Journal of Clinical Hypertension最新文献

{"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}

{"title":"Commentary on “Association of Plasma Homocysteine With Peripheral Arterial Disease in Hypertensive Adults: A Cross-Sectional Study”","authors":"Mostafa Javanian,&nbsp;Mohammad Barary,&nbsp;Mohammad Ranaee,&nbsp;Danial Hosseinzadeh,&nbsp;Soheil Ebrahimpour","doi":"10.1111/jch.70051","DOIUrl":"https://doi.org/10.1111/jch.70051","url":null,"abstract":"&lt;p&gt;Dear Editor,&lt;/p&gt;&lt;p&gt;We have carefully read the article “Association of Plasma Homocysteine with Peripheral Arterial Disease in Hypertensive Adults: A Cross-Sectional Study,” published recently in your esteemed journal [&lt;span&gt;1&lt;/span&gt;]. The main objectives of this examination were to ascertain the association between plasma homocysteine (Hcy) and peripheral artery disease (PAD) and the potential modifier factors in Chinese hypertensive adults. The results of the study indicate a strong relationship: an increase in plasma Hcy is clearly linked to an increase in PAD. Although we acknowledge the added value of the authors’ contribution to the current scientific literature, we argue that a few methodological and interpretative limitations deserve attention to improve the generalizability and robustness of the study's findings.&lt;/p&gt;&lt;p&gt;First, the investigation did not sufficiently consider confounding comorbidities, such as malignancies and autoimmune diseases, that could materially affect patient outcomes.&lt;/p&gt;&lt;p&gt;Second, more laboratory parameters should be included in the study. The overall validity of the conclusions is diminished by the lack of data on other markers such as zinc levels, vitamin B6, vitamin D, vitamin C, serum liver function tests, and ratios such as the monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), systemic inflammatory response index (SIRI), and systemic immune-inflammatory index (SII) [&lt;span&gt;2, 3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Third, it did not include extensive documentation of the participants’ pharmacological regimens, especially with nonsteroidal anti-inflammatory drugs (NSAIDs) and proton pump inhibitors (PPIs). Exclusion of these important treatment characteristics can lead to bias, and the interpretation of identified associations can be difficult.&lt;/p&gt;&lt;p&gt;Additionally, many key demographic and lifestyle-related factors (e.g., socioeconomic status, education, and opium use) were not accounted for in the analysis, limiting the generalizability of the results. Furthermore, the adjustments made for insulin resistance, exercise, family history of PAD, and heavy metal (lead, cadmium, and arsenic) exposure were inadequate. A more rigorous and precise classification of PAD is also warranted in fortifying the study's methodologic structure [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;In conclusion, we appreciate the authors’ significant contribution regarding the relationship between plasma Hcy and PAD, but the study could be significantly strengthened if these limitations were acknowledged and addressed.&lt;/p&gt;&lt;p&gt;&lt;b&gt;Mostafa Javanian:&lt;/b&gt;conceptualization, investigation, and supervision.&lt;b&gt;Mohammad Barary&lt;/b&gt;: investigation, writing–original draft preparation, and writing–review and editing. &lt;b&gt;Mohammad Ranaee&lt;/b&gt;: investigation and writing–original draft preparation. &lt;b&gt;Danial Hosseinzadeh&lt;/b&gt;: investigation and writing–original draft preparation. &lt;b&gt;Soheil Ebrahimpour&lt;/b&gt;: investigation, supervision, and wr","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856861","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":"Obesity, Visceral Adipose Tissue, and Essential Hypertension: Evidence From a Mendelian Randomization Study and Mediation Analysis","authors":"Chen Cheng,&nbsp;Zheng Li,&nbsp;Yue Su,&nbsp;Jin-Yu Sun,&nbsp;Chang-Hao Xu,&nbsp;Xiang-Qing Kong,&nbsp;Wei Sun","doi":"10.1111/jch.70045","DOIUrl":"https://doi.org/10.1111/jch.70045","url":null,"abstract":"<p>This study aims to investigate the causal relationship between obesity and essential