Journal of Clinical Hypertension最新文献

{"title":"Photoplethysmography-Derived Arterial Stiffness Index Delivered Greater Cardiovascular Prevention Value to Non-Elderly: A Retrospective Cohort Study Based on UK Biobank","authors":"Hongyu Chen,&nbsp;Fangfang Fan,&nbsp;Ziliang Ye,&nbsp;Zhe Liang,&nbsp;Xianhui Qin,&nbsp;Yan Zhang","doi":"10.1111/jch.70058","DOIUrl":"https://doi.org/10.1111/jch.70058","url":null,"abstract":"<p>Photoplethysmography-derived arterial stiffness index (ASI) has been proven to be associated with various cardiovascular diseases. The present study aims to determine whether the predictive value of ASI varies between elderly and non-elderly and whether ASI improves the discrimination and reclassification ability of the updated Systematic Coronary Risk Evaluation (SCORE2) in different age groups. This retrospective study included UK Biobank participants with ASI recordings. Multivariable Cox proportional hazard models were used to estimate the associations between ASI and major adverse cardiovascular events (MACE) in different age groups. The difference in C-statistic, integrated discrimination improvement (IDI), and continuous net reclassification improvement (NRI) were calculated to test the predictive performance of ASI beyond SCORE2 in the elderly and non-elderly. A total of 127 045 participants were included in the primary analysis. During a median of 11.7 years, 2606 (10.7%) and 4408 (4.3%) MACE were identified in the elderly and non-elderly, respectively. The non-elderly exhibited a greater extent of increased risk for MACE with higher ASI (HR, 1.314 [1.280–1.350] vs. HR, 1.066 [1.026–1.107]). Furthermore, the IDI and continuous NRI of ASI beyond SCORE2 for MACE were more than two times higher for non-elderly individuals than their elderly counterparts (IDI, 0.0481% [0.0182%–0.0953%] vs. IDI, 0.0010% [−0.0052% to 0.0295%]; NRI, 8.76% [6.83% to 10.60%] vs. NRI, 3.27% [−3.92% to 5.97%]). Our findings suggested that ASI should primarily be utilized for primary cardiovascular prevention in individuals below 65.</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.70058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930383","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":"Thiazide-Associated Hyponatremia: A Retrospective Cohort Study Comparing Hydrochlorothiazide Versus Indapamide Versus Chlorthalidone","authors":"Josef Klhůfek,&nbsp;Martin Vodička,&nbsp;Petr Ponížil,&nbsp;Ilja Ryšavý,&nbsp;Petr Fojtík,&nbsp;Vladimír Kojecký,&nbsp;Tomáš Šálek","doi":"10.1111/jch.70060","DOIUrl":"https://doi.org/10.1111/jch.70060","url":null,"abstract":"<p>Hyponatremia is a crucial complication of therapy with thiazide diuretics. This study compares the epidemiological and biochemical profiles and hospital course of patients using hydrochlorothiazide (HCTZ), indapamide (INDA), and chlorthalidone (CTD) admitted with thiazide-associated hyponatremia (TAH). Data were obtained retrospectively from the hospital's digital registries. The epidemiological and biochemical parameters between the HCTZ, INDA, and CTD groups were compared. The correlation between dose and biochemical parameters in each group was performed. The thiazide groups without diuretic co-medication were compared (HCTZ vs. INDA), and the correlation between dose and biochemical parameters in each group was examined. A comparison of the HCTZ (<i>n</i> = 135), INDA (<i>n</i> = 125), and CTD (<i>n</i> = 27) groups identified differences in serum potassium (s-K; <i>p</i> = 0.03). The hyponatremia correction rate was slower in the CTD group at 96 h after admission (<i>p</i> &lt; 0.001). After the exclusion of diuretic co-medication, the HCTZ group (<i>n</i> = 64/135) showed a higher prevalence of ARBs, s-K (both <i>p</i> &lt; 0.001), and a lower median (IQR) equipotent dose (12.5 (o) mg vs. 2.5 (1.2) mg), prevalence of ACE-I (<i>p</i> &lt; 0.001), and eGFR (<i>p</i> = 0.03), when compared to the INDA group (<i>n</i> = 109/125). In conclusion, except for s-K, we observed no significant difference in biochemical and epidemiological profiles between HCTZ, INDA, and CTD. After excluding the influence of other diuretics, we observed higher s-K in the HCTZ group compared to the INDA group, potentially explained by the lower equipotent dose of HCTZ. The CTD group showed a statistically significant trend of slower hyponatremia correction.</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.