Journal of Clinical Hypertension最新文献

{"title":"Additional Non-Pharmacological Intervention for Elderly Patients With Hypertension","authors":"Tomoyuki Kawada","doi":"10.1111/jch.70054","DOIUrl":"https://doi.org/10.1111/jch.70054","url":null,"abstract":"<p>To the Editor,</p><p>I read with interest the article by Xu and colleagues [<span>1</span>]. The authors evaluated the effectiveness of the knowledge, attitude, practice (KAP) intervention model for elderly patients with hypertension. They compared the change of blood pressure before and after the KAP intervention for a period of 1 year. The blood pressure control rate and the mean values of systolic (SBP) and diastolic blood pressure (DBP) improved significantly, and they concluded that the community physician-led KAP intervention model was effective in the management of hypertension in the elderly. I have some concerns about their study.</p><p>Loucks and colleague [<span>2</span>] conducted a 2-year follow-up study to investigate the effect of the Mindfulness-Based Blood Pressure Reduction (MB-BP) program on SBP, regardless of whether they were prescribed antihypertensive medications. MB-BP was significantly associated with a reduction in SB. Although KAP and MB-BP are different concepts, a non-pharmacological approach to blood pressure management may contribute to reducing the risk of hypertension. Medical treatment and non-pharmacological approaches such as KAP and MB-BP would integrate the efficacy of reducing blood pressure.</p><p>I think that elderly hypertensive patients should pay attention to emotional disorders such as depression. Regarding the effect of mental disorder on hypertension, Jeon and colleagues [<span>3</span>] reported that the adjusted hazard ratios (95% confidence intervals) of moderate and severe depressive symptoms for incident hypertension were 1.12 (1.02–1.24) and 1.29 (1.10–1.50). They also clarified that high blood pressure was associated with a decreased risk of developing depressive symptoms. This means that depressive status would affect subsequent increase in blood pressure, and mental care is important to prevent hypertension.</p><p>Finally, Mir and colleagues [<span>4</span>] reviewed the effect of mindfulness-based meditation (MBM) on blood pressure among adults with elevated blood pressure and hypertension. MBM interventions are effective for preventing hypertension and reducing elevated blood pressure. According to a meta-analysis by Chen and colleagues [<span>5</span>], significant reductions in SBP and DBP were observed by MB interventions regardless of gender and baseline blood pressure. I suppose that KAP would become a fundamental basis to improve the efficacy of MB-BP intervention. A randomized control trial with sufficient statistical power and long-term follow-up is needed to understand the combined effect of KAP and MBM intervention on subsequent advantages for controlling hypertension.</p><p>The author declares no conflicts of interest.</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.70054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856863","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":"Nonlinear Association Between the Visceral-to-Subcutaneous Fat Area Ratio and the Risk of Hypertension in Prediabetic Individuals: Evidence From a Large-Scale Health Screening Dataset in China","authors":"Ao Liu,&nbsp;Zhi Zou,&nbsp;Yongbing Sun,&nbsp;Jing Zhou,&nbsp;Zhonglin Li,&nbsp;Xiaoling Wu,&nbsp;Xue Lv,&nbsp;Hao Li,&nbsp;Tao Li,&nbsp;Zhiping Guo,&nbsp;Yong Wang,&nbsp;Xiao Ma,&nbsp;Yongli Li","doi":"10.1111/jch.70056","DOIUrl":"https://doi.org/10.1111/jch.70056","url":null,"abstract":"<p>Abdominal fat distribution, particularly the visceral-to-subcutaneous fat area ratio (V/S ratio), offers a promising avenue for exploring the development of hypertension. However, there is a paucity of quantitative studies examining the relationship between the V/S ratio and the risk of hypertension in individuals with prediabetes, especially within the Chinese population. This cross-sectional study was conducted at the Health Management Center of Henan Provincial People's Hospital, involving 4071 participants with prediabetes. Visceral fat area (VFA) and subcutaneous fat area (SFA) were measured using computed tomography (CT) scans, and the V/S ratio was calculated. Statistical analyses, including multivariable logistic regression, restricted cubic spline regression models, and subgroup analyses, were employed to investigate the relationship between the V/S ratio and hypertension in individuals with prediabetes. The prevalence of hypertension among