The Lancet最新文献

{"title":"Semaglutide, weight loss, and cardiovascular outcomes in the SELECT trial.","authors":"Justin Tondt,Vernon M Chinchilli","doi":"10.1016/s0140-6736(26)00256-4","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00256-4","url":null,"abstract":"","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"150 1","pages":"1601"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular benefit of blood-pressure lowering in chronic kidney disease.","authors":"Yingxian Sun,Xiaofan Guo","doi":"10.1016/s0140-6736(26)00553-2","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00553-2","url":null,"abstract":"","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"1 1","pages":"1578-1580"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semaglutide, weight loss, and cardiovascular outcomes in the SELECT trial.","authors":"Sridhar Mangalesh,Panagiotis Theodoropoulos,Kuan-Yu Chi,Michael G Nanna","doi":"10.1016/s0140-6736(26)00255-2","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00255-2","url":null,"abstract":"","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"426 1","pages":"1601"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-coeliac gluten sensitivity: rethinking challenge studies - Author's reply.","authors":"Jessica R Biesiekierski","doi":"10.1016/s0140-6736(26)00591-x","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00591-x","url":null,"abstract":"","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"4 1","pages":"1598-1599"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological blood-pressure lowering for the prevention of cardiovascular disease and death across the full spectrum of chronic kidney disease severity: an individual-participant data meta-analysis.","authors":"Guyu Zeng,Zeinab Bidel,Qianqian Yang,Dexter Canoy,Mark Woodward,Julia Lewis,Sverre E Kjeldsen,William C Cushman,Jinqing Yuan,Koon Teo,Barry R Davis,John Chalmers,Carl J Pepine,Kazem Rahimi,Milad Nazarzadeh, ","doi":"10.1016/s0140-6736(26)00367-3","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00367-3","url":null,"abstract":"BACKGROUNDIndividuals with chronic kidney disease (CKD), particularly those at more advanced stages, have been systematically under-represented in randomised controlled trials (RCTs) of blood-pressure-lowering treatment due to safety concerns, leading to a persistent paucity of evidence for cardiovascular risk management in this high-risk group. We investigated the effect of blood-pressure-lowering treatment on the risk of major cardiovascular disease and death across the full spectrum of CKD stages and by key clinical subgroups.METHODSWe conducted a one-stage meta-analysis of individual-participant data from RCTs in which participants were randomly assigned to a blood-pressure-lowering therapy versus a comparator. We used RCTs collated in the Blood Pressure Lowering Treatment Trialists' Collaboration dataset, published at any time in any language, which were eligible for inclusion if they had at least 1000 person-years of follow-up per arm, baseline blood-pressure and creatinine measurements, and time-to-event outcomes; those with unclear randomisation procedures or restricted to heart failure or acute care settings were excluded. Participants with a documented history of heart failure or extreme creatinine values were excluded. No age criteria were applied. The primary outcome was major cardiovascular events, defined as a composite of fatal or non-fatal stroke, ischaemic heart disease, or hospitalisation for, or death from, heart failure. Relative treatment effects were estimated with a stratified Cox proportional hazards model. Heterogeneity of treatment effects was evaluated across prespecified subgroups defined by CKD status, CKD stage (1-5), diabetes, proteinuria, and baseline blood pressure. A stratified network meta-analysis was performed to examine whether treatment effects differed by defined subgroups within each of five principal antihypertensive drug classes. The systematic review was registered in PROSPERO (CRD42018099283).FINDINGSFrom 52 RCTs (363 684 participants), a total of 285 124 participants from 46 randomised trials met the eligibility criteria; 116 145 (40·7%) were women, 168 979 (59·3%) were men, 59 185 (20·7%) had CKD at baseline, and 86 067 (30·2%) had type 2 diabetes. During a median follow-up of 4·4 years (IQR 3·2-5·1), a 5 mm Hg reduction in systolic blood pressure reduced the risk of major cardiovascular disease in individuals with CKD (hazard ratio [HR] 0·91 [95% CI 0·87-0·94]) and without CKD (0·90 [0·88-0·93]; pinteraction>0·99). Furthermore, these observed relative risk reductions were consistent across all CKD stages, including severe stages 4-5 (pinteraction>0·99). Similar treatment effects were observed by proteinuria status and across blood-pressure categories, down to <120/70 mm Hg. However, the relative treatment effect in individuals with CKD was notably attenuated among those with coexisting diabetes (HR 0·96 [95% CI 0·90-1·02]) compared with those without (0·88 [0·84-0·93]; pinteraction=0·044). The strat","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"1 1","pages":"1626-1638"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiological governance and the Lancet Commission on Ukraine.","authors":"Guido Granata,Clive Kilgallen,Nicola Petrosillo","doi":"10.1016/s0140-6736(26)00259-x","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00259-x","url":null,"abstract":"","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"33 1","pages":"1597"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Off-target benefits of influenza vaccination in cardiovascular disease - Authors' reply.","authors":"Xin Du,Craig S Anderson","doi":"10.1016/s0140-6736(26)00705-1","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00705-1","url":null,"abstract":"","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"46 1","pages":"1600"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How does it feel to live with kidney disease?","authors":"Roland Bleiker,Zoltan Endre,Sophie Harman","doi":"10.1016/s0140-6736(26)00764-6","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00764-6","url":null,"abstract":"","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"26 1","pages":"1592-1593"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiological governance and the Lancet Commission on Ukraine - Authors' reply.","authors":"Adrianna Murphy,Nataliia Riabtseva,Pavlo Kovtoniuk,Erica Richardson","doi":"10.1016/s0140-6736(26)00640-9","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00640-9","url":null,"abstract":"","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"11 1","pages":"1597-1598"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-coeliac gluten sensitivity: rethinking challenge studies.","authors":"Armin Alaedini,Jimin Yang,Benjamin Lebwohl,Peter H Green","doi":"10.1016/s0140-6736(26)00260-6","DOIUrl":"https://doi.org/10.1016/s0140-6736(26)00260-6","url":null,"abstract":"","PeriodicalId":22898,"journal":{"name":"The Lancet","volume":"23 1","pages":"1598"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147751327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}