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930384","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":"Impact of Variability in Blood Pressure and Heart Rate on Beta-Blocker Adherence","authors":"Yan Li,&nbsp;Jia-Yin Sun,&nbsp;Qian-Yun Guo,&nbsp;Hong-Ya Han,&nbsp;De-An Jia,&nbsp;Zhi-Ming Zhou,&nbsp;Zhi-Jian Wang,&nbsp;Ying-Xin Zhao,&nbsp;Yu-Jie Zhou,&nbsp;Shi-Wei Yang","doi":"10.1111/jch.70065","DOIUrl":"https://doi.org/10.1111/jch.70065","url":null,"abstract":"<p>Adherence to antihypertensive medications is essential for blood pressure (BP) control, influencing long-term outcomes in hypertensive patients. This study examines the association between visit-to-visit variability in BP and heart rate (HR) and its effect on adherence to beta-blocker therapy among outpatients. Conducted across 160 hospitals in China from January 1, 2011, to December 31, 2011, this study included 9225 hypertensive outpatients prescribed metoprolol succinate. BP and HR variability were assessed over three visits (baseline, 1-month, and 2-month follow-up) using standard deviation (SD) and mean-independent parameters. Nonadherence was defined as medication discontinuation or treatment regimen changes by the 2-month follow-up. Among the 9037 patients analyzed, the mean age was 58.85 years (±12.54), and 52.9% were male. Visit-to-visit variability in the rate–pressure product (RPP; SBP×HR) was a significant predictor of nonadherence, with an odds ratio (OR) of 1.26 (95% confidence interval [CI]: 1.04–1.53, <i>p</i> &lt; 0.05) for the top-decile SD of RPP, independent of mean RPP. Variability in diastolic blood pressure (DBP) and pulse pressure (PP) were also associated with nonadherence, with ORs of 1.65 (95% CI: 1.35–2.00, <i>p</i> &lt; 0.001) for DBP and 1.66 (95% CI: 1.39–1.99, <i>p</i> &lt; 0.001) for PP, independent of their mean values. Patients with fluctuations in PP or HR had a higher risk of nonadherence compared to those with consistent reductions in these measures. Visit-to-visit variability in RPP, DBP, and PP is a significant predictor of nonadherence to beta-blockers, regardless of mean levels. Addressing this variability is critical for improving adherence to antihypertensive treatments and optimizing patient outcomes.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930348","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":"Association of Screenings for Hypertension, Diabetes, and High Cholesterol With All-Cause and Cardiovascular Mortality: Evidence From a Cohort Study","authors":"Jiayue Zhang,&nbsp;Shuting Wang,&nbsp;Ying Huang,&nbsp;Wenxiao Zheng,&nbsp;Ying Xiao,&nbsp;Zuyao Yang","doi":"10.1111/jch.70053","DOIUrl":"https://doi.org/10.1111/jch.70053","url":null,"abstract":"<p>Screenings for hypertension, diabetes, and high cholesterol are widely conducted in routine clinical practice for cardiovascular disease (CVD) prevention. However, few studies have investigated whether these screenings could eventually lead to lower risks of hard outcomes such as mortality. This cohort study aimed to examine directly the association of screenings for hypertension, diabetes, and high cholesterol with all-cause and cardiovascular mortality and whether the association, if existent, varied with important characteristics. A nationally representative sample of 86 587 US adults without the three conditions and CVD at baseline were recruited. The history of screenings for the three conditions was elicited by a series of questions in the surveys. All-cause and cardiovascular mortality were ascertained by linkage to National Death Index records through December 31, 2019. The association of screenings with mortality was investigated by multivariable Cox regression analysis and expressed as hazard ratio (HR) with 95% confidence interval (CI), adjusting for major risk factors of CVD and mortality. The “1 screening,” “2 screenings,” “3 screenings,” and “any screening” (combining the above three) groups were compared with the “no screening” group separately. During a median follow-up of 51 months (4.3 years), 1783 participants died and 366 of them were attributed to CVD. After adjusting for all covariates, no statistically significant association was found between “any screening” and all-cause mortality (HR = 1.08, 95% CI 0.92–1.26) or cardiovascular mortality (HR = 1.06, 95% CI 0.76–1.47). The results were consistent across various subgroups. The associations of “1 screening,” “2 screenings,” and “3 screenings” respectively with all-cause and cardiovascular mortality were not statistically significant either (HRs ranging from 0.65 to 1.40). Overall, in this population of US general adults, there was no evidence that screening for hypertension, diabetes, and high cholesterol could lead to lower all-cause or cardiovascular mortality.