Journal of Clinical Hypertension最新文献

{"title":"Cardioprotective and Anti-Hypertensive Effects of Epigallocatechin Gallate: Novel Insights Into Biological Evidence","authors":"Reza Eshraghi,&nbsp;Ashkan Bahrami,&nbsp;Faraz Tayyar Iravanlou,&nbsp;Mehdi Karimi,&nbsp;Mohammad Saeed Soleimani,&nbsp;Mohammad Hossein Paknahad,&nbsp;Mohammad Yaghoubi,&nbsp;Arman Beheshtirooy,&nbsp;Fatemeh Qasemi Talouki,&nbsp;Javad Shaabanzadeh,&nbsp;Fatemeh Hasani,&nbsp;Alireza Rafi,&nbsp;Mohammad Hossein Pourhanifeh","doi":"10.1111/jch.70036","DOIUrl":"https://doi.org/10.1111/jch.70036","url":null,"abstract":"<p>Epigallocatechin gallate (EGCG), the major catechin in green tea, is of considerable interest principally due to its proposed antihypertensive and cardioprotective properties. New research shows that EGCG can help relax the circulation of blood vessels, reduce arterial stiffness of arteries, and promote antioxidant activity promotion, which results in lowering blood pressure (BP) and better-improving heart health. It also affects signaling pathways related to nitric oxide (NO) production, inflammation, and oxidative stress, which are crucial for vascular homeostasis. Although animal research and clinical trials demonstrate that regular intake of EGCG significantly decreases BP and improves lipid profiles, further studies are needed to confirm these benefits in diverse populations. This review highlights the relevant biological data supporting these effects and the mechanisms by which EGCG impacts cardiovascular health. This review provides a new perspective on the many favorable effects of EGCG, such as its potential role in cardiovascular disease prevention, essential hypertension (HTN), and atherosclerosis. These results point to the need for more clinical trials aimed at determining whether EGCG may be used as a natural approach to reducing HTN and its cardiovascular complications through dietary interventions to enhance public health.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 6","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256319","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 Catheter-Based Renal Denervation for Patients With Hypertension: A Systematic Review and Meta-Analysis","authors":"Xiao Chen,&nbsp;Jie Meng,&nbsp;Qiufeng Zhou,&nbsp;Yuehua Ni,&nbsp;Changyang Zuo,&nbsp;Yanfang Zhang","doi":"10.1111/jch.70080","DOIUrl":"https://doi.org/10.1111/jch.70080","url":null,"abstract":"<p>This meta-analysis evaluates the efficacy and safety of renal denervation (RDN) for patients with hypertension. PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov were systematically searched to identify relevant studies published before December 31, 2024. Review Manager 5.3 software was used to assess the results of the meta-analyses and the risk of bias plot. We pooled 2208 participants from 13 studies. The RDN was superior to the sham surgery group in the change in 24 h ambulatory systolic blood pressure (ASBP) and the change in 24 h ambulatory diastolic blood pressure (ADBP) (MD: −4.55 mmHg, 95% CI: −5.65 to −3.44; MD: −2.37 mmHg, 95% CI: −3.06 to −1.68, respectively). For the change in daytime ASBP and ADBP, significant differences were found between the RDN group and the sham group (MD: −6.21 mmHg, 95% CI: −7.61 to −4.80; MD: −2.96, 95% CI: −3.85 to −2.07). Compared to the sham surgery group, the RDN group showed better results in the change in night-time ASBP and ADBP (MD: −4.67 mmHg, 95% CI: −6.32 to −3.03; MD: −2.28 mmHg, 95% CI: −3.33 to −1.24). No significant differences were found between the RDN group and the sham group in terms of adverse events (AEs) and serious adverse events (SAEs) (<i>p</i> = 0.39 and 0.07). Subgroup analyses showed that RDN remains effective at long-term follow-up, and both ultrasound and radiofrequency RDN were effective. Current evidence shows that RDN is an effective treatment for patients with hypertension and does not increase the risk of AEs and SAEs.