the 4071 prediabetic participants was 35.54%. Prediabetic individuals with elevated V/S ratios had a significantly higher risk of developing hypertension (Q4 vs. Q1: odds ratio [OR] = 2.78, 95% confidence interval (CI) = 2.03–3.82, <i>p</i> &lt; 0.001; <i>p</i> _{for trend} &lt; 0.001), a relationship that remained statistically significant after adjusting for other variables. Importantly, a non-linear association between the V/S ratio and hypertension risk was observed, indicating a notable increase in hypertension risk when the V/S ratio exceeded 1.80 (OR = 1.21, 95% CI: 1.06–1.39, <i>p</i> &lt; 0.05). These findings underscore the importance of abdominal fat distribution in improving metabolic health outcomes in individuals with prediabetes. Monitoring abdominal fat distribution is essential for prediabetic patients to mitigate the risk of 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.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856775","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":"Caspase-7 and Vitamin D Receptor Gene as Key Genes of Hypertension Caused by Pyroptosis in Human","authors":"Yu-Xuan Lou,&nbsp;Yang Hua,&nbsp;Ting-Ting Wu,&nbsp;Wei Sun,&nbsp;Yang Yang,&nbsp;Xiang-Qing Kong","doi":"10.1111/jch.70047","DOIUrl":"https://doi.org/10.1111/jch.70047","url":null,"abstract":"<p>This study aims to elucidate the underlying mechanisms of pyroptosis in hypertension through bioinformatics and machine learning approaches. R language was utilized to integrate differentially expressed genes (DEGs) between hypertension samples and healthy control samples in GSE24752 and GSE75360 datasets, followed by GO analysis, KEGG enrichment analysis, and GSEA. Key genes were screened based on the expression levels of DEGs using logistic regression, LASSO regression, and support vector machine (SVM). A visualized protein–protein interaction regulatory network was constructed, and immune cell infiltration analysis was performed on integrated GEO datasets of hypertensive samples. Collect serum samples from hypertensive subjects and healthy control subjects for RT-qPCR detection of key gene expression. A total of 1005 DEGs were obtained from peripheral blood samples of 13 hypertension cases and 14 control samples. GO analysis, KEGG enrichment analysis, and GSEA revealed that the DEGs function synergistically in various biological pathways. LASSO regression and SVM identified six key genes related to pyroptosis (CASP7 (caspase-7), CYBB, NEK7, NLRP2, RAB5A, VDR (vitamin D receptor)). Immune infiltration analysis showed that activated B cell, effector memory CD8 T cell, immature B cell, MDSC, and T follicular helper cell accounted for the largest proportion of immune cells. RT-qPCR results indicated significantly higher relative expression levels of caspase-7 and vitamin D receptor in hypertensive samples compared to controls. These findings suggest that CASP7 and the vitamin D receptor gene may offer new research targets for the diagnosis and treatment of hypertension, and they also provide fresh evidence for the involvement of pyroptosis in 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.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143856860","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":"Arterial Stiffness and Wave Reflection Responses Following Heavy and Moderate Load Resistance Training Protocols","authors":"Eleftherios Karanasios,&nbsp;Scott Hannah,&nbsp;Helen Ryan - Stewart,&nbsp;James Faulkner","doi":"10.1111/jch.70020","DOIUrl":"https://doi.org/10.1111/jch.70020","url":null,"abstract":"<p>This study compared the acute effects of resistance training (RT) between a moderate (ML) and a high loading (HL) intensity (12RM vs. 4RM, respectively), with the same intensity of effort on arterial stiffness and wave reflection in young healthy adults. Eleven healthy adults (age 36.4 ± 6.8 years) performed two RT protocols, ML and HL, in a randomized order. Both RT sessions consisted of three sets of deadlifts and three sets of bench presses, with 2 min rest between sets and exercises. Loading intensity was 12RM and 4RM for the ML and HL conditions, respectively. Measurements of pulse wave velocity (PWV) and pulse wave analysis (PWA; e.g., augmentation index) were collected at baseline, immediately post, and 15 min post-training. ML elicited significantly greater increases in carotid-femoral PWV (from 6.4 ± 0.3 to 7.3 ± 0.5), and augmentation index normalized to 75 bpm (from −5.1 ± 1.1) than HL (all <i>p</i> &lt; 0.05). These findings demonstrate that an acute bout of RT performed to volitional failure using lower loads and higher repetitions impose a greater workload on the arterial and cardiovascular system in comparison to a RT scheme with heavier loads and lower repetitions.