0001). A significant difference was also seen in DBP reduction between groups (MD −1.13 mmHg; CI −1.91, −0.35; p = 0.005). Reporting of other secondary outcomes relating to lifestyle change was too heterogenous for meta-analysis. Digital interventions targeting lifestyle factors were associated with an improvement in blood pressure in patients with hypertension, but interpretation of the results is limited by significant heterogeneity between studies. Further research is required to understand which lifestyle factors, when targeted with digital interventions, result in maximal blood pressure reduction.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 10","pages":"690-700"},"PeriodicalIF":3.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41371-025-01051-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789317","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":"Cerebrovascular reactivity impairment in resistant hypertension","authors":"G. Miceli, M. Velardo, A. Casuccio, M. Daidone, M. G. Basso, A. Tuttolomondo","doi":"10.1038/s41371-025-01058-w","DOIUrl":"10.1038/s41371-025-01058-w","url":null,"abstract":"Resistant hypertension (RH) is defined as office systolic blood pressure (BP) that remains uncontrolled despite the concurrent use of three or more antihypertensive drug classes and may be associated with altered vasomotor responses to physiological stimuli. However, the effect of RH on cerebrovascular reactivity (CVR) remains poorly understood. Furthermore, the potential contribution of autonomic nervous system dysfunction to these alterations has not yet been fully clarified. Understanding these mechanisms may offer insights into the pathophysiology of resistant hypertension and could have important prognostic implications. This study aims to analyze CVR in a cohort of patients with RH, compared with patients with non-resistant hypertension (NRH), taking into account the differences in sympathovagal balance between the two groups. Forty consecutive hypertension patients, 20 with NRH and 20 with RH, underwent heart rate variability analysis and transcranial color-coded Doppler at rest and during a breath-holding maneuver to evaluate CVR. Hypertensive individuals presented a significant reduction of the Breath Holding Index (BHI) and time-domain parameters (SDNN and SDANN) in comparison to the control group (BHI control 1.32 ± 0.41 vs hypertensive 0.92 ± 0.65; p = 0.018; SDANN control 125.76 ± 24.96 vs hypertensive 87.65 ± 20.63; p < 0.0001). RH patients presented a significant reduction in BHI (NRH BHI 1.15 ± 0.65 vs RH BHI 0.70 ± 0.58; p = 0.027) and HRV parameters (SDANN in NRH 95.09 ± 22.12 vs RH 80.21 ± 16.36; p = 0.021). Our results show that RH is associated with impaired HRV and CRV. Autonomic dysfunction could be a concurrent cause of cerebral vasomotor reactivity impairment.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 9","pages":"626-633"},"PeriodicalIF":3.4,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41371-025-01058-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768666","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":"Association between bullous pemphigoid and hypertension: a systematic review and meta-analysis of observational studies","authors":"XiaoLi Yang, XiaoRan Tao, PanLing Wei, Chen Xu, JinPing Gao, FuSheng Zhou, ZaiXing Wang","doi":"10.1038/s41371-025-01056-y","DOIUrl":"10.1038/s41371-025-01056-y","url":null,"abstract":"Studies have indicated a relationship between bullous pemphigoid (BP) and hypertension, but the findings remain controversial. To examine this association, we conducted a systematic review using studies from PubMed, EMBASE, Web of Science, and the Cochrane Library, applying a random-effects model while performing subgroup and sensitivity analyses to explore potential sources of heterogeneity. Subgroup analyses were performed by country, data source, and sample size. The quality of evidence was evaluated using the Newcastle-Ottawa Scale. The review protocol was registered in PROSPERO (ID: CRD42024573911). The analysis included 20 studies, primarily consisting of case-control studies from Europe and Asia, encompassing 72,981,822 participants, of whom 29,199 had BP. The mean ages of the BP group and the non-BP group were 74.62 and 74.25 years, respectively. Random-effects meta-analysis demonstrated a significant association between BP and hypertension (odds ratio [OR] = 1.13, 95% confidence interval [CI]: 1.07–1.20). Subgroup analyses revealed stronger associations in database studies (OR = 1.24, 95% CI: 1.17–1.31) and in studies with over 1000 BP cases (OR = 1.30, 95% CI: 1.23–1.37). No significant association was observed in studies conducted in Asia (OR = 1.05) or Europe (OR = 1.07). However, a significant relationship was found in studies from the United States (OR = 1.29, 95% CI: 1.12–1.48). This study found a significant correlation between BP and hypertension, particularly in the United States. However, as most included studies were observational in nature, causality cannot be inferred. Further research is needed to elucidate the underlying mechanisms and causal relationship between BP and hypertension.