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 6","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232341","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":"Neutrophil Percentage to Albumin Ratio Is Associated With In-Hospital Mortality in Patients With Acute Type A Aortic Dissection","authors":"Xuecui Zhang,&nbsp;Lingyu Lin,&nbsp;Yanchun Peng,&nbsp;Sailan Li,&nbsp;Xizhen Huang,&nbsp;Liangwan Chen,&nbsp;Yanjuan Lin","doi":"10.1111/jch.70067","DOIUrl":"https://doi.org/10.1111/jch.70067","url":null,"abstract":"<p>The neutrophil percentage to albumin ratio (NPAR) has been associated with prognosis of various cardiovascular diseases, but its role in acute type A aortic dissection (AAAD) mortality remains unclear. The aim of this study was to investigate the relationship between preoperative NPAR and in-hospital mortality in AAAD patients. Clinical data from patients who underwent AAAD surgery at the Cardiac Medical Center of Fujian Province between January 2020 and April 2024 were retrospectively analyzed. Patients were categorized into three groups based on NPAR tertiles. Univariate and multivariate logistic regression analyses were employed to identify factors contributing to in-hospital mortality. The predictive performance of NPAR was assessed using ROC curve analysis. The results revealed that out of 813 AAAD patients meeting the inclusion criteria, 137 (16.9%) died in hospital. Multivariate logistic regression analysis indicated that compared to the low tertile group, the odds ratios (95% CI) for in-hospital mortality in the middle and high tertile groups were (OR 3.041, 95% CI: 1.502–6.158, <i>p</i> = 0.002) and (OR 6.586, 95% CI: 3.324–13.049, <i>p</i>&lt;0.001), respectively. Additionally, cardiopulmonary bypass time (OR 1.010, 95% CI: 1.007-1.013, <i>p</i>&lt;0.001) and mechanical ventilation time (OR 1.115, 95% CI: 1.082–1.150, <i>p</i>&lt;0.001) were also independently associated with in-hospital mortality in AAAD patients. The area under the curve for NPAR was 0.708 (95% CI: 0.676–0.739) (<i>p</i>&lt;0.001), with an optimal cut-off value of 24.105, yielding a sensitivity of 73.7% and a specificity of 64.8%. In conclusion, higher preoperative NPAR may be independently associated with increased in-hospital mortality, suggesting its potential as a novel indicator for monitoring AAAD patients.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206493","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":"Reducing the Risk of Developing Diabetes: The Role of Angiotensin Receptor Blockers and Angiotensin Converting Enzyme Inhibitors in Patients With Hypertension Combined Prediabetes","authors":"Chenyu Yang,&nbsp;Zhiping Hu,&nbsp;Rina Sa,&nbsp;Rongjing Li,&nbsp;Yi Li,&nbsp;Youwei Wu,&nbsp;Guoshuai Shi,&nbsp;Lin Qiu,&nbsp;Chao Li","doi":"10.1111/jch.70025","DOIUrl":"https://doi.org/10.1111/jch.70025","url":null,"abstract":"<p>Diabetes has emerged as a pressing public health crisis in numerous nations, with individuals afflicted by hypertension exhibiting an elevated susceptibility to diabetes. Our main objective was to investigate the risk of developing new-onset diabetes in hypertensive patients with pre-diabetes undergoing treatment with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), thereby furnishing valuable evidence for informed clinical decision-making. Our study was a retrospective cohort study in which individuals with hypertension and meeting other inclusion criteria were enrolled into the cohort. The study population was divided into two groups: one group receiving ARBs or ACEIs as antihypertensive medications, and the other group receiving calcium antagonists, diuretics, beta-blockers, or alpha-blockers. Kaplan–Meier curve and Cox proportional hazard model were used to evaluate the cumulative incidence and hazard ratio (HR) of new-onset diabetes in the ARBs or ACEIs grouprespectively. Out of the 1373 hypertensive individualswith pre-diabetes included in the study, 385 were prescribed ARBs or ACEIs for hypertension management. Subsequent follow-up revealed that 24 new cases of diabetes emerged in the ARBs or ACEIs group, whereas 104 cases were reported in the comparison group. Utilization of ARBs or ACEIs as antihypertensive therapy was linked to a decreased risk of incident diabetes compared to the alternative regimen (HR: 0.51, 95% CI: 0.33, 0.79) and was statistically significant in the male population. In conclusion, antihypertensive drugs of the ACEIs and ARBs class reduce the risk of new-onset diabetes in patients with hypertension combinedwith pre-diabetes.