Journal of Clinical Hypertension最新文献

{"title":"Association of Retinal Arterial Narrowing With New-Onset Carotid Plaque: A Chinese Community-Based Nested Case-Control Cohort Study","authors":"Yimeng Jiang,&nbsp;Shenshen Yan,&nbsp;Fangfang Fan,&nbsp;Jinqiong Zhou,&nbsp;Haicheng She,&nbsp;Danmei He,&nbsp;Ying Yang,&nbsp;Jia Jia,&nbsp;Yan Zhang","doi":"10.1111/jch.14983","DOIUrl":"https://doi.org/10.1111/jch.14983","url":null,"abstract":"<p>To investigate whether retinal arterial narrowing is associated with incident carotid plaque in the general population. Individuals without carotid plaque in 2014 who developed new-onset carotid plaque in 2018 were selected as cases (<i>n</i> = 156) for the atherosclerosis group and matched for age and sex in a ratio of 1:1 for the control group. The effects of the baseline central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), and arteriovenous ratio (AVR) on the risk of new-onset carotid plaque were evaluated in multivariable conditional logistic regression models. Subgroup analyses were performed. The mean CRAE, CRVE, and AVR were 153.03 ± 12.77 µm, 232.41 ± 19.78 µm, and 0.66 ± 0.07, respectively. After adjusting for multiple variables, the risk of developing new-onset carotid plaque increased by 4% (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.02–1.07, <i>p</i> &lt; 0.01) with each 1-µm decrease in CRAE and 80% (OR 1.80, 95% CI 1.17–2.78, <i>p</i> &lt; 0.01) with each 0.1-point decline in AVR. When CRAE and AVR were considered as categorical variables, compared with subjects in the highest CRAE and AVR groups, those in the lowest CRAE and AVR groups had a 159% (OR 2.59, 95% CI 1.34–5.01, <i>p</i> &lt; 0.01) and 93% (OR 1.93, 95% CI 1.08–3.46, <i>p</i> = 0.03) increase in risk of developing new-onset carotid plaque, respectively. However, CRVE was not significantly related to new-onset carotid plaque. Subgroup and interaction analyses were performed, and no significant modification effect was found. In conclusion, retinal arterial narrowing was strongly related to the risk of incident carotid plaque.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14983","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521866","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":"Modulatory Effects of Hypertension on Aging-Related White Matter Hyperintensities: A Comparative Study Among Stroke Patients and Stroke-Free Community-Based Cohort","authors":"Joseph A. Ackah,&nbsp;Du Heng,&nbsp;Xuelong Li,&nbsp;Lu Zheng,&nbsp;Jason Tsz Lok Chan,&nbsp;Michael Lung Cheung Lo,&nbsp;Jun Hu,&nbsp;Xiangyan Chen","doi":"10.1111/jch.70002","DOIUrl":"https://doi.org/10.1111/jch.70002","url":null,"abstract":"<p>The increased vulnerability of the aging human brain to hypertension-induced neurovascular impairments, including cerebral small vessel diseases (SVD), marked by MRI-visible white matter hyperintensities (WMH), is well recognized. We examined WMH burdens between stroke patients and stroke-free participants across three age groups and explored patterns of modifiable risk factors, specifically the modulating effects of hypertension on WMH burden, providing insights for potential therapeutic interventions. This study comprised one hospital-based cohort of 254 stroke patients and another community-based cohort of 254 stroke-free normative participants. Clinical variables were obtained consecutively, and MRI neuroimaging classified WMH as absent, mild, moderate, or severe. A step-by-step statistical analysis was performed to explore the said gaps. There were 508 participants (mean age 63.5 ± 8.9 years) with 285 males. A similar prevalence but different WMH burden was recorded between stroke and normative cohorts across different age groups. The modulating effect of hypertension on WMH severity varied across age groups and is greater in middle-aged adults; intriguingly, this effect diminished in elderly adults (<i>b</i> = −0.882, 95%CI [−1.591, –0.172], <i>t</i> = −2.442, <i>p</i> = 0.015). It was shown that, in a non-uniform fashion across different age groups, hypertension is a culprit risk factor for exacerbating WMH severity, and middle-aged adults are the most vulnerable. While the elevation of systolic blood pressure predisposes adults to brain white matter deterioration, the decline in diastolic blood pressure suggests a protective role. Recognizing hypertension as a modifiable risk factor and understanding the aging-related changes in blood pressure patterns open avenues for developing age-specific strategies for the mitigation and management of WMH progression.