Journal of Clinical Hypertension最新文献

{"title":"Improving the Generalizability and Risk Interpretation of Adolescent Hypertension Research: A Commentary on Loo et al.","authors":"Aisha Fatima, Mubashira Noor, Syeda Eraj Zehra Rizvi, Muhammad Hassan Saeed","doi":"10.1111/jch.70150","DOIUrl":"https://doi.org/10.1111/jch.70150","url":null,"abstract":"<p>Dear Editor,</p><p>We have read with interest the article ‘’Blood Pressure and Hypertension in Adolescents and Young Adults: Results From a Nationwide Screening Program ‘’by Loo et al. [<span>1</span>]. The authors' investigation into the prevalence of hypertension among Asian adolescents and young adults in Singapore is a remarkable contribution to the existing literature. A noteworthy advancement which offers insights that can play a pivotal role in future studies and public health initiatives. However, several methodological and contextual considerations warrant discussion to strengthen the study's interpretation and applicability.</p><p>As the study focuses solely on a Singaporean male population, its findings, particularly regarding risk factors such as diet and environmental exposures, may reflect region-specific trends. Previous studies, such as that by Meher et al., emphasize the significant impact of dietary habits, salt intake, and alcohol consumption, and these factors are not addressed in the current study [<span>2</span>]. Multicenter data collection would have enhanced the generalizability. The exclusion of females further limits generalizability, as blood pressure patterns are known to differ by sex. Including both genders would have yielded more representative and inclusive findings [<span>3</span>].</p><p>This study did not identify smoking as a significant factor in hypertension, which further contradicts the existing evidence, which suggests that smoking can increase the risk up to two to three folds [<span>4</span>]. Although the author's explanation regarding limited smoking exposure due to age is understandable, interpretation of the findings should be made with caution as it might mislead. Future studies should focus on the potential long-term effects of smoking initiation at adolescence. Additionally, the study did not evaluate secondary causes (such as renal or endocrine conditions) relevant in the younger populations [<span>5</span>]. These considerations would have provided a more comprehensive understanding of hypertension in this population and informed more effective prevention and treatment strategies.</p><p>Although the cross-sectional design provides a valuable snapshot in time, it does not evaluate the progression of blood pressure overtime. This limits further understanding of how early hypertension might later on progress into cardiovascular disease. Longitudinal follow-up is essential to understand whether early hypertension leads to adverse cardiovascular outcomes. Chen and Wang demonstrated that childhood blood pressure tracks into adulthood, underscoring the importance of longitudinal studies [<span>6</span>]. Socioeconomic status and environmental factors, which significantly influence adolescent blood pressure, were not considered, introducing potential residual confounding. These factors are known to influence adolescent blood pressure and should be prioritized in future analyses [<span>7</span>]. Add","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 9","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110894","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":"Amlodipine-Based Therapy and Its Effect on Time in Target Range and Long-Term Blood Pressure Variability Across Age Groups in Chinese Patients With Primary Hypertension: A Retrospective Study","authors":"Jinghan Yang,&nbsp;Shuling Chen,&nbsp;Dajun Chai,&nbsp;Feng Peng,&nbsp;Ningling Sun,&nbsp;Jinxiu Lin","doi":"10.1111/jch.70151","DOIUrl":"https://doi.org/10.1111/jch.70151","url":null,"abstract":"<p>This study aimed to compare systolic blood pressure (SBP) time in target range (TTR), long-term blood pressure (BP) variability (BPV), and BP control across age groups (18–45, 46–64, 65–79, ≥80 years) in patients with primary hypertension treated with amlodipine-based antihypertensive therapy for ≥12 months. Data were obtained from adult patients enrolled in the China Hypertension Center who received amlodipine-based antihypertensive