Journal of Clinical Hypertension最新文献

{"title":"Hypertension Exacerbates Endothelial Dysfunction in Patients With Atrial Fibrillation","authors":"Samuel Thomas,&nbsp;Fiona L. Wilkinson,&nbsp;Amy R. Bland,&nbsp;Gregory Y. H. Lip,&nbsp;James P. Fisher,&nbsp;Rehan T. Junejo","doi":"10.1111/jch.70028","DOIUrl":"https://doi.org/10.1111/jch.70028","url":null,"abstract":"<p>Atrial fibrillation (AF) and hypertension (HT) often coincide and both are independently associated with endothelial dysfunction. We tested the hypothesis that brachial artery flow-mediated dilation (FMD), an indicator of endothelial health, will be poorer in AF patients with HT (AF + HT) than AF without concurrent HT. In a cross-sectional design study, AF (<i>n</i> = 29; mean 70 years; 9 females) and AF + HT (<i>n</i> = 33; 68 years (<i>p </i>= 0.302); 14 females) patients underwent Duplex-Doppler ultrasound imaging of brachial artery diameter and flow velocity during baseline (2 min), distal tourniquet cuff inflation (5 min), and following cuff deflation (3 min). The peak increase in artery diameter following cuff deflation was taken as FMD and analyzed as absolute, percentage change, FMD and shear-rate area-under-the-curve (SR_AUC; FMD-to-SR_AUC) ratio, and using SR_AUC as a covariate (FMD_SRAUC). Body mass index (BMI) was used as an additional covariate for between-group comparisons of vascular data. Mean arterial pressure was higher in the AF + HT versus the AF group (median [interquartile range] 93 [85–99] vs. 84 [80–90] mm Hg, respectively; <i>p </i>&lt; 0.05). Baseline brachial artery diameters were similar (<i>p </i>&gt; 0.05). FMD was lower in AF + HT than AF patients (3.36 [1.69–5.21] vs. 4.98 [2.96–7.11] %, respectively; <i>p </i>&lt; 0.05). Similar group differences were observed in absolute FMD, FMD-to-SR_AUC ratio and FMD_SRAUC (<i>p</i> &lt; 0.05). AF patients with concurrent HT exhibit poorer endothelium-dependent vasodilation compared to AF patients, indicating that the presence of comorbid HT exacerbates endothelial dysfunction in AF patients.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Policosanol (Sugarcane Wax Alcohols) 20 mg/Day in Cuban Prehypertensive Patients: A Randomized, Double-Blind, Multicentre Study","authors":"Moura Revueltas,&nbsp;Amarilys Jimenez Chiquet,&nbsp;Yamile Valdes,&nbsp;Julio C. Fernández,&nbsp;Yenney Reyes,&nbsp;Yanay Fernández,&nbsp;Evelyn González,&nbsp;Sarahi Mendoza,&nbsp;Yohani Pérez,&nbsp;Manuel Delfin Pérez,&nbsp;Deisy Navarro,&nbsp;Yolanda Cruz,&nbsp;Meilis Mesa,&nbsp;Gladys Jiménez,&nbsp;Carlos Sánchez,&nbsp;the Family's Doctors of the polyclinical centres of Plaza Municipality","doi":"10.1111/jch.14948","DOIUrl":"https://doi.org/10.1111/jch.14948","url":null,"abstract":"<p>Hypertension is the most common modifiable cardiovascular risk factor. Policosanol exhibits lipid-modifying and beneficial vascular pleiotropic effects. Some previous Cuban trials found that policosanol lowered blood pressure in hypercholesterolemic patients. Similar results were found recently in prehypertensive Asian subjects. The aim of this study was to report the effects of 20 mg/day of policosanol on blood pressure in Cuban patients with prehypertension. A double-blind multicenter trial randomized 400 eligible patients into two strata of 200 patients each (prehypertension and Grade 1 hypertension), treated with placebo or 20 mg/day of policosanol (100 patients/group/stratum) for 12 weeks. The primary outcome was to determine whether policosanol could achieve significant systolic blood pressure (SBP) reductions ≥10 mmHg versus placebo. Changes in diastolic blood pressure (DBP) and lipid profile were secondary outcomes. Safety indicators and adverse events (AE) were assessed. Statistical analyses were conducted by intention-to-treat (ITT). Here we report the results of the prehypertension stratum (SBP 120–139 mmHg, DBP 80–89 mmHg). Both groups were similar at randomization. At study completion, policosanol significantly lowered (<i>p</i> &lt; 0.001) SBP and DBP values versus baseline and placebo. Also, more (<i>p</i> &lt; 0.0001) policosanol patients (44%) reached SBP reductions ≥10 mmHg and DBP reductions ≥5 mmHg versus baseline (44% and 61%, respectively) than placebo patients (7% and 22%, respectively). Policosanol significantly lowered low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) and increased low-density lipoprotein cholesterol (HDL-C). Policosanol was well tolerated. Nine patients (4.5%) discontinued the trial, none because of AE. Four patients (3 placebo, 1 policosanol) reported AE. It is concluded that policosanol 20 mg/day given for 12 weeks to Cuban patients with prehypertension lowered SBP and DBP and produced beneficial changes in the lipid profile, being well tolerated.