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521869","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":"Diabetes Mellitus and Hyperlipidemia Status Among Hypertensive Patients in the Community and Influencing Factors Analysis of Blood Pressure Control","authors":"Shijia Zhang,&nbsp;Yunou Yang,&nbsp;Xiongfei Chen,&nbsp;Liumei Fan,&nbsp;Jiagang Wu,&nbsp;Xiangyi Liu,&nbsp;Weiquan Lin,&nbsp;Zhiyu Zhai,&nbsp;Guozhen Lin,&nbsp;Hui Liu,&nbsp;Qin Zhou","doi":"10.1111/jch.14965","DOIUrl":"https://doi.org/10.1111/jch.14965","url":null,"abstract":"<p>To evaluate the prevalence of type 2 diabetes mellitus (T2DM) and hyperlipidemia in hypertensive patients in South China and assess the relationship between these comorbidities and blood pressure control to develop targeted strategies for hypertension management. Data from the 2020 Guangzhou National Basic Public Health Service Program were analyzed using Chi-square tests, <i>t</i>-tests, and logistic regression with R 4.1.2. Among 275,789 hypertensive patients, the blood pressure control rate was 51.51%. The prevalence of T2DM and hyperlipidemia comorbidities was 12.79%, with 12.78% for T2DM alone, 33.54% for hyperlipidemia alone, and 40.89% with no comorbidities. Blood pressure control rates significantly differed by comorbidity (<i>p</i> &lt; 0.05): 52.84% for those without T2DM/hyperlipidemia, 54.18%, 49.25% for T2DM or hyperlipidemia alone, and 50.52% for both conditions. Multivariate analysis indicated a lower blood pressure control rate in patients with hyperlipidemia alone (OR = 1.144) or both T2DM and hyperlipidemia (OR = 1.082), and a higher rate in those with T2DM alone (OR = 0.936). Subgroup analysis revealed that males, older age, higher education, obesity, alcohol use, lack of physical activity, and poor medication adherence were associated with lower control rates. This study found a high prevalence of diabetes and hyperlipidemia among hypertensive patients in Guangzhou. Additionally, hypertensive patients with hyperlipidemia had poorer blood pressure control compared to other diabetic patients. Key factors such as obesity, being overweight, and unhealthy lifestyle choices significantly impact blood pressure management in this population. Therefore, comprehensive measures should be implemented to integrate lipid management into community health efforts and to effectively control blood pressure levels among hypertensive patients.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14965","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143489775","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 Longitudinal Changes in Left Ventricular Structure and Function and 24-Hour Urinary Free Cortisol in Essential Hypertension","authors":"Gao-Zhen Cao,&nbsp;Jia-Yi Huang,&nbsp;Qing-Shan Lin,&nbsp;Run Wang,&nbsp;Cong Chen,&nbsp;Jian-Cheng Xiu,&nbsp;Kai-Hang Yiu","doi":"10.1111/jch.14979","DOIUrl":"https://doi.org/10.1111/jch.14979","url":null,"abstract":"<p>This study aimed to investigate the associations between 24-hour urinary cortisol levels (24 h-UFC) and alterations in left ventricular (LV) structure and function in patients with essential hypertension. A prospective cohort study was conducted, including 315 patients with essential hypertension who underwent baseline 24 h-UFC measurement and echocardiographic evaluation of left ventricular mass (LVM), left ventricular ejection fraction (LVEF), and the E/e′ ratio. Over a mean follow-up period of 28.54 ± 14.21 months, patients were grouped into tertiles based on baseline 24 h-UFC levels. Higher baseline 24 h-UFC levels were significantly associated with greater increases in LVM and E/e′, reflecting adverse LV remodeling and diastolic dysfunction. These associations persisted after adjusting for potential confounders, including age, gender, baseline blood pressure, and their changes during follow-up. Moreover, patients in the highest 24 h-UFC tertile showed an increased prevalence of LV hypertrophy, contrasting with a reduction observed in the lower tertiles. These findings underscore the independent role of elevated 24 h-UFC levels in driving adverse cardiac structural and functional changes in essential hypertension.