therapy. Demographics, BP measurements, and laboratory results were recorded. Baseline characteristics, SBP TTR, long-term BPV, and BP control were compared among age groups. A total of 36 153 patients were included: 2681 in the 18–45 group, 14 300 in the 46–64 group, 15 595 in the 65–79 group, and 3577 in the ≥ 80 group. Younger and middle-aged patients demonstrated better indicator improvements. SBP TTR declined with age (82.52% ± 19.68%, 81.98% ± 20.69%, 79.10% ± 22.96%, and 78.33% ± 23.50%, respectively; <i>p</i> &lt; 0.001). BP control also declined with age (84.04%, 83.20%, 80.44%, and 79.59%, respectively; <i>p</i> &lt; 0.001). BPV increased with age, though not significantly (<i>p</i> = 0.051). During follow-up, SBP TTR and BP control improved, while BPV declined, with most changes reaching statistical significance. Across all age groups, SBP TTR remained above 78% throughout follow-up. Long-term continuous use of amlodipine is beneficial for achieving improved BP control, enhanced TTR, and reduced BPV.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 9","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70151","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110896","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 Platelet to High-Density Lipoprotein Cholesterol Ratio and Cardiometabolic Multimorbidity in Middle-Aged and Elderly Chinese Hypertensive Patients","authors":"Yang Zheng,&nbsp;Yubing Huang,&nbsp;Haitao Li","doi":"10.1111/jch.70138","DOIUrl":"https://doi.org/10.1111/jch.70138","url":null,"abstract":"<p>Hypertensive patients exhibit elevated risk for cardiometabolic multimorbidity (CMM). The platelet-to-high-density lipoprotein cholesterol ratio (PHR) has emerged as a biomarker for cardiovascular risk assessment. However, the precise relationship between PHR and CMM remains inconclusive. To assess the association between PHR and CMM risk among middle-aged and elderly Chinese hypertensive patients. We included patients with documented hypertension history using data from the China Health and Retirement Longitudinal Study. Participants were stratified into tertiles per baseline PHR. Logistic regression models examined the PHR-CMM risk association. To evaluate nonlinear relationships, restricted cubic splines (RCS) were built. Subgroup analyses were used to assess effect modification across population characteristics. Sensitivity analysis was performed by reclassifying participants into quartiles per baseline PHR. 4355 middle-aged and elderly Chinese hypertensive patients were included. Logistic regression showed that in the fully adjusted model, each one-standard-deviation (Per SD) increase in PHR was significantly associated with a 19% higher CMM risk (OR = 1.19, 95% CI: 1.06–1.32, <i>p</i> &lt; 0.01). Compared with the lowest tertile group, patients in the highest PHR tertile exhibited a significantly increased CMM risk (OR = 1.76, 95% CI: 1.27–2.46, <i>p</i> &lt; 0.001), with no significant nonlinear relationship (<i>p</i> for nonlinear = 0.613). PHR-CMM association showed no significant interaction across subgroups (<i>p</i> for interaction &gt;0.05). Sensitivity analysis results were consistent with primary findings. Elevated PHR levels were associated with increased CMM risk among middle-aged and elderly Chinese hypertensive patients. Monitoring PHR may help predict CMM risk in elderly individuals with hypertension.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 9","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110893","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":"Identify Sensitive Periods for Onset and Resolution of Hypertension and Its Subtypes Over the Lifespan","authors":"Xin Meng,&nbsp;Chaonan Gao,&nbsp;Jingfan Xiong,&nbsp;QianJin Qi,&nbsp;Wei Liu,&nbsp;Yongxi Xue,&nbsp;Hongbo Dong,&nbsp;Jie Mi,&nbsp;Yinkun Yan","doi":"10.1111/jch.70154","DOIUrl":"https://doi.org/10.1111/jch.70154","url":null,"abstract":"<p>Hypertension represents a significant public health issue globally, yet the age-related changes in prevalence and transition patterns of blood pressure (BP) categories and hypertension subtypes throughout the lifespan remain unclear. This dynamic cohort study included 22 858 participants aged 3–80 years from the China Health and Nutrition Survey 1989–2015. Participants were categorized into eight sub-cohorts based on baseline age in 