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909123","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":"Aerobic, Resistance, and Isometric Exercise to Reduce Blood Pressure Variability: A Network Meta-Analysis of 15 Clinical Trials","authors":"Ziyu Hao,&nbsp;Joshua Tran,&nbsp;Amy Lam,&nbsp;Karen Yiu,&nbsp;Kelvin Tsoi","doi":"10.1111/jch.70050","DOIUrl":"https://doi.org/10.1111/jch.70050","url":null,"abstract":"<p>Elevated blood pressure variability (BPV) is an emerging independent risk factor for increased cardiovascular diseases (CVD). Many studies are exploring the impacts of regular physical exercise on reducing BPV. This study aimed to investigate whether exercise can be an intervention to control for the short-term and long-term BPV. A literature search was conducted on MEDLINE, Embase, and PsycINFO on February 10, 2025. The clinical trials and other observational studies that investigated the effects of exercise on systolic and diastolic BPV were included. There were no limitations on age, blood pressure (BP) category, or the use of antihypertensive medication. Mean differences and standard deviations (SDs) of the BPV measurements were extracted to derive standardized mean differences (SMD) with a 95% confidence interval (CI). The heterogeneity was assessed by <i>I</i>^2, and random-effect models were performed. Our search identified 8359 studies, of which 25 studies reported BPV outcomes. Fifteen clinical trials compared the short-term BPV among participants with or without exercise. Exercise interventions can significantly reduce both systolic BPV (SMD [95% CI] = −0.37[−0.61 to −0.12]) and diastolic BPV (−0.48 [−0.72 to −0.23]). The benefits are stronger for those with hypertension. Different types of exercise were compared in the network meta-analyses, and aerobic exercise showed more benefits than other types of exercise to improve BPV, especially on the diastolic BPV when it was compared with no exercise (−2.52 [−4.05 to −0.99]). No evidence was observed for the long-term BPV. Exercise interventions effectively reduce the variability of both systolic and diastolic blood pressure (DBP). Aerobic exercise is shown to be more effective in reducing diastolic BPV versus no exercise.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909221","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":"Association Between Multidimensional Social Participation and Hypertension Among Middle-Aged and Older Adults in China: A Cross-Sectional Analysis From the China Health and Retirement Longitudinal Study","authors":"Zilong Shao,&nbsp;Yu Chen,&nbsp;Sheng Sun,&nbsp;Mengping Wang","doi":"10.1111/jch.70059","DOIUrl":"https://doi.org/10.1111/jch.70059","url":null,"abstract":"<p>Hypertension is a significant public health issue, particularly among middle-aged and older adults. This study investigated the impact of multidimensional social participation, including its diversity and frequency, on hypertension in this population in China, with a focus on urban–rural differences. Using data from the 2015 China Health and Retirement Longitudinal Study (CHARLS), which included 12 165 participants aged 45 and older, social participation was categorized by diversity (e.g., voluntary activities, Mahjong, cards, chess, or other clubs) and frequency. Hypertension was determined based on self-reported diagnoses, medication use, and blood pressure measurements. Logistic regression analyses, adjusted for demographic and health-related factors, revealed that more diverse social participation was associated with lower hypertension rates (OR = 0.718, 95% CI = 0.612, 0.840). Participating more than once a week also correlated with reduced hypertension risk (OR = 0.877, 95% CI = 0.803, 0.958). Specific activities, such as volunteering, internet use, and Mahjong, were notably protective against hypertension. Subgroup analyses highlighted urban–rural disparities, with differing impacts of social participation observed. However, interaction analyses showed that urban–rural residency did not significantly modify the relationship between social participation and hypertension. These findings emphasize the role of social participation in mitigating hypertension risk among middle-aged and older Chinese adults, and underscore the need for targeted public health strategies to address urban–rural disparities and promote social participation.