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14979","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143489777","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":"Cardiovascular Outcomes in Initial and Sustained Orthostatic Hypotension: A Retrospective Cohort Study","authors":"Hui Geng,&nbsp;Dingfeng Fang,&nbsp;Xiahuan Chen,&nbsp;Meilin Liu","doi":"10.1111/jch.14976","DOIUrl":"https://doi.org/10.1111/jch.14976","url":null,"abstract":"<p>Classic orthostatic hypotension (OH) is a common geriatric disorder and is associated with cardiovascular risk. There is so far too few data available on the prognostic importance of initial OH and the comparison with sustained OH. This study investigated cardiovascular outcomes in initial and sustained OH in a cohort of patients aged ≥50 years. The study included 435 participants; 94 (21.6%) patients had initial (43, 45.7%) or sustained (51, 54.3%) OH, diagnosed by an active orthostatic test using the CNAP monitor. The median follow-up period was 65 months (inter-quartile range, 30 to 71). One hundred and fifty-nine (36.6%) of the patients had the primary outcome (a composite of major adverse cardiovascular events [MACE] and death from any cause), among which 142 (32.6%) had MACE, and 21 (4.8%) died. Analysis through Kaplan–Meier and further Cox regression models for multivariable adjustment both showed that, initial OH increased both the risk of the primary outcome and MACE (HR 2.20, 95% CI 1.39 to 3.50; HR 2.38, 95% CI 1.48 to 3.84), while didn't increase the mortality. In contrast, sustained OH increased both the risk of the primary outcome and MACE (HR 1.77, 95% CI 1.17 to 2.69; HR 1.71, 95% CI 1.09 to 2.70), as well as the mortality (HR 3.32, 95% CI 1.29 to 8.50). In conclusion, the preliminary exploration of this relatively small-sample study indicates that, OH, no matter initial or sustained OH, increased the cardiovascular risk in patients aged ≥50 years, while only sustained OH increased the risk of mortality.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14976","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143489776","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":"Directional Temporal Relationship Between Hypertension and Non-Alcoholic Fatty Liver Disease: A Cross-Lagged Cohort Study","authors":"Jianmin Tang,&nbsp;Halengbieke Aheyeerke,&nbsp;Xuetong Ni,&nbsp;Tengrui Cao,&nbsp;Xuan Wang,&nbsp;Shuo Chen,&nbsp;Yumei Han,&nbsp;Linrun Kong,&nbsp;Xinghua Yang","doi":"10.1111/jch.70012","DOIUrl":"https://doi.org/10.1111/jch.70012","url":null,"abstract":"<p>The temporal relationship between non-alcoholic fatty liver disease (NAFLD) and hypertension (HTN) remains unclear despite their known association. Using data from the Beijing Health Management Cohort (BHMC) with a 5-year follow-up, we investigated these bidirectional links through Cox proportional hazards regression and a cross-lagged panel model (CLPM), adjusting for confounders. Systolic/diastolic blood pressure (SBP/DBP) and hepatic steatosis index (HSI) were treated as continuous variables to enhance biological interpretability. Cox regression revealed that HTN increased the risk of NAFLD (hazard ratio [HR]: 1.15, 95% confidence interval [CI]: 1.01–1.30, <i>p</i> &lt; 0.05) among participants without NAFLD at baseline, while NAFLD elevated the risk of HTN (HR: 1.11, 95% CI: 1.02–1.21, <i>p</i> &lt; 0.05) among those without HTN at baseline. However, CLPM involving 7349 participants identified a unidirectional temporal relationship from HTN to NAFLD, regression coefficients <i>β</i>_{SBP2017→HSI2022}: 0.036 (95% CI: 0.012, 0.059), <i>β</i>_{DBP2017→HSI2022}: −0.044 (95% CI: −0.068, −0.020), both <i>p</i> &lt; 0.05; but not from NAFLD to HTN, regression coefficients <i>β</i>_{HSI2017→SBP2022}: 0.017 (95% CI: −0.003,0.037), <i>β</i>_{HSI2017→DBP2022}:0.006 (95% CI: −0.016,0.028), both <i>p</i> &gt; 0.05. Overall, our study demonstrates a unidirectional temporal association from HTN to NAFLD. However, a bidirectional relationship was also observed in individuals under 60 years and in those without central obesity. These findings highlight the importance of considering age and central obesity to manage HTN to reduce the risk of future NAFLD and to manage NAFLD to reduce the risk of future HTN.