hypertension, and evaluate the mediation effect of visceral adipose tissue (VAT) by Mendelian randomization (MR) analysis. We included body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), WC adjusted for BMI (WCadjbmi), and WHR adjusted for BMI (WHRadjbmi) as obesity-related anthropometric traits. In the bidirectional MR analyses, we found that higher BMI (OR, 1.638; <i>p</i> = 3.97 × 10⁻¹⁹), WC (OR, 1.702; <i>p</i> = 1.45 × 10⁻¹²), and WHR (OR, 1.863; <i>p</i> = 1.84 × 10⁻⁸) were significantly associated with increased risk of essential hypertension, while no evidence of reverse causality was observed. Then, in the two-step MR analyses, all five anthropometric traits had a positive and significant association with VAT mass, especially WC (OR, 2.315; <i>p</i> = 1.00 × 10⁻²¹⁰). Meanwhile, higher predicted VAT mass was significantly associated with increased risk of essential hypertension (OR, 1.713; <i>p</i> = 1.18 × 10⁻³⁸). Furthermore, the mediation analyses revealed that VAT had a significant mediation effect on the causal relationship between obesity-related anthropometric traits and essential hypertension, and mediated proportions in BMI, WC, and WHR were 77.8%, 80.1%, and 41.4%, respectively. Finally, the sensitivity analyses using two other datasets showed a similar result. In conclusion, our results showed that BMI, WC, and WHR have a positive and significant association with increased risk of essential hypertension. Moreover, VAT has a significant mediation effect on the causal relationship between obesity-related anthropometric traits and essential hypertension. Our study provided important statistical evidence suggesting that VAT may play a crucial meditation role in the occurrence and development of obesity-related hypertension.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856776","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":"Age-Dependent Associations Between Pulse Pressure and Long-Term Outcomes After Myocardial Infarction","authors":"Congliang Miao,&nbsp;Dandan Zhao,&nbsp;Shuohua Chen,&nbsp;Lina Xu,&nbsp;Yusong Huang,&nbsp;Huimin Li,&nbsp;Huibiao Deng,&nbsp;Lili Wu,&nbsp;Yuchen Wang,&nbsp;Yu Fu,&nbsp;Guoyan Wu,&nbsp;Shouling Wu,&nbsp;Jiang Hong,&nbsp;Wen-Yi Yang","doi":"10.1111/jch.70043","DOIUrl":"https://doi.org/10.1111/jch.70043","url":null,"abstract":"<p>Pulse pressure (PP) is a recognized marker of cardiovascular risk in the general population. However, its role as an independent predictor of recurrent cardiovascular events following myocardial infarction (MI) and whether there are age-dependent differences in this relationship remains uncertain. We analyzed data from 4091 participants with a history of MI were enrolled in the Kailuan Study. Univariate and multivariable Cox models were used to analyze the associations between PP and primary outcome (composite cardiovascular events, a composite of all-cause death, nonfatal recurrent MI, nonfatal hospitalization for heart failure or nonfatal stroke) and secondary outcomes (each individual components of composite endpoint) after MI. Over a median follow-up of 7.8 years, 1610 composite cardiovascular events occurred. The mean baseline PP was 54.2 ± 16.1 mmHg. Compared with individuals in the first PP quartile, those in the fourth quartile had significantly greater risks of composite cardiovascular events (adjusted HR: 1.20; 95% CI: 1.03–1.41; <i>p</i> = 0.02) and recurrent MI (adjusted HR: 1.56; 95% CI: 1.03–2.36; <i>p</i> = 0.04). A linear, dose–response relationship was observed between PP and the risk of adverse cardiovascular outcomes (all <i>p</i> ≤ 0.02), except for stroke (<i>p</i> = 0.36). Subgroup analyses indicated that the association between PP and adverse outcomes was stronger among participants aged &lt;60 years compared with older individuals. Elevated PP is an independent predictor of recurrent cardiovascular outcomes in post-MI patients, with particularly stronger associations observed in younger and middle-aged adults.</p><p><b>Trial Registration</b>: ChiCTR-TNRC-11001489</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856992","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}