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 9","pages":"666-674"},"PeriodicalIF":3.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742273","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":"Vagal dysfuction in resistant hypertension: no longer the “cinderella” of the autonomic cardiovascular profile","authors":"Guido Grassi","doi":"10.1038/s41371-025-01053-1","DOIUrl":"10.1038/s41371-025-01053-1","url":null,"abstract":"","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 7","pages":"465-466"},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717956","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":"Exploration of potential therapeutic target genes for preeclampsia through genetic analysis","authors":"Huihui Wang, Meihong Shen, Guangtong She, Huiyan Wang, Wenbo Zhou","doi":"10.1038/s41371-025-01054-0","DOIUrl":"10.1038/s41371-025-01054-0","url":null,"abstract":"Preeclampsia (PE) is a prevalent and severe pregnancy-related complication, for which effective intervention targets remain limited, posing significant risks to maternal and fetal health. This study aimed to identify potential therapeutic target genes through genetic analyses. Specifically, we utilized cis-expression quantitative trait loci (cis-eQTL) of druggable genes derived from blood samples obtained from the eQTLGen consortium as exposure data. Subsequently, Mendelian randomization (MR) analysis was conducted to explore causal associations between these druggable genes and PE. Functional enrichment analysis, Summary-data-based MR (SMR), and colocalization analysis were employed to validate the identified genes. MR results revealed 17 druggable genes significantly associated with PE after multiple testing correction (FDR < 0.05). Functional enrichment analysis indicated that these genes are involved in key biological processes such as leukocyte proliferation and activation, immune response regulation, and the metabolism of water-soluble vitamins. Additionally, they were found to participate in several critical signaling pathways, including the complement and coagulation cascades, the renin-angiotensin system, and folate biosynthesis. SMR and colocalization analyses further confirmed the causal relationships between PE and five genes—TESK2, LNPEP, CD320, NELL2, and SF3B3. Moreover, single-cell RNA sequencing data supported the association between the expression levels of TESK2, CD320, and SF3B3 and the development of PE. This study provides preliminary evidence identifying several potential genetic targets that may help reduce the risk of PE from a genomic perspective. These findings offer novel scientific insights and research directions for future drug development and the optimization of therapeutic strategies aimed at managing and preventing PE.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 9","pages":"643-651"},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717955","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":"Call to action: British and Irish hypertension society position statement on blood pressure treatment thresholds and targets","authors":"Luca Faconti, Nayanatara Tantirige, Neil R. Poulter, Jacob George, Vikas Kapil, Ajay Gupta, Pauline A. Swift, Anthony Heagerty, Eduard Shantsila, Sarah Partridge, Ian B. Wilkinson","doi":"10.1038/s41371-025-01055-z","DOIUrl":"10.1038/s41371-025-01055-z","url":null,"abstract":"In this position statement the British and Irish Hypertension Society (BIHS) present a review of the current evidence for blood pressure (BP) treatment thresholds and targets. The BIHS recommend initiating pharmacological antihypertensive therapy, irrespective of cardiovascular disease risk, following a confirmed diagnosis of hypertension (sustained out-of-office BP ≥ 135/85 mmHg despite diet and lifestyle advice). The BIHS recommend an on-treatment BP target < 130/80 mmHg or as low as reasonably achievable without causing unacceptable side-effects, within 6-months of initiating treatment, for all adults. Possible subgroups to whom this may not apply are those who are frail and/or have limited life expectancy where higher targets may be appropriate based on clinical judgement and the individuals’ tolerance to treatment. The BIHS believe that this simple 2-step approach will facilitate practitioners deliver evidence-based best practice, discourage therapeutic inertia around BP lowering and improve heath outcomes for all adults living with high BP.