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481316","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":"Antihypertensive Drug Use and COVID-19 Disease Severity in Hospitalized US Veterans: A Retrospective Cohort Study","authors":"Merodean Huntsman,&nbsp;Jessica L. Marquez,&nbsp;Gregory J. Stoddard,&nbsp;Guo Wei,&nbsp;Aaron J. Miller,&nbsp;Jayant P. Agarwal,&nbsp;Sujee Jeyapalina","doi":"10.1111/jch.70021","DOIUrl":"https://doi.org/10.1111/jch.70021","url":null,"abstract":"<p>This research investigated associations between hypertensive patients with COVID-19 who did and did not use specific antihypertensive medications and had incurred hospital ventilation/death in the US Veterans Hospital System. This study included de-identified medical records of 572 994 hypertensive US veterans who were diagnosed with COVID-19 and hospitalized between March 1, 2020, and February 28, 2022, with a 60-day follow-up period. Mechanical ventilation and/or death within 60 days of COVID-19 hospitalization served as the outcome variables. On multivariable analysis, CCB use was associated with a 9% increased risk of mechanical ventilation, while ACE inhibitors (HR: 0.90), alpha blockers (HR: 0.92), and CCB (HR: 0.93) users were associated with a significantly decreased risk of death. Additional multivariable analysis on those with and without additional comorbidities, such as chronic kidney disease (CKD), heart failure, and diabetes, revealed that in those with at least one additional comorbidity, CCB uses led to a 9% increased deleterious risk for ventilation. In contrast, the use of ACE inhibitors (HR: 0.86), alpha blockers (HR: 0.92), and CCB (HR: 0.93) demonstrated a moderate protective effect against mortality. Lastly, in hypertensive veterans without any additional comorbidities, there was a lack of significant association between hypertensive medication usage and mechanical ventilation and/or death. In summary, although CCB use was associated with an increased risk of requiring mechanical ventilation, it also demonstrated a protective effect against mortality. At the same time, ACEI, alpha blocker, and CCB usage led to a significantly decreased risk for death within all hypertensive hospitalized COVID-19 veteran cohorts.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481318","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":"Associations of microRNA Gene Polymorphisms With Salt Sensitivity, Longitudinal Blood Pressure Changes, and Hypertension Incidence in the Chinese Population","authors":"Xi Zhang,&nbsp;Shi Yao,&nbsp;Yang Wang,&nbsp;Chao Chu,&nbsp;Mingfei Du,&nbsp;Jianjun Mu","doi":"10.1111/jch.70019","DOIUrl":"https://doi.org/10.1111/jch.70019","url":null,"abstract":"<p>MicroRNAs (miRNAs) are small endogenous RNA molecules that play an essential role in various disease processes including elevated blood pressure (BP). Although the effects of dietary salt and potassium intake on BP regulation have been established, their co-interaction with miRNAs are still unclear. The purpose of the current study was to explore the connection between miRNA gene polymorphisms and BP response to salt and potassium intake, and the relationship between miRNA gene polymorphisms and long-term BP changes and hypertension development. A total of 333 participants underwent a chronic sodium-potassium dietary intervention trial, which included a 3-day normal diet, followed by a 7-day low-salt diet, then a 7-day high-salt diet, and finally a 7-day high-salt with potassium-supplemented diet. This cohort was subsequently followed for up to 14 years. Single-nucleotide polymorphisms (SNPs) rs115254818 in miR-26b-3p, rs11191676 and rs2292807 in miR-1307-5p, and rs4143957 in miR-382-5p were significantly correlated with systolic BP (SBP) and mean arterial pressure (MAP) responses to high-salt intake, whereas rs11191676 and rs2292807 in miR-1307-5p exhibited significant associations with SBP response to potassium-supplemented diet. Furthermore, SNPs rs2070960 in miR-3620-5p and rs12364149 in miR-210-3p demonstrated significant correlations with diastolic BP and MAP alterations at 14 years of follow-up. Generalized linear mixed model analysis revealed a significant association between rs2070960 in miR-3620-5p and hypertension development over a 14-year period. Our study indicates that miRNA gene polymorphisms are pivotal in the salt and potassium sensitivity of BP, as well as in the longitudinal BP progression and hypertension incidence.