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818670","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":"Hypertension Exacerbates Endothelial Dysfunction in Patients With Atrial Fibrillation","authors":"Samuel Thomas,&nbsp;Fiona L. Wilkinson,&nbsp;Amy R. Bland,&nbsp;Gregory Y. H. Lip,&nbsp;James P. Fisher,&nbsp;Rehan T. Junejo","doi":"10.1111/jch.70028","DOIUrl":"https://doi.org/10.1111/jch.70028","url":null,"abstract":"<p>Atrial fibrillation (AF) and hypertension (HT) often coincide and both are independently associated with endothelial dysfunction. We tested the hypothesis that brachial artery flow-mediated dilation (FMD), an indicator of endothelial health, will be poorer in AF patients with HT (AF + HT) than AF without concurrent HT. In a cross-sectional design study, AF (<i>n</i> = 29; mean 70 years; 9 females) and AF + HT (<i>n</i> = 33; 68 years (<i>p </i>= 0.302); 14 females) patients underwent Duplex-Doppler ultrasound imaging of brachial artery diameter and flow velocity during baseline (2 min), distal tourniquet cuff inflation (5 min), and following cuff deflation (3 min). The peak increase in artery diameter following cuff deflation was taken as FMD and analyzed as absolute, percentage change, FMD and shear-rate area-under-the-curve (SR_AUC; FMD-to-SR_AUC) ratio, and using SR_AUC as a covariate (FMD_SRAUC). Body mass index (BMI) was used as an additional covariate for between-group comparisons of vascular data. Mean arterial pressure was higher in the AF + HT versus the AF group (median [interquartile range] 93 [85–99] vs. 84 [80–90] mm Hg, respectively; <i>p </i>&lt; 0.05). Baseline brachial artery diameters were similar (<i>p </i>&gt; 0.05). FMD was lower in AF + HT than AF patients (3.36 [1.69–5.21] vs. 4.98 [2.96–7.11] %, respectively; <i>p </i>&lt; 0.05). Similar group differences were observed in absolute FMD, FMD-to-SR_AUC ratio and FMD_SRAUC (<i>p</i> &lt; 0.05). AF patients with concurrent HT exhibit poorer endothelium-dependent vasodilation compared to AF patients, indicating that the presence of comorbid HT exacerbates endothelial dysfunction in AF patients.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Policosanol (Sugarcane Wax Alcohols) 20 mg/Day in Cuban Prehypertensive Patients: A Randomized, Double-Blind, Multicentre Study","authors":"Moura Revueltas,&nbsp;Amarilys Jimenez Chiquet,&nbsp;Yamile Valdes,&nbsp;Julio C. Fernández,&nbsp;Yenney Reyes,&nbsp;Yanay Fernández,&nbsp;Evelyn González,&nbsp;Sarahi Mendoza,&nbsp;Yohani Pérez,&nbsp;Manuel Delfin Pérez,&nbsp;Deisy Navarro,&nbsp;Yolanda Cruz,&nbsp;Meilis Mesa,&nbsp;Gladys Jiménez,&nbsp;Carlos Sánchez,&nbsp;the Family's Doctors of the polyclinical centres of Plaza Municipality","doi":"10.1111/jch.14948","DOIUrl":"https://doi.org/10.1111/jch.14948","url":null,"abstract":"<p>Hypertension is the most common modifiable cardiovascular risk factor. Policosanol exhibits lipid-modifying and beneficial vascular pleiotropic effects. Some previous Cuban trials found that policosanol lowered blood pressure in hypercholesterolemic patients. Similar results were found recently in prehypertensive Asian subjects. The aim of this study was to report the effects of 20 mg/day of policosanol on blood pressure in Cuban patients with prehypertension. A double-blind multicenter trial randomized 400 eligible patients into two strata of 200 patients each (prehypertension and Grade 1 hypertension), treated with placebo or 20 mg/day of policosanol (100 patients/group/stratum) for 12 weeks. The primary outcome was to determine whether policosanol could achieve significant systolic blood pressure (SBP) reductions ≥10 mmHg versus placebo. Changes in diastolic blood pressure (DBP) and lipid profile were secondary outcomes. Safety indicators and adverse events (AE) were assessed. Statistical analyses were conducted by intention-to-treat (ITT). Here we report the results of the prehypertension stratum (SBP 120–139 mmHg, DBP 80–89 mmHg). Both groups were similar at randomization. At study completion, policosanol significantly lowered (<i>p</i> &lt; 0.001) SBP and DBP values versus baseline and placebo. Also, more (<i>p</i> &lt; 0.0001) policosanol patients (44%) reached SBP reductions ≥10 mmHg and DBP reductions ≥5 mmHg versus baseline (44% and 61%, respectively) than placebo patients (7% and 22%, respectively). Policosanol significantly lowered low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) and increased low-density lipoprotein cholesterol (HDL-C). Policosanol was well tolerated. Nine patients (4.5%) discontinued the trial, none because of AE. Four patients (3 placebo, 1 policosanol) reported AE. It is concluded that policosanol 20 mg/day given for 12 weeks to Cuban patients with prehypertension lowered SBP and DBP and produced beneficial changes in the lipid profile, being well tolerated.