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14948","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher Food and Lifestyle Oxidative Balance Scores Decreases the Risk of Hypertension in Chinese Adults: A Population-Based Cross-Sectional Study","authors":"Wenxin Qiu,&nbsp;Ying Han,&nbsp;Jingru Huang,&nbsp;Danjing Chen,&nbsp;Jiangwang Fang,&nbsp;Huajing Chang,&nbsp;Xian-e Peng","doi":"10.1111/jch.70042","DOIUrl":"https://doi.org/10.1111/jch.70042","url":null,"abstract":"<p>Oxidative stress plays an important role in the development of hypertension (HTN). A population-based cross-sectional study was conducted in Fujian province of China. The construction of FoodL-OBS relied on diet and lifestyle components, which included four food and six lifestyle factors. Multivariable-adjusted logistic regression was performed to investigate the association between FoodL-OBS and the risk of HTN. A subgroup analysis was also conducted. Restricted cubic spline (RCS) regression was used to elucidate the dose-response relationship between FoodL-OBS and the risk of HTN. A total of 9578 participants were included, 3271 of whom suffered from HTN. The results of multivariable logistic regression analysis showed that the HTN risk decreased by 14% for each FoodL-OBS unit added [OR: 0.86 (0.84, 0.88), <i>p</i> &lt; 0.01]. Compared with participants with the lowest levels of Food-L-OBS, those with the highest quartile were less likely to have HTN [0.43 (0.37, 0.50)]. Further stratified analysis showed that Food-L-OBS was negatively associated with the risk of HTN, which was statistically significant in participants in subgroups of ≤60 years, female, and no-dyslipidemia. The results of RCS showed a linear negative correlation between Food-L-OBS and HTN in men, but not in women. In conclusion, FoodL-OBS was negatively associated with HTN, and a healthy lifestyle and antioxidant-rich diet may be useful for preventing HTN.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrolyte Levels in Poor Prognosis and Early Neurological Deterioration in Patients With Acute Ischemic Stroke","authors":"Shengli Pan,&nbsp;Bohuai Yu,&nbsp;Yilin Chen,&nbsp;Yufan Gao,&nbsp;Wei Xie,&nbsp;Yining Jin,&nbsp;Guoliang Zhou,&nbsp;Jialing Lou,&nbsp;Rui Zhang,&nbsp;Chao Chen,&nbsp;Yiyun Weng,&nbsp;Guangyong Chen","doi":"10.1111/jch.70037","DOIUrl":"https://doi.org/10.1111/jch.70037","url":null,"abstract":"<p>Discrepancies in serum electrolyte levels have been observed between stroke patients and healthy individuals. Previous studies have indicated an association between electrolytes and all-cause mortality as well as cardiovascular events in stroke patients. However, there still lacks comprehensive analysis on the connection between electrolytes and negative outcomes in hypertensive individuals with early neurological deterioration (END). Totally 1341 patients treated with thrombolysis for acute ischemic stroke at the First Affiliated Hospital of Wenzhou Medical University were included. Outcomes included END, 3-month, 6-month, and 1-year poor prognosis. Logistic regression assessed the correlation and restricted cubic spline analysis examined dose-response relationships. Subgroup analysis validated the relationship between electrolytes and prognosis in hypertensive patients. A total of 242 patients exhibited a 3-month poor prognosis. Significant differences were observed in Cl⁻, Ca²⁺, and Mg²⁺ levels between mRS binary classification. Logistic regression identified Cl⁻ as the strongest predictor for 3-month, 6-month, and 1-year mRS score and Ca²⁺ for END. Restricted cubic spline analysis revealed relationships between higher concentrations of Na⁺ and poorer prognosis. In the hypertension subgroup, a higher concentration of Na⁺ indicated worse 6-month and 1-year outcomes and a lower concentration of Ca²⁺ was linked to a higher risk of END. The concentration of Na⁺ is related to adverse clinical outcomes, while that of Cl⁻ and Ca²⁺ are associated with END. Among hypertensive patients, elevated levels of Na⁺ and Ca2⁺ concentration are respectively associated with 6-month poor prognosis and END. Monitoring the electrolytes may promote the early identification of individuals at high risk of poor functional outcomes.