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190866","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":"Machine Learning Prediction Model for Carotid-Femoral Pulse Wave Velocity in Cardiovascular Health Assessments","authors":"Minglong Xin,&nbsp;Vipin Kumar,&nbsp;Megumi Narisawa,&nbsp;Chunzi Jin,&nbsp;Wenhu Xu,&nbsp;Xian Wu Cheng","doi":"10.1111/jch.70049","DOIUrl":"https://doi.org/10.1111/jch.70049","url":null,"abstract":"&lt;p&gt;Cardiovascular disease (CVD) remains a major global health concern and consistently ranks as the leading cause of mortality worldwide. Among the key pathophysiological factors that drive the progression of CVD, vascular health and structural changes in the arterial wall play crucial roles [&lt;span&gt;1&lt;/span&gt;]. Aortic stiffness, in particular, is known as a significant and independent predictor of cardiovascular events and mortality, retaining its prognostic value even after adjustment for traditional risk factors. Aortic stiffness refers to the loss of the aortic wall's elasticity, which occurs naturally with age but is accelerated by conditions such as hypertension, diabetes, dyslipidemia, and chronic inflammation [&lt;span&gt;2&lt;/span&gt;]. The pathophysiological consequences of increased aortic stiffness are complex; the stiffness increases systolic blood pressure (SBP) while decreasing diastolic blood pressure (DBP), leading to increased pulse pressure and left ventricular afterload (Figure 1). These hemodynamic changes promote left ventricular hypertrophy and significantly increase the risk of cardiovascular events [&lt;span&gt;1&lt;/span&gt;]. Monitoring arterial stiffness can detect changes in vascular function earlier and predict the risk of CVD, potentially allowing preventive interventions before clinical manifestations occur.&lt;/p&gt;&lt;p&gt;The development of CVD is a long-term process, and early detection and intervention can prevent disease progression, reduce medical costs, and lower mortality rates. In this context, machine learning methods offer a promising approach to the detection of early signs of CVD and potentially improve cardiovascular health. For example, an algorithm for estimating the size of an abdominal aortic aneurysm that uses deep learning models to analyze pressure waves from the carotid, brachial, and femoral arteries was proposed in 2021 [&lt;span&gt;3&lt;/span&gt;]. In vascular aging research, an artificial neural network was used to estimate carotid-femoral pulse wave velocity (cf-PWV), but that approach required central carotid pressure wave data and additional medical information such as chronological age [&lt;span&gt;4&lt;/span&gt;]. The cf-PWV, widely considered the gold standard for assessing atherosclerosis, plays a central role in estimations of the cf-PWV [&lt;span&gt;5&lt;/span&gt;]. Guidelines issued by the European Society of Cardiology and the European Society of Hypertension incorporate the cf-PWV as a recommended parameter for cardiovascular risk assessments, with values &gt;10 m/s indicating an increased risk [&lt;span&gt;6&lt;/span&gt;]. Elevated cf-PWV has been established as independently associated with increased risks of myocardial infarction, heart failure, and cardiovascular mortality over and above traditional cardiovascular risk factors [&lt;span&gt;1, 5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The study by Chen et al. in this issue of the &lt;i&gt;Journal of Clinical Hypertension&lt;/i&gt; [&lt;span&gt;7&lt;/span&gt;] presents a significant advance in cardiovascular risk assessment based on the development of machine le","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135799","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":"Can Cardiovascular Risk Factors Be Predicted? The Case of Weight-Adjusted Waist Index","authors":"Claudio Borghi,&nbsp;Giulia Fiorini","doi":"10.1111/jch.70074","DOIUrl":"https://doi.org/10.1111/jch.70074","url":null,"abstract":"&lt;p&gt;In recent years, the quest for reliable indicators of metabolic health has intensified, particularly in the context of rising global obesity rates [&lt;span&gt;1&lt;/span&gt;]. The increase in the prevalence of obesity is associated with an increase in cardiovascular and metabolic-related mortality and morbidity that can be partially explained with the increase in the prevalence of several cardiometabolic risk factors, including