10-year intervals, i.e., 3–10, 11–20, 21–30, 31–40, 41–50, 51–60, 61–70, and 71–80 years. The study found that for participants with normal BP, the probabilities of developing hypertension over a 10-year follow-up period increased with age during adulthood, with the probabilities of developing systolic hypertension surpassing those of diastolic hypertension beginning at 41–50 years. In comparison, for participants with hypertension, the probabilities of reverting to normal BP generally decreased with age during adulthood, with those aged 11–20 years having the highest probabilities. The probabilities of maintaining hypertension showed contrasting age-related trends. These findings remained largely unchanged in additional analyses of adjustment for covariates, being restricted to a 20-year follow-up or being stratified by sex. In conclusion, individuals with normal BP are more likely to develop hypertension in late adulthood, whereas those with hypertension are more likely to revert to normal BP during adolescence. The age-related changes in prevalence and dynamic transition of hypertension over the lifespan underscore the necessity for developing age-appropriate prevention and intervention strategies.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 9","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110936","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":"Effect Modification of Sex and Hypertension Status on the Association Between Systolic Time-in-Target-Range and Cardiovascular Outcomes","authors":"Neil Garg,&nbsp;Aayush Visaria","doi":"10.1111/jch.70148","DOIUrl":"10.1111/jch.70148","url":null,"abstract":"&lt;p&gt;To the Editor,&lt;/p&gt;&lt;p&gt;It is with pleasure that we read the work of Agarwal et al. titled “Association of Systolic Blood Pressure Time in Target Range With Cardiovascular Events Among PRECISION Participants” [&lt;span&gt;1&lt;/span&gt;], which demonstrated that participants with systolic blood pressure (SBP) within a target range (TTR) of 110–130 mmHg for a longer duration (&gt;75% vs. &lt;25%) had a lower risk of major adverse cardiovascular events (MACE) using both traditional and Rosendaal TTR methods. We were particularly surprised with the significant effect modification of sex and hypertension status on SBP TTR and would like to provide additional insight.&lt;/p&gt;&lt;p&gt;Women had lower risks of MACE at each level of TTR compared to men. Men, in fact, demonstrated no significant association between TTR and MACE. We speculate that this is due to both selection bias and physiologic differences: (1) the PRECISION trial used different inclusion criteria for men and women, including differences in age, insulin use, and cardiometabolic morbidities. This was likely in part due to the high prevalence of women with rheumatoid arthritis necessitating amended criteria to ensure adequate inclusion of men [&lt;span&gt;2&lt;/span&gt;]. Such differences may reflect baseline differences in ASCVD risk and an imbalance of comorbidities. For example, women, in general, are less likely to have hypertension and be using antihypertensives for primary prevention rather than secondary prevention. This coincides with lack of significant effects in the subgroup for secondary prevention and with hypertension; (2) secondly, the selected target range (110–130 mm Hg) may have aligned more with average women BP, as women tend to have lower BP than men and only begin approaching that of men in the eighth decade [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Hypertension status was also an effect modifier. We speculate that differential misclassification bias from measurement error likely drives some of the lack of difference seen in participants with hypertension. Those with hypertension are more likely to have higher SBP variability, which is not captured from routine office visit-based TTR. Thus, there may be individuals in the &gt;75% TTR group with actual lower TTR, regressing the effect estimates towards the null. Those without hypertension are less likely to have SBP variability, and thus, TTR is likely prone to less misclassification [&lt;span&gt;4&lt;/span&gt;]. Additionally, participants in the PRECISION trial were administered nonsteroidal anti-inflammatory drugs (NSAIDs), which are known to increase BP, CKD risk, and may have contributed to elevated MACE risk in