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurse-Managed Hypertension Care in Primary Health Care Centers in Region Stockholm and Its Association With Blood Pressure Control and Key Indicators for Contractual Follow-Up","authors":"Charlotte Ivarsson,&nbsp;Per Wändell,&nbsp;Monica Bergqvist,&nbsp;Anders Norrman,&nbsp;Julia Eriksson,&nbsp;Jan Hasselström,&nbsp;Sebastian Lindblom,&nbsp;Christina Sandlund,&nbsp;Axel C. Carlsson","doi":"10.1111/jch.70041","DOIUrl":"https://doi.org/10.1111/jch.70041","url":null,"abstract":"<p>The study aimed to investigate if primary health care centers (PHCCs) offering nurse-managed hypertensive care differ from PHCCs with other types of hypertension care regarding blood pressure levels and other key indicators. In this cross-sectional study of the hypertension care given in PHCCs in Stockholm County (now called Region Stockholm), we included all 227 PHCCs in the region. To assess the extent of nurses' involvement in the PHCCs hypertension care, a questionnaire was distributed to all PHCCs in Region Stockholm. Data on blood pressure levels was collected from a primary health care quality system (Primary Care Quality). Data on key indicators regarding follow-up was obtained from the Region Stockholm database on follow-up (LUD). Blood pressure levels and LUD-data were then analyzed with regards to whether the PHCC had nurse-managed hypertension care or not. Our analysis comprised 119 267 patients diagnosed with hypertension registered in any of the regions 227 PHCCs. Of the 81 PHCCs that responded to the questionnaire, 55 reported having nurse-managed hypertension care, and 26 were classified as having non-nurse managed hypertension care, while 146 were classified as unknown type of hypertension care. There were no differences in patients reaching desired blood pressure levels between nurse-managed and non–nurse-managed hypertension care. Nurse-led hypertension care units were on par with the other types of PHCCs. Thus, nurse-led hypertension care seems to be as safe and effective as other types of hypertension care in PHCCs.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulse Wave Velocity Assessment: A Useful Tool to Screen Asymptomatic Individuals at High Cardiovascular Risk?","authors":"Giacomo Pucci,&nbsp;Riccardo Alcidi,&nbsp;Guido Grassi","doi":"10.1111/jch.70040","DOIUrl":"https://doi.org/10.1111/jch.70040","url":null,"abstract":"&lt;p&gt;The global burden of cardiovascular (CV) disease is very high worldwide, and it is expected to increase further due to the aging of the population. The estimated expected 20.5 million deaths in 2025 are projected to increase to 35.6 million by 2050 [&lt;span&gt;1&lt;/span&gt;]. These alarming data necessitate urgent action to tackle such rising burden. Strengthening actions of screening, early detection and prevention of individuals at high CV risk at the global level is crucial. Healthcare systems, particularly in countries with high rates of CV deaths from atherosclerotic disease and relatively low financial resources, should implement effective and targeted interventions to address this growing challenge.&lt;/p&gt;&lt;p&gt;The atherosclerotic process, like its risk factors—including hyperglycemia, dyslipidemia, and hypertension—often progresses asymptomatically. This makes risk stratification for CV disease particularly challenging among general population and supports the need of developing screening strategies using simple, reliable, and cost-effective methods. Simple tools to perform CV risk stratification at the individual level include blood pressure (BP) measurement and blood tests for serum glucose and cholesterol. Automated BP monitors offer a simple and relatively inexpensive option for mass screening. In contrast, blood tests require additional costs, specialized personnel, and dedicated facilities, making them more suitable for selective screening of individuals after an initial selection.&lt;/p&gt;&lt;p&gt;Some novel BP monitors, such as the Tel-o-Graph, integrate brachial BP measurement with pressure waveform detection [&lt;span&gt;2&lt;/span&gt;]. The subsequent analysis of the brachial waveform profile using proprietary algorithms enables the non-invasive measurement of pulse wave velocity (PWV), a measure of arterial stiffness. This parameter is a recognized marker of vascular aging, reflecting the progressive decline in arterial elasticity which may be accelerated by the cumulative CV risk factors and other determinants. Automated oscillometric cuff-based PWV measurement could therefore be promising to identify individuals at high CV risk where asymptomatic CV risk factors have already cumulatively accelerated arterial degeneration [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The results of the study presented by Celenk et al. in the current issue of the Journal [&lt;span&gt;4&lt;/span&gt;] provide seminal evidence in support of the hypothesis that automated PWV assessment could be useful as a screening tool to identify individuals at high CV risk. The authors analyzed the characteristics of a selected population of 209 participants from a cohort of subjects aged 40–69 years who attended a Family medicine clinic in Turkey. These clinics usually serve as primary points of contact for medical care, offering comprehensive primary healthcare services for individuals and families.