hypertension, diabetes, lipid disorders, and elevated serum uric acid [&lt;span&gt;2&lt;/span&gt;]. The traditional methods for assessing obesity, such as body mass index (BMI) and waist circumference, have their limitations since BMI does not account for fat distribution, while waist circumference fails to consider body weight. This problem has been recently emphasized by a publication of the Lancet Diabetes &amp; Endocrinology Commission [&lt;span&gt;3&lt;/span&gt;] suggesting the need for a new estimate of overweight/obesity to overcome the limitations of the current definitions. This is the reason why several alternative measures of overweight have come into play. Among the plethora of metrics available, the Weight-Adjusted Waist Index (WWI) estimated by dividing the waist circumference (in cm) by the square root of body weight (in kg) [&lt;span&gt;4&lt;/span&gt;] has emerged as a promising contender [&lt;span&gt;5&lt;/span&gt;]. By adjusting waist circumference for weight, the WWI offers a more nuanced perspective on an individual's metabolic status. It effectively combines the advantages of both waist measurement and weight, providing a clearer picture of visceral fat accumulation, which is more closely associated with metabolic diseases.&lt;/p&gt;&lt;p&gt;In the present issue of the Journal, Miao et al. [&lt;span&gt;6&lt;/span&gt;] have explored the potential of WWI as a predictive tool in patients with hypertension and hyperuricemia (HTN-HUA), two conditions that are increasingly prevalent and often interlinked. Hypertension is a major risk factor for cardiovascular diseases and is often exacerbated by obesity [&lt;span&gt;7&lt;/span&gt;]. Hyperuricemia, characterized by elevated uric acid levels in the blood, is not only a precursor to gout but is also associated with various metabolic disorders, including hypertension [&lt;span&gt;8&lt;/span&gt;]. Hypertension and elevated urate levels are frequently associated in the same patients, particularly in the presence of obesity [&lt;span&gt;9, 10&lt;/span&gt;] that could represent an early promoter of both cardiometabolic risk factors. The interplay between these three conditions underscores the need for effective screening tools that can identify individuals at risk before the onset of more severe health issues.&lt;/p&gt;&lt;p&gt;The study has examined the population of the National Health and Nutrition Examination Survey (NHANES) database during the period 1999–2018 and has reached the conclusion of a significant and nonlinear association between WWI and HTN-HUA. A weaker, but significant correlation has also been observed between WWI and SUA or HTN alone, suggesting the predictive role of su","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118059","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":"Uncovering Gaps: Dietary Influence and Machine Learning in Hypertension and Comorbidities","authors":"Javeria Akhter,&nbsp;Javed Iqbal","doi":"10.1111/jch.70073","DOIUrl":"https://doi.org/10.1111/jch.70073","url":null,"abstract":"&lt;p&gt;Dear Editor,&lt;/p&gt;&lt;p&gt;We read with great interest the recent article by Zhang et al., “Diabetes Mellitus and Hyperlipidemia Status Among Hypertensive Patients in the Community and Influencing Factors Analysis of Blood Pressure Control,” which provides valuable insights into the prevalence of type 2 diabetes mellitus (T2DM) and hyperlipidemia among hypertensive patients and investigates their impact on blood pressure (BP) control using a large dataset from the National Basic Public Health Service Program in Guangzhou. The authors successfully underscore key risk factors influencing BP control, including obesity, alcohol use, physical inactivity, and poor medication adherence [&lt;span&gt;1&lt;/span&gt;]. Although the study presents significant findings, several methodological aspects warrant further discussion.&lt;/p&gt;&lt;p&gt;First, the study appropriately recognizes the increased prevalence of comorbid T2DM and hyperlipidemia among hypertensive patients and its association with poorer BP control. However, one major constraint is the lack of stratification based on the severity of hyperlipidemia and diabetes. Given the varied nature of these conditions, a more detailed subgroup analysis considering glycemic control levels (e.g., HbA1c categories) and lipid profiles (e.g., LDL/HDL ratios) would provide deeper insights into their precise impact on BP regulation.