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909124","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":"Association Between Antioxidant Capacity and Vascular Hemodynamics in Premenopausal Women Following Exercise Training","authors":"Gordon Fisher,&nbsp;Aparna Tamhane,&nbsp;Douglas R. Moellering,&nbsp;Christian E. Behrens,&nbsp;Gary R. Hunter","doi":"10.1111/jch.70046","DOIUrl":"https://doi.org/10.1111/jch.70046","url":null,"abstract":"<p>Oxidative stress plays a role in vascular dysfunction and cardiometabolic health. The purpose of this study was to assess the effects of aerobic exercise training on antioxidant capacity (ferric reducing ability of plasma/FRAP) and hemodynamic measures: systolic blood pressure (∆SBP), diastolic blood pressure (∆DBP), mean arterial blood pressure (∆MAP), large arterial elasticity index (∆LAEI), and small arterial elasticity index (∆SAEI) in a cohort of healthy women. This was a secondary data analysis of a study designed to evaluate cardiometabolic outcomes. Participants performed supervised aerobic exercise 3 times/week on a stationary cycle ergometer. FRAP and hemodynamic measures were measured baseline and post-training. The analysis included 15 African American and 14 Caucasian women aged 32.2 ± 5.5 years. No significant changes were observed for FRAP or hemodynamic measures. However, significant negative correlations between ∆FRAP and ∆SBP, ∆DBP, and MAP, as well as a positive correlation with ∆SAEI and ∆LAEI were observed. ∆SBP, ∆DBP, and ∆MAP were each modeled with three multiple regression models: (1) ∆FRAP, ∆SAEI, and ∆LAEI as independent variables. All models had significant <i>R</i>². ∆FRAP was significantly related to ∆DBP and ∆MAP after adjusting for ∆SAEI and ∆LAEI (partial <i>R</i> −0.38 and −0.32 respectively). ∆SAEI was independently related to ∆SBP (partial −0.32) and ∆MAP (partial −0.34). ∆LAEI was independently related to ∆SBP (partial −0.36) and ∆MAP (partial −0.40). ∆FRAP is significantly associated with lowered blood pressure and elevated arterial elasticity. While multiple regression analysis suggests that at least some of the lowered blood pressure is achieved through processes associated with increased arterial elasticity.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143875680","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":"The Role of Serum Calcium Levels in the Progression of Arterial Stiffness: Cross-Sectional and Longitudinal Analyses in a Multicenter Cohort","authors":"Kyung An Kim,&nbsp;Hae-Ok Jung,&nbsp;Mi-Jeong Kim,&nbsp;So-Young Lee,&nbsp;Dong-Hyeon Lee,&nbsp;Donghee Han,&nbsp;Hyuk-Jae Chang,&nbsp;Su-Yeon Choi,&nbsp;Jidong Sung,&nbsp;Eun Ju Chun","doi":"10.1111/jch.70055","DOIUrl":"https://doi.org/10.1111/jch.70055","url":null,"abstract":"<p>Increased arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV) is a well-known risk factor for hypertension and future cardiovascular events. The relationship between serum calcium levels and increased arterial stiffness is not well understood. Individuals undergoing baPWV measurements as part of a generalized health examination, with normal serum calcium (8.5–10.5 mg/dL) and phosphate levels and no significant renal dysfunction, were selected from the Korea Initiatives on Coronary Artery (KOICA) registry. The cross-sectional relationship between serum calcium levels and baPWV, and the longitudinal effect of baseline serum calcium levels on baPWV progression in those with repeated baPWV measurements, were analyzed using multivariable regression models. A total of 9150 individuals with baseline baPWV and 2329 individuals (5451 PWV measurements) with follow-up baPWV were selected for cross-sectional and longitudinal analyses, respectively. After adjustment for confounders, higher serum calcium levels were associated with increased baseline baPWV (β-coefficient per 1 mg/dL increase, 19.61; 95% CI 7.77–31.45; <i>p</i> = 0.001). Higher serum calcium was also independently associated with a greater annualized baPWV progression rate longitudinally (β-coefficient per 1 mg/dL increase, 5.17; 95% CI, 1.82–8.67; <i>p</i> = 0.004). Subgroup analysis showed that the effect of serum calcium on baPWV progression had a significant interaction with baseline baPWV, systolic blood pressure, and the presence of diabetes (interaction <i>p </i>&lt; 0.001). In conclusion, higher serum calcium levels within the normal range were associated with faster arterial stiffness progression measured by baPWV. Further studies are required to explore the potential for modulating calcium metabolism to slow arterial stiffness progression.