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 8","pages":"537-540"},"PeriodicalIF":3.4,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41371-025-01055-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698789","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":"Beyond lipid levels: unraveling the hypertensive factor in familial hypercholesterolemia. The HELLAS-FH registry","authors":"Christina Antza, Christos V. Rizos, Vasileios Kotsis, George Liamis, Ioannis Skoumas, Loukianos Rallidis, Anastasia Garoufi, George Sfikas, Genovefa Kolovou, Athanasios Penopoulos, Emmanouil Skalidis, Kimon Stamatelopoulos, Michalis Doumas, Vaia Lambadiari, Panagiotis Anagnostis, Evgenia Mavrokefalou, Amalia Boufidou, Vasiliki Giannakopoulou, Georgia Anastasiou, Ermioni Petkou, Charalambos Vlachopoulos, Ioanna Dima, Georgios Fakas, Konstantinos A. Papathanasiou, Achilleas Attilakos, Charalambos Koumaras, Vana Kolovou, Dimitrios Agapakis, Evangelos Zacharis, Chrysoula Moustou, Niki Katsiki, Aikaterini Kountouri, Eleni Mpellou, Elisavet Prodromiadou, Evangelos Liberopoulos","doi":"10.1038/s41371-025-01052-2","DOIUrl":"10.1038/s41371-025-01052-2","url":null,"abstract":"Arterial hypertension (AH) and familial hypercholesterolemia (FH) are major risk factors for atherosclerotic cardiovascular disease (ASCVD). The extent to which the coexistence of AH and FH amplifies the ASCVD risk is not well known. We aimed to explore the effect of AH on the prevalence of ASCVD in patients with FH. This was a cross-sectional analysis from the HELLAS-FH registry. A total of 2367 adults with heterozygous FH were studied. Out of these, 602 (25.4%) patients had AH. Patients with AH were more likely to have additional ASCVD risk factors (diabetes, smoking, obesity, elevated triglycerides and reduced high-density lipoprotein cholesterol levels) compared with patients without AH. Patients with AH had significantly higher prevalence of established coronary artery disease (CAD) (44 vs 14%, p < 0.001), premature CAD (39 vs 13%, p < 0.001), stroke (6 vs 2%, p < 0.001), and peripheral artery disease (6 vs 1%, p < 0.001) compared with those without after adjustment for major ASCVD risk factors. Systolic blood pressure (SBP) was significantly associated with increased odds of established CAD per 1 mmHg [odds ratio (OR) 1.075; 95% CI 1.001–1.153; p = 0.048], stroke (OR 1.023; 95% CI 1.004–1.042; p = 0.019) and PAD (OR 1.022; 95% CI 1.002–1.041; p = 0.028), while diastolic blood pressure showed no significant association with these outcomes. In conclusion, AH is associated with higher ASCVD risk factor burden and increased prevalence of ASCVD in patients with FH.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 9","pages":"619-625"},"PeriodicalIF":3.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41371-025-01052-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682723","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":"Independent and joint associations of hypertension and depression with cardiovascular diseases and all-cause mortality: a population-based cohort study","authors":"Qiang Tu, Shuanglan Lin, Nashid Hafiz, Karice Hyun, Deborah Manandi, Emma Zhao, Haisheng Wu, Yangxi Huang, Shuzhen Ma, Zhengqiu Zhang, Jiazhen Zheng, Julie Redfern","doi":"10.1038/s41371-025-01045-1","DOIUrl":"10.1038/s41371-025-01045-1","url":null,"abstract":"Hypertension frequently co-exists with depression, leading to adverse health outcomes. This study aimed to examine the individual and joint effects of hypertension and depression on the risks of new-onset cardiovascular disease (CVD) and all-cause mortality among the middle-aged and older Chinese individuals. Data from the China Health and Retirement Longitudinal Study (CHARLS) during 2011–2020 were used. Participants were divided into four groups for comparison: hypertension alone, depression alone, both conditions, neither condition. Multivariate logistic regression models were established to compare the risks of all-cause mortality and CVD among the four groups. A total of 9178 participants without pre-existing CVD were included and followed for nine years. Compared with individuals with neither condition, the risk of all-cause mortality increased among individuals with hypertension alone (adjusted odds ratio [aOR]: 1.414, 95% confidence interval [CI]: 1.133–1.764), depression alone (aOR: 1.023, 95% CI: 0.795–1.317) and comorbid hypertension and depression (aOR: 1.524, 95% CI: 1.180–1.968). The aORs for CVD events in individuals with both conditions, hypertension alone, and depression only were 2.207 (95% CI: 1.885–2.584), 1.945 (95% CI: 1.702–2.222) and 1.572 (95% CI: 1.365–1.809), respectively. Furthermore, those with severe depressive symptoms were at higher risks of all-cause mortality and CVD, regardless of having hypertension. Hypertension with comorbid depression leads to higher risks of CVD and all-cause mortality than either condition alone. Screening and management of depression among individuals with hypertension are essential for the primary prevention of CVD and premature death.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 9","pages":"634-642"},"PeriodicalIF":3.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41371-025-01045-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659395","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}