&lt;/p&gt;&lt;p&gt;Second, while the study underlines key lifestyle factors affecting BP control, the role of dietary patterns is not sufficiently addressed. Prior studies have shown that dietary sodium intake, fat composition, and overall macronutrient distribution significantly affect BP levels in hypertensive patients with metabolic comorbidities [&lt;span&gt;2&lt;/span&gt;]. Incorporating dietary data into the analysis would strengthen the study's conclusions and provide actionable recommendations for community-based hypertension management.&lt;/p&gt;&lt;p&gt;Third, although the study investigates important influencing factors on BP control, it does not sufficiently address the role of medication adherence beyond a general assessment. Hypertensive patients with comorbidities like T2DM and hyperlipidemia often require complex polypharmacy, and adherence patterns can significantly impact BP control outcomes. Previous researches have shown that factors such as medication burden, side effects, and patient perceptions of treatment efficacy affect adherence rates [&lt;span&gt;3&lt;/span&gt;]. Including a more comprehensive evaluation of medication adherence, such as pill burden or self-reported adherence scales, would provide more in-depth insights into its effect on BP regulation.&lt;/p&gt;&lt;p&gt;Moreover, the study employs logistic regression models to identify factors associated with BP regulation, but does not include machine learning techniques, which have been increasingly used in cardiovascular research for predictive modeling. Advanced statistical approaches, such as the random forest model, could increase risk stratification and improve predictive accuracy in ide","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118060","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":"Sex-Specific Association of Left Ventricular Hypertrophy With Cardiovascular Events in High-Risk of Cardiovascular Disease Population: Findings From the Sub-Cohort of China PEACE Million Persons Project","authors":"Shiping Wu,&nbsp;Xiaoxuan Feng,&nbsp;He Zheng,&nbsp;Jiabin Wang,&nbsp;Mengqi Yan,&nbsp;Dan Zhou,&nbsp;Yingqing Feng","doi":"10.1111/jch.70072","DOIUrl":"https://doi.org/10.1111/jch.70072","url":null,"abstract":"<p>Sex differences significantly influence the prognosis of left ventricular hypertrophy (LVH). To investigate sex-specific differences in the incidence of major adverse cardiovascular event (MACE) among individuals with LVH, we enrolled 14 636 (mean age 57 years, women 59.1%) participants with high risk for cardiovascular diseases (CVD) from the sub-cohort of the China PEACE Million Persons Project. LVH was identified by echocardiography dividing left ventricular mass (LVM) by body surface area (BSA), height^1.7, or height^2.7 using validated sex-specific cutoff values. MACE was defined as a composite of coronary heart disease, myocardial infarction, strokes, heart failure, and/or cardiovascular death. During a median follow-up of 3.62 years, 1327 patients developed MACE. The prevalence of LVH was higher when indexing LVM to BSA and height^1.7 in women. Higher blood pressure (BP) and previous diabetes mellitus (DM) were associated with a higher risk of LVH in both genders, while aging and adiposity had a more hazardous impact in women than in men. Multivariable Cox regression analyses indicated an increasing risk between LVH and MACE exclusively in men. In individuals diagnosed with LVH, women exhibited a reduced risk for MACE. When indexing LVM to BSA, concentric hypertrophy (adjusted hazard ratio [aHR]: 1.73, 95% CI: 1.37–2.19; <i>p</i> &lt; 0.001] and eccentric hypertrophy (aHR: 1.54, 95% CI: 1.06–2.25; <i>p</i> = 0.025) were significantly associated with MACE in men. In this population study, risk factors including BP, blood glucose, lipids level, and BMI should be managed strictly. Additionally, men should pay more attention to the occurrence of LVH, which had a greater association with MACE.