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866047","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":"Endothelial Activation and Stress Index Predicts All-Cause and Cardiovascular Mortality in Hypertensive Individuals: A Nationwide Study","authors":"Gaiying Dong,&nbsp;Tingting Wu,&nbsp;Xiaofan Gu,&nbsp;Liangliang Wu","doi":"10.1111/jch.70057","DOIUrl":"https://doi.org/10.1111/jch.70057","url":null,"abstract":"<p>Emerging evidence links the Endothelial Activation and Stress Index (EASIX) and mortality risk in coronary artery disease, but its relevance in hypertensive patients remains unclear. This study examines the association between EASIX and all-cause and cardiovascular mortality in hypertensive individuals. The analysis included 6138 hypertensive patients from seven National Health and Nutrition Examination Survey (NHNES) cycles (2003–2016), with mortality data obtained from the National Death Index (NDI). Over a median follow-up of 98 months, 1435 (23.4%) participants died, including 400 (6.5%) from cardiovascular causes. Restricted cubic spline analysis revealed a positive association between EASIX and both all-cause and cardiovascular mortality. Weighted multivariable Cox regression indicated that each 1-unit increase in EASIX corresponding to a 25% and 23% rise in mortality risk, respectively. Based on the optimal cutoff value determined using the maximally selected rank statistics method, participants were stratified into higher (&gt;0.79) and lower (≤0.79) EASIX groups. Higher EASIX was significantly associated with increased all-cause mortality risk (HR 1.46, 95% CI 1.23–1.73, <i>p</i> &lt; 0.0001). Higher EASIX scores were associated with increased cardiovascular mortality, especially in former/current smokers and those with diabetes/prediabetes. Time-dependent receiver operating characteristic analysis assessed the predictive accuracy of EASIX, yielding area under the curve (AUC) for 1-, 3-, 5-, and 10-year survival of 0.71, 0.67, 0.67, and 0.67 for all-cause mortality and 0.79, 0.73, 0.73, and 0.71 for cardiovascular mortality. In conclusion, elevated EASIX is independently associated with increased all-cause and cardiovascular mortality in hypertensive patients, suggesting its potential as a predictive biomarker in clinical practice.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866048","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":"Association Between Visit-to-Visit Blood Pressure Variability and Incidence of Atrial Fibrillation in Hypertensive Patients: A Post-Hoc Analysis of the SPRINT Trial","authors":"Guixin Liu,&nbsp;Ning Wang,&nbsp;Keyang Zheng,&nbsp;Wenli Cheng","doi":"10.1111/jch.70052","DOIUrl":"https://doi.org/10.1111/jch.70052","url":null,"abstract":"<p>Visit-to-visit blood pressure variability (BPV) has been recognized as a cardiovascular risk factor, but its association with new-onset atrial fibrillation (AF) remains underexplored. This study investigated the relationship between BPV and AF incidence among hypertensive patients using data from the Systolic Blood Pressure Intervention Trial (SPRINT). Visit-to-visit BPV was quantified using standard deviation (SD), coefficient of variation (CV), and average real variability (ARV) of systolic and diastolic blood pressure measurements. Participants were stratified into three groups based on systolic BPV tertiles. AF cases were identified via follow-up electrocardiograms and reports of AF-related serious adverse events. After excluding individuals with baseline AF or missing BPV data, 7378 patients were analyzed over a median follow-up of 3.8 years. The incidence of new-onset AF increased across ascending tertiles of systolic BPV (CV), with rates of 2.5% (62 cases), 4.1% (104 cases), and 5.2% (127 cases) observed in the lowest to highest tertiles, respectively. After adjusting for age, race, blood pressure, and cardiovascular risk factors, the hazard ratios for AF in the second and third tertiles compared to the lowest tertile were 1.52 (95% CI: 1.10–2.09) and 1.83 (95% CI: 1.34–2.49), respectively. Consistent trends were noted for systolic BPV measured via SD and ARV, as well as diastolic BPV. These findings indicate that elevated visit-to-visit BPV independently predicts AF development in hypertensive populations. Assessing BPV may enhance risk stratification and identify patients at heightened risk for AF, underscoring its clinical relevance in hypertension management.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143865798","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}