participants with hypertension [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Future studies should also report diastolic BP TTR and HR TTR to get a more complete picture of hemodynamics. Abnormal DBP patterns may have influenced the effect modifications observed [&lt;span&gt;6&lt;/span&gt;]. Furthermore, the study cohort consisted mostly of older adults whose vessels are likely of lower elasticity, lea","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 9","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083296","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":"Effects of Two Allisartan Isoproxil-Based Antihypertensive Therapies on Sexual Function and Blood Pressure in Male Hypertensive Patients: A Single-Center, Open-Label, and Randomized Controlled Trial","authors":"Mingming Wang,&nbsp;Jianshu Chen,&nbsp;Miaomiao Qi,&nbsp;Runmin Sun,&nbsp;Zhangyou Long,&nbsp;Quanbin Su,&nbsp;Yanhong Mou,&nbsp;Hengxia Liu,&nbsp;Qiongying Wang,&nbsp;Qiang Wu,&nbsp;Xiaowei Zhang,&nbsp;Jing Yu","doi":"10.1111/jch.70145","DOIUrl":"10.1111/jch.70145","url":null,"abstract":"<p>This study evaluated the effects of allisartan isoproxil combined with amlodipine besylate tablets (Group A+C) or metoprolol succinate extended-release tablets (Group A+B) on sexual function and nighttime blood pressure (nBP) in 130 male patients with essential hypertension (EH). Patients were randomized to two groups. After 6-month, the IIEF-15 total score (ITS) of sexual function significantly improved in Group A+C (<i>p</i> = 0.015), including intercourse satisfaction (IS) (<i>p</i> = 0.003), orgasmic function (OF) (<i>p</i> = 0.021), and overall satisfaction (OS) (<i>p</i> = 0.019), while erectile function (EF) (<i>p</i> = 0.081) and sexual desire (SD) (<i>p</i> = 0.08) were unchanged. In contrast, the ITS was decreased (<i>p</i> = 0.008), including EF (<i>p</i> = 0.005), IS (<i>p</i> = 0.048), SD (<i>p</i> = 0.003), and OS (<i>p</i> = 0.010), but OF remained unchanged (<i>p</i> = 0.076) in Group A+B. Between-group comparisons confirmed significant differences across IIEF-15 domains (all <i>p</i> &lt; 0.05). Compared to baseline, office systolic BP (OSBP), office diastolic BP (ODBP), nighttime average SBP (nSBP), and nighttime average DBP (nDBP) were significantly reduced at 6 months in two groups (all <i>p</i> &lt; 0.05). Although nSBP fall (nSBPF) (<i>p</i> = 0.010) and nDBP fall (nDBPF) (<i>p</i> = 0.002) significantly increased in Group A+C. In Group A+C, the nighttime-daytime BP fall ratio of SBP was 1.04 (0.45, 1.70) and that of DBP was 1.13 (0.38, 1.44) after treatment, with a median value &gt; 1, indicating that nBP fall after treatment was greater than dBP fall. Compared to Group A+B, ODBP (difference = −4.00 mmHg, 95% CI [−7.64, −0.36], <i>p</i> = 0.032), daytime average DBP (difference = −5.47 mmHg, 95% CI [−10.05, −0.79], <i>p</i> = 0.023) and 24-h average DBP (difference = −5.77 mmHg, 95% CI [−10.31, −1.24], <i>p</i> = 0.014) decreased more significantly in Group A+C, nDBPF increased significantly (difference = 4.99 mmHg, 95% CI [0.04, 9.93], <i>p</i> = 0.048), and the decrease in the nighttime-daytime BP fall ratio of SBP and DBP was higher (<i>p</i> &lt; 0.05). It was concluded that combined antihypertension of allisartan isoproxil with amlodipine besylate tablets improved sexual function in male hypertensive patients in terms of the ITS, IS, OF, and OS, but there was no significant improvement in EF and SD. Both combined antihypertensive regimens were effective in lowering BP, but allisartan isoproxil combined with amlodipine besylate tablets demonstrated more advantageous in lowering DBP and nBP.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 9","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083291","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":"Long-Term Blood Pressure Variability and Physical Performance in Older Adults","authors":"Kerry M. Sheets,&nbsp;Katherine L. Webb,&nbsp;Robyn L. Woods,&nbsp;Suzanne G. Orchard,&nbsp;Lawrence Beilin,&nbsp;Michelle A. Fravel,&nbsp;Christopher M. Reid,&nbsp;Kevan R. Polkinghorne,&nbsp;Rory Wolfe,&nbsp;Zhen Zhou,&nbsp;Joanne Ryan,&nbsp;Anne M. Murray,&nbsp;Michael E. Ernst","doi":"10.1111/jch.70139","DOIUrl":"10.1111/jch.70139","url":null,"abstract":"<p>High variability in long-term blood pressure (BPV) independently predicts cardiovascular disease