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108746","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":"Advanced Practice Nurse Intervention Versus Usual Care for Hypertension Control: A Pilot Open-Label Randomized Controlled Trial","authors":"Juliette Vay-Demouy,&nbsp;Hélène Lelong,&nbsp;Jacques Blacher","doi":"10.1111/jch.70068","DOIUrl":"https://doi.org/10.1111/jch.70068","url":null,"abstract":"<p>The aim of this pilot study was to test the feasibility of a clinical trial to evaluate the impact of an advanced practice nurse (APN) intervention on blood pressure (BP) control versus usual care in hypertension management, and to provide initial trends. This pilot study was designed as a prospective, open-label, randomized 1:1, controlled, and monocentric superiority trial, conducted in a French-labeled European Society of Hypertension excellence center. The APN intervention consisted of an in-depth therapeutic education and an assessment of therapeutic strategies with adjustments if needed. The study sample included 437 participants (<i>n</i> = 229 in the experimental group; <i>n</i> = 208 in the “usual care” group). Considering the selection bias identified for baseline systolic BP, statistical analyses were adjusted on this parameter. The APN intervention significantly reduced adjusted systolic BP in the experimental group compared with the “usual care” group (−2.72 mm Hg, <i>p</i> = 0.04) and showed a trend toward a decrease in adjusted diastolic BP (−1.85 mm Hg, <i>p</i> = 0.07) and improved BP control with the APN intervention (−8.5%, <i>p</i> = 0.08). The experimental group was significantly more likely to adhere to the HBPM protocol compared with the control group (OR = 1.82, 95% CI [1.22–2.71], <i>p</i> = 0.003). This pilot study confirmed the feasibility of the clinical trial and offered the first data about APNs in hypertension management in France. Initial significant or borderline significant results are encouraging and suggest the benefit of an APN intervention on BP control in hypertension management. Further studies are needed to confirm these results.</p><p><b>Trial registration</b>: This clinical trial was registered on ClinicalTrials platform (NCT06227884).</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70068","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930500","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":"LC-MS/MS-Based Assay for Steroid Profiling in Peripheral and Adrenal Venous Samples for the Subtyping of Primary Aldosteronism","authors":"Xiuqing Chen,&nbsp;Qinyi Li,&nbsp;Linjing Huang,&nbsp;Peiwen Wu","doi":"10.1111/jch.70062","DOIUrl":"https://doi.org/10.1111/jch.70062","url":null,"abstract":"<p>Given the largely unexplored application of liquid chromatography-tandem mass spectrometry (LC-MS/MS) steroid analysis in primary aldosteronism (PA), we aimed to investigate its diagnostic utility in PA classification and to characterize steroid secretion patterns across PA subtypes. We retrospectively enrolled 67 patients with PA and collected samples from both peripheral and adrenal veins. We performed a steroid analysis to compare the steroid panel differences between aldosterone-producing adenoma (APA), bilateral adrenal hyperplasia (BAH), and unilateral adrenal hyperplasia (UAH). Analyses included steroid concentrations and secretion ratios, with the latter calculated as individual steroid concentrations divided by total steroid content. The concentrations of 18-hydroxycortisol (18-OHF) were higher in the peripheral veins of patients with APA than in those with BAH and UAH (<i>p</i> &lt; 0.01). A threshold of 4.83 ng/mL for peripheral 18-OHF specifically identified APA cases. In APA cases, adrenal vein secretion ratios of aldosterone, 18-hydroxycorticosterone (18-OHB), and 18-OHF were significantly higher in dominant versus non-dominant adrenal veins (<i>p</i> &lt; 0.001). A secretion ratio of 18-OHF ≥ 14.6‰ and 18-OHB ≥ 4.03‰ from the adrenal vein achieved 100% specificity for identifying the dominant secretory side in cases of APA. Collectively, our findings demonstrate that LC-MS/MS steroid profiling effectively differentiates APA from other PA subtypes. The biochemical criteria for the secretion ratios of 18-OHF and 18-OHB from the adrenal vein provide objective criteria for lateralization diagnosis in APA. These findings could refine diagnostic strategies for PA subtyping.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930385","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}