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14948","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786852","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":"Higher Food and Lifestyle Oxidative Balance Scores Decreases the Risk of Hypertension in Chinese Adults: A Population-Based Cross-Sectional Study","authors":"Wenxin Qiu,&nbsp;Ying Han,&nbsp;Jingru Huang,&nbsp;Danjing Chen,&nbsp;Jiangwang Fang,&nbsp;Huajing Chang,&nbsp;Xian-e Peng","doi":"10.1111/jch.70042","DOIUrl":"https://doi.org/10.1111/jch.70042","url":null,"abstract":"<p>Oxidative stress plays an important role in the development of hypertension (HTN). A population-based cross-sectional study was conducted in Fujian province of China. The construction of FoodL-OBS relied on diet and lifestyle components, which included four food and six lifestyle factors. Multivariable-adjusted logistic regression was performed to investigate the association between FoodL-OBS and the risk of HTN. A subgroup analysis was also conducted. Restricted cubic spline (RCS) regression was used to elucidate the dose-response relationship between FoodL-OBS and the risk of HTN. A total of 9578 participants were included, 3271 of whom suffered from HTN. The results of multivariable logistic regression analysis showed that the HTN risk decreased by 14% for each FoodL-OBS unit added [OR: 0.86 (0.84, 0.88), <i>p</i> &lt; 0.01]. Compared with participants with the lowest levels of Food-L-OBS, those with the highest quartile were less likely to have HTN [0.43 (0.37, 0.50)]. Further stratified analysis showed that Food-L-OBS was negatively associated with the risk of HTN, which was statistically significant in participants in subgroups of ≤60 years, female, and no-dyslipidemia. The results of RCS showed a linear negative correlation between Food-L-OBS and HTN in men, but not in women. In conclusion, FoodL-OBS was negatively associated with HTN, and a healthy lifestyle and antioxidant-rich diet may be useful for preventing HTN.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143786841","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":"Electrolyte Levels in Poor Prognosis and Early Neurological Deterioration in Patients With Acute Ischemic Stroke","authors":"Shengli Pan,&nbsp;Bohuai Yu,&nbsp;Yilin Chen,&nbsp;Yufan Gao,&nbsp;Wei Xie,&nbsp;Yining Jin,&nbsp;Guoliang Zhou,&nbsp;Jialing Lou,&nbsp;Rui Zhang,&nbsp;Chao Chen,&nbsp;Yiyun Weng,&nbsp;Guangyong Chen","doi":"10.1111/jch.70037","DOIUrl":"https://doi.org/10.1111/jch.70037","url":null,"abstract":"<p>Discrepancies in serum electrolyte levels have been observed between stroke patients and healthy individuals. Previous studies have indicated an association between electrolytes and all-cause mortality as well as cardiovascular events in stroke patients. However, there still lacks comprehensive analysis on the connection between electrolytes and negative outcomes in hypertensive individuals with early neurological deterioration (END). Totally 1341 patients treated with thrombolysis for acute ischemic stroke at the First Affiliated Hospital of Wenzhou Medical University were included. Outcomes included END, 3-month, 6-month, and 1-year poor prognosis. Logistic regression assessed the correlation and restricted cubic spline analysis examined dose-response relationships. Subgroup analysis validated the relationship between electrolytes and prognosis in hypertensive patients. A total of 242 patients exhibited a 3-month poor prognosis. Significant differences were observed in Cl⁻, Ca²⁺, and Mg²⁺ levels between mRS binary classification. Logistic regression identified Cl⁻ as the strongest predictor for 3-month, 6-month, and 1-year mRS score and Ca²⁺ for END. Restricted cubic spline analysis revealed relationships between higher concentrations of Na⁺ and poorer prognosis. In the hypertension subgroup, a higher concentration of Na⁺ indicated worse 6-month and 1-year outcomes and a lower concentration of Ca²⁺ was linked to a higher risk of END. The concentration of Na⁺ is related to adverse clinical outcomes, while that of Cl⁻ and Ca²⁺ are associated with END. Among hypertensive patients, elevated levels of Na⁺ and Ca2⁺ concentration are respectively associated with 6-month poor prognosis and END. Monitoring the electrolytes may promote the early identification of individuals at high risk of poor functional outcomes.