and cognitive decline. Increased BPV and declining physical performance may share mechanistic pathways. However, associations of BPV with gait speed and grip strength have not been examined. We completed a gender-stratified analysis of 16 692 participants enrolled in ASPREE/ASPREE-XT. Systolic and diastolic BPV were estimated from baseline-year 2 (Y2); gait speed/grip strength were assessed every 1–2 years following this period. Linear mixed models examined gait speed/grip strength trajectories over a median of 7.3 years of follow-up after Y2. Following adjustment, men with SBPV in tertile 3 (T3) versus T1 had slower gait speed at Y2 (0.021 m/s slower) and greater declines in gait speed (0.003 m/s greater decline/year, <i>p</i> &lt; 0.001). Women with SBPV in T3 versus T1 had slower gait speed at Y2 (0.018 m/s slower), but similar rates of gait speed decline. Men with higher SBPV had weaker grip strength at Y2 (0.994 kg weaker for BPV T3 vs. T1) and greater declines in grip strength (0.016 kg greater decline/year/5 mmHg increase in BPV, <i>p</i> = 0.006). Women with BPV in T3 versus T1 had 0.486 kg weaker grip strength at Y2, but similar rates of grip strength decline. Associations of DBPV and SBPV with gait speed/grip strength were largely consistent. In summary, we found that higher BPV was independently associated with slower gait speed and weaker grip strength cross-sectionally in men and women, but only associated with trajectories of gait speed and grip strength in men. Future studies should examine high BPV as a target to preserve physical performance.</p><p><b>Trial Registration</b>: ISRCTN number: ISRCTN83772183; ClinicalTrials.gov identifier: NCT01038583</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 9","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077190","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 Accuracy of 24-Hour Urinary Aldosterone for Primary Aldosteronism in Northeast China","authors":"Kaiwen Sun,&nbsp;Minghui Gong,&nbsp;Yang Yu,&nbsp;Minghui Yang,&nbsp;Yinong Jiang,&nbsp;Ying Zhang,&nbsp;Wei Song","doi":"10.1111/jch.70130","DOIUrl":"10.1111/jch.70130","url":null,"abstract":"<p>This study aimed to evaluate the diagnostic accuracy of 24-hour urinary aldosterone (UALD) for primary aldosteronism (PA) in Northeast China. A total of 423 patients with hypertension were consecutively enrolled. After 1:2 propensity score matching (PSM), 100 patients were classified into the PA group, and 194 patients were classified into the essential hypertension (EH) group. The clinical characteristics and biochemistry measurements were collected and analyzed. A receiver operating characteristic (ROC) curve was generated, and the area under the curve (AUC) was calculated to determine optimal diagnostic thresholds. No significant difference in age was observed between the groups (PA: 53.4 ± 11.3 years vs. EH: 52.8 ± 11.3 years, <i>p</i> &gt; 0.05). The median 24-hour UALD was significantly greater in the PA group (6.4 [3.7, 13.9] µg/24 h vs. 4.8 [2.5, 7.8] µg/24 h, <i>p</i> &lt; 0.05), with levels declining with age in both cohorts. The optimal UALD cutoff value was 11.4 µg/24 h (AUC = 0.652; Youden index = 0.257). For patients over 55 years, the 24-hour urinary aldosterone-to-creatinine ratio (UACR) showed superior diagnostic performance, with an optimal cutoff of 0.8 µg/mmol/L (AUC = 0.695). 24-Hour UALD was a promising diagnostic marker for PA in North China, whereas 24-hour UACR might increase accuracy in older populations. However, further studies are needed to validate these findings.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 9","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077151","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":"2025 Thai Hypertension Society Guidance for Ambulatory Blood Pressure Monitoring in Adults","authors":"Sirisawat Wanthong,&nbsp;Pairoj Chattranukulchai,&nbsp;Chavalit Chotruangnapa,&nbsp;Praew Kotruchin,&nbsp;Weranuj Roubsanthisuk,&nbsp;Prin Vathesatogkit,&nbsp;Apichard Sukonthasarn","doi":"10.1111/jch.70136","DOIUrl":"10.1111/jch.70136","url":null,"abstract":"<p>More than 40 years of research has consolidated ambulatory blood pressure monitoring (ABPM) as a validated choice in out-of-office blood pressure (BP) measurement methods other than home BP measurement (HBPM). ABPM can evaluate 24-h BP and BP variability. ABPM improves the diagnosis of hypertension phenotypes such as white coat hypertension, masked hypertension, dipper or non-dipper. BP values derived from ABPM had better prognostic values than clinic BP. Ambulatory BP devices have been available in Thailand for several years. This recommendation of the Thai Hypertension Society for ABPM was designed to apply this practical knowledge, based on our limited health resource circumstances, to help guide clinical practice and improve the treatment and control of hypertension among the adult Thai population.