&lt;/p&gt;&lt;p&gt;All participants underwent the assessment of their 10-year absolute risk of fatal and non-fatal CV events using both the Fr","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of Arterial Stiffness as an Integrated Marker of Cardiovascular Risk","authors":"Grethzel Prado,&nbsp;María J. Forner,&nbsp;Oscar Calaforra,&nbsp;Sara Vela,&nbsp;Carlos Bea,&nbsp;Gernot Pichler,&nbsp;Ana de Gracia,&nbsp;Lucas Serna,&nbsp;Enrique Rodilla,&nbsp;Josep Redon,&nbsp;Fernando Martínez-García","doi":"10.1111/jch.70038","DOIUrl":"https://doi.org/10.1111/jch.70038","url":null,"abstract":"<p>We analyzed the usefulness of the carotid-femoral pulse wave velocity (cfPWV) as an integrated marker for hypertension (HTN)-mediated organ damage (HMOD) and cardiovascular (CV) risk in a cohort with repeated measurements. A total of 1031 patients, 80% of whom had HTN, underwent cfPWV determinations by SphygmoCor. An HMOD score was developed, including microalbuminuria, left ventricular hypertrophy (LVH), intima-media thickness (IMT), and carotid plaques. CV complications included atrial fibrillation (AF), heart failure (HF), stroke, ischemic heart disease (IHD), peripheral artery disease (PAD), or CV death. Survival curves based on Cox regression adjusted for age and systolic blood pressure (SBP), along with Harrell's <i>C</i> statistic, were assessed. There was a trend toward higher cfPWV across categories of the HMOD score. Significant correlations were found among different AS parameters and blood pressure (BP) levels. Age and SBP were highly correlated with cfPWV. Among the 174 patients with at least two cfPWV measurements, there were 12 CV complications over a follow-up period of 2.4 years. The first and second cfPWV measurements, as well as the delta values, were significantly higher in those with CV complications, with most patients experiencing an increase in PWV during follow-up of ≥ 1 m/s. Survival curves significantly differed among tertiles of PWV and the delta, particularly for the second PWV determination, which also showed the highest predictive value (Harrell's <i>C</i> = 0.86). The optimal threshold to predict complications was 9.10 m/s. Our findings suggest that cfPWV represents a promising integrated marker of HMOD, potentially serving as a surrogate endpoint for CV risk.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Denervation—“Gizmo Idolatry” Fact Checker","authors":"Markus P. Schlaich,&nbsp;Murray D. Esler","doi":"10.1111/jch.70039","DOIUrl":"https://doi.org/10.1111/jch.70039","url":null,"abstract":"<p>We read with interest the eloquent opinion piece by Dr. Messerli [<span>1</span>] questioning the utility of a “glorified high-tech gadget,” also known as renal denervation (RDN), as an adjunct therapeutic approach to lower blood pressure (BP) in patients with uncontrolled hypertension. Views expressed should build on the entirety of scientific evidence available—this is perhaps where the viewpoint has some shortcomings.</p><p>The critical role of renal nerves in blood pressure regulation is undoubted, as is the experimental evidence for BP lowering with RDN [<span>2</span>]. When we, with the late Henry Krum, performed the first two renal denervation trials out of Melbourne [<span>3</span>], clinical need coupled with our earlier discoveries of the neural pathophysiology of hypertension [<span>4</span>], not a gadget early adopter mentality, provided the motivation.</p><p>Pharmacotherapy is the mainstay of antihypertensive therapy. Professor Messerli makes special mention of amlodipine, a powerful antihypertensive drug we all use frequently in our practices, mostly in combination with other drug classes. However, as noted by the former US Surgeon General C. Everett Koop: “Drugs don't work in patients who don't take them…”. Adherence and persistence rates for amlodipine in a usual-care setting have been reported to be 53% at 12 months [<span>5</span>], alternatives should be explored.