</p><p><b>Trial Registration</b>: ClinicalTrials.gov identifier: NCT02734472</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481317","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 a New Model of Insulin Sensitivity and Hypertension in Patients With Type 2 Diabetes: A Cross-Sectional Study","authors":"Baolan Ji,&nbsp;Shuwei Shi,&nbsp;Guanqi Gao,&nbsp;Yangang Wang,&nbsp;Bo Ban","doi":"10.1111/jch.70008","DOIUrl":"https://doi.org/10.1111/jch.70008","url":null,"abstract":"<p>Type 2 diabetes (T2D) and hypertension often coexist, and insulin resistance (IR) plays an important role in their pathological progression. An increasing number of studies have focused on the relationship between different IR indices and hypertension. A natural log transformation of the glucose disposal rate (log_e GDR) has been proposed as a new model for insulin sensitivity in patients with T2D. The study aimed to explore the relationship between log_e GDR and hypertension in T2D patients. This cross-sectional study included 1544 Chinese T2D patients. Clinical and biochemical characteristics were collected. The log_e GDR was calculated based on triglycerides, urinary albumin to creatinine ratio, gamma-glutamyl transferase, and body mass index. Patients were categorized into hypertension and nonhypertension groups stratified by gender. Among both females and males, compared with the nonhypertension group, the level of log_e GDR was significantly decreased in the hypertension group (both <i>p</i> &lt; 0.001). As the log_e GDR increased, the levels of systolic and diastolic blood pressure, and the prevalence of hypertension were obviously increased (all <i>p</i> &lt; 0.001). Univariate analysis displayed that log_e GDR was negatively related to hypertension (correlation coefficient: −0.243, <i>p</i> &lt; 0.001 in females; correlation coefficient: −0.181, <i>p</i> &lt; 0.001 in males). Furthermore, the logistic regression analysis showed that log_e GDR was independently associated with hypertension (OR: 0.456; 95% CI: 0.224–0.927 in females; OR: 0.544; 95% CI: 0.314–0.941 in males). This study revealed that log_e GDR was closely related to hypertension, which might help monitor and manage hypertension in T2D patients.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481611","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":"Meta-Analysis of Real-World Clinical Practice to Assess the Effectiveness of Riociguat in Treating Chronic Thromboembolic Pulmonary Hypertension","authors":"Esra Pamukçu,&nbsp;Mehmet Onur Kaya","doi":"10.1111/jch.70015","DOIUrl":"https://doi.org/10.1111/jch.70015","url":null,"abstract":"<p>Riociguat is a drug that improves hemodynamic parameters and increases the exercise capacity of patients with chronic thromboembolic pulmonary hypertension (CTEPH). This meta-analysis evaluated cohort studies that measured changes in parameters such as the 6-minute walk distance (6MWD), mean pulmonary arterial pressure (mPAP), pulmonary vascular resistance (PVR), cardiac output (CO), and pulmonary arterial wedge pressure (PAWP). The study utilized cohort studies with a paired samples group design to measure the changes in these parameters. We searched for articles containing the keywords “Riociguat” and “Chronic thromboembolic pulmonary hypertension” in their titles in PubMed, Web of Science, Scopus, and ScienceDirect databases until May 2024. We conducted five meta-analyses to combine the mean difference values. We identified nine studies that examine the effects of Riociguat on patients. Analyzing data from 565 patients revealed that Riociguat increases the distance walked during the 6MWD test by an average of 35.86 m. After analyzing data from 717 patients, it was found that Riociguat reduces mPAP by an average of 9.23 mm Hg. Analyzing data from 586 patients, it was found that Riociguat reduces PVR by an average of 220.11 <span></span><math>\u0000 <semantics>\u0000 <mrow>\u0000 <mi>dyn</mi>\u0000 <mo>.</mo>\u0000 <mi>s</mi>\u0000 <mo>.</mo>\u0000 <mi>c</mi>\u0000 <msup>\u0000 <mi>m</mi>\u0000 <mrow>\u0000 <mo>−</mo>\u0000 <mn>5</mn>\u0000 </mrow>\u0000 </msup>\u0000 </mrow>\u0000 <annotation>${mathrm{dyn}}.{mathrm{s}}.{mathrm{c}}{{{mathrm{m}}}^{ - 5}}$</annotation>\u0000 </semantics></math>. Moreover, analyzing data from 643 patients showed that Riociguat increases CO by an average of 0.49 L/min. Finally, after analyzing data from 645 patients, it was concluded that Riociguat treatment did not have a statistically significant effect on PAWP. Our findings indicate that Riociguat improved certain hemodynamic parameters and exercise capacity in CTEPH patients.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424301","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}