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 9","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145077175","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":"Integrating Sleep Disruption, Dietary Changes, and Therapy in Assessing the Effects of Ramadan Fasting on Blood Pressure","authors":"Mucahit Yetim,&nbsp;Abdullah Sarıhan,&nbsp;Macit Kalçık","doi":"10.1111/jch.70142","DOIUrl":"https://doi.org/10.1111/jch.70142","url":null,"abstract":"&lt;p&gt;Dear Editor,&lt;/p&gt;&lt;p&gt;We have read with great interest the article by Tezcan and Büyükterzi on the effect of Ramadan fasting on blood pressure and kidney function in newly diagnosed hypertensive patients [&lt;span&gt;1&lt;/span&gt;]. The study contributes valuable data on a unique and culturally relevant context. However, we would like to raise several methodological and interpretative issues that may affect the generalizability of the conclusions.&lt;/p&gt;&lt;p&gt;The retrospective design and single-center setting may limit the strength of causal inferences. Previous studies have emphasized that prospective, multicenter cohorts are better suited to capture the heterogeneous impact of fasting across different populations [&lt;span&gt;2&lt;/span&gt;]. The authors acknowledge this limitation, but its implications deserve stronger emphasis, particularly considering dietary, lifestyle, and medication adherence variability.&lt;/p&gt;&lt;p&gt;All patients in the study received a diuretic-containing regimen. While this provides uniformity, it restricts external validity. Other antihypertensive classes, such as calcium channel blockers or beta-blockers, may interact differently with fasting physiology. Dietary sodium intake and hydration patterns that strongly influence blood pressure and renal function were not systematically assessed. Prospective trials with structured food-frequency questionnaires and biochemical markers have shown that these parameters substantially modify outcomes during Ramadan [&lt;span&gt;3&lt;/span&gt;]. Neglecting them may underestimate important confounders. Therefore, it remains uncertain whether the findings apply broadly to hypertensive patients treated with varied regimens.&lt;/p&gt;&lt;p&gt;Another important factor that warrants attention is the alteration of sleep patterns during Ramadan. The practice of waking up for suhoor (pre-dawn meal) often leads to fragmented nocturnal sleep and daytime somnolence. Disrupted circadian rhythms are known to influence blood pressure variability and autonomic balance, potentially confounding the observed outcomes [&lt;span&gt;4&lt;/span&gt;]. Since sleep quality was not evaluated in the present study, its interaction with blood pressure and kidney function during fasting remains uncertain.&lt;/p&gt;&lt;p&gt;Although the authors report no significant deterioration in kidney function, longer follow-up is essential. Renal adaptation to repeated annual fasting periods may differ from short-term observations. Indeed, longitudinal studies highlight that subtle cumulative effects may only emerge over years rather than a single month [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In conclusion, this article provides a useful foundation for understanding Ramadan fasting in newly diagnosed hypertensive patients, but further prospective, multicenter, and regimen-diverse studies—also accounting for sleep patterns and lifestyle changes—are warranted to establish robust clinical recommendations.&lt;/p&gt;&lt;p&gt;Sincerely,&lt;/p&gt;&lt;p&gt;Mucahit Yetim, Abdullah Sarıhan, and Macit Kalçık&lt;/p&gt;&lt;p&gt;Department of Cardiology, Faculty of Medi","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 9","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145062356","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}