</p><p>Comparing RDN with beta-blockade is problematic. Inhibiting sympathetic outflow to a key regulatory organ such as the kidney via interference with both efferent sympathetic and afferent sensory renal nerves is fundamentally different from blocking an adrenergic receptor. A case in point is that BP response to RDN is not altered by beta-blockade.</p><p>The magnitude of the mean BP fall with RDN is moderate and can vary substantially, perhaps a function of whether the underlying dominant pathophysiology is present or not in individual patients.</p><p>The safety profile of RDN across all studies and registries with every device available has been demonstrated to be very favorable, notwithstanding the potential risk that comes with any interventional vascular approach. Renal artery stenosis can occur naturally, and even beyond 70% stenoses treatment recommendations favor medical therapy.</p><p>Finally, the durability of BP lowering is critical. Although observational, multiple cohort studies out to ∼10 years after RDN report improved control of ambulatory systolic (12–16 mmHg) and diastolic (8–10 mmHg) on similar or less numbers of antihypertensive drugs. Histologic assessment of renal nerves after RDN demonstrate alterations of nerve integrity that make functionally relevant regrowth extremely unlikely.</p><p>No form of idolatry is helpful, growing scientific evidence is.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Value of Let-7a-5p in Essential Hypertension","authors":"Lan Wang,&nbsp;Qianqian Zhu,&nbsp;Bin Cheng,&nbsp;Nan Jiang,&nbsp;Changwu Dong","doi":"10.1111/jch.70033","DOIUrl":"https://doi.org/10.1111/jch.70033","url":null,"abstract":"<p>This study aimed to investigate the role of let-7a-5p in the pathogenesis of essential hypertension (EH) and its correlation with the renin-angiotensin-aldosterone system (RAAS) biomarkers. Ninety-eight EH patients and 24 healthy controls (HC) enrolled in the study were assayed for the relative expression of let-7a-5p in plasma by quantitative real-time polymerase chain reaction (Q-PCR), and biomarkers of the RAAS system, including angiotensin-converting enzyme 2 (ACE2), Ang (1-7), MAS1, angiotensin-converting enzyme (ACE), angiotensin II (Ang II), and angiotensin II type 1 receptor (AT1R), were determined by enzyme-linked immunosorbent assay (ELISA) The expression levels of the biomarkers of RAAS system were determined. The results showed that the expression levels of let-7a-5p in the plasma of EH patients were remarkably higher than those of HC. The prediction model of combined let-7a-5p showed high accuracy by constructing a subject operating characteristic (ROC) curve with an area under the curve (AUC) of 0.885, and the reliability of the model was further verified by the Hosmer–Lemeshow (H–L) goodness-of-fit test, the Model Calibration Curve, and the Decision Curve Analysis. Spearman correlation analysis revealed that the expression of let-7a-5p was positively correlated with ACE (<i>r</i> = 0.352, <i>p</i> &lt; 0.001), and mediation analysis indicated that ACE partially mediated between let-7a-5p and the development of hypertension. The present study concludes with the potential of let-7a-5p as a companion diagnostic biomarker for EH. It suggests that there may be a complex regulatory mechanism between it and specific RAAS biomarkers, which provides a new perspective on the pathogenesis and diagnosis of EH.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal Patterns in Blood Pressure Management Before and After Recent Clinical Trials and Guideline Recommendations","authors":"Eric J. Brandt,&nbsp;Craig J. Beavers,&nbsp;Zhuxuan Fu,&nbsp;Erica S. Spatz,&nbsp;Philip G. Jones,&nbsp;Suzanne V. Arnold,&nbsp;Nihar R. Desai","doi":"10.1111/jch.70030","DOIUrl":"https://doi.org/10.1111/jch.70030","url":null,"abstract":"<p>We aimed to study trends in achieving blood pressure (BP) goals, antihypertensive prescribing, and whether clinician behavior changed in temporal relationship to the JNC-8 (October 1, 2014), SPRINT results (November 9, 2015), and the 2017 hypertension guideline (November 13, 2017). We used the National Cardiovascular Data Registry (NCDR) Practice INNovation and CLinical Excellence (PINNACLE) registry and studied patients with hypertension aged &gt;65 years (<i>n</i> = 3 678 774). We found a statistically significant, albeit small and minimally relevant, increase from 2013 to 2018 in achieving office-based SBP.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}