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 4","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741489","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":"Nurse-Managed Hypertension Care in Primary Health Care Centers in Region Stockholm and Its Association With Blood Pressure Control and Key Indicators for Contractual Follow-Up","authors":"Charlotte Ivarsson,&nbsp;Per Wändell,&nbsp;Monica Bergqvist,&nbsp;Anders Norrman,&nbsp;Julia Eriksson,&nbsp;Jan Hasselström,&nbsp;Sebastian Lindblom,&nbsp;Christina Sandlund,&nbsp;Axel C. Carlsson","doi":"10.1111/jch.70041","DOIUrl":"https://doi.org/10.1111/jch.70041","url":null,"abstract":"<p>The study aimed to investigate if primary health care centers (PHCCs) offering nurse-managed hypertensive care differ from PHCCs with other types of hypertension care regarding blood pressure levels and other key indicators. In this cross-sectional study of the hypertension care given in PHCCs in Stockholm County (now called Region Stockholm), we included all 227 PHCCs in the region. To assess the extent of nurses' involvement in the PHCCs hypertension care, a questionnaire was distributed to all PHCCs in Region Stockholm. Data on blood pressure levels was collected from a primary health care quality system (Primary Care Quality). Data on key indicators regarding follow-up was obtained from the Region Stockholm database on follow-up (LUD). Blood pressure levels and LUD-data were then analyzed with regards to whether the PHCC had nurse-managed hypertension care or not. Our analysis comprised 119 267 patients diagnosed with hypertension registered in any of the regions 227 PHCCs. Of the 81 PHCCs that responded to the questionnaire, 55 reported having nurse-managed hypertension care, and 26 were classified as having non-nurse managed hypertension care, while 146 were classified as unknown type of hypertension care. There were no differences in patients reaching desired blood pressure levels between nurse-managed and non–nurse-managed hypertension care. Nurse-led hypertension care units were on par with the other types of PHCCs. Thus, nurse-led hypertension care seems to be as safe and effective as other types of hypertension care in PHCCs.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689970","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":"Pulse Wave Velocity Assessment: A Useful Tool to Screen Asymptomatic Individuals at High Cardiovascular Risk?","authors":"Giacomo Pucci,&nbsp;Riccardo Alcidi,&nbsp;Guido Grassi","doi":"10.1111/jch.70040","DOIUrl":"https://doi.org/10.1111/jch.70040","url":null,"abstract":"&lt;p&gt;The global burden of cardiovascular (CV) disease is very high worldwide, and it is expected to increase further due to the aging of the population. The estimated expected 20.5 million deaths in 2025 are projected to increase to 35.6 million by 2050 [&lt;span&gt;1&lt;/span&gt;]. These alarming data necessitate urgent action to tackle such rising burden. Strengthening actions of screening, early detection and prevention of individuals at high CV risk at the global level is crucial. Healthcare systems, particularly in countries with high rates of CV deaths from atherosclerotic disease and relatively low financial resources, should implement effective and targeted interventions to address this growing challenge.&lt;/p&gt;&lt;p&gt;The atherosclerotic process, like its risk factors—including hyperglycemia, dyslipidemia, and hypertension—often progresses asymptomatically. This makes risk stratification for CV disease particularly challenging among general population and supports the need of developing screening strategies using simple, reliable, and cost-effective methods. Simple tools to perform CV risk stratification at the individual level include blood pressure (BP) measurement and blood tests for serum glucose and cholesterol. Automated BP monitors offer a simple and relatively inexpensive option for mass screening. In contrast, blood tests require additional costs, specialized personnel, and dedicated facilities, making them more suitable for selective screening of individuals after an initial selection.&lt;/p&gt;&lt;p&gt;Some novel BP monitors, such as the Tel-o-Graph, integrate brachial BP measurement with pressure waveform detection [&lt;span&gt;2&lt;/span&gt;]. The subsequent analysis of the brachial waveform profile using proprietary algorithms enables the non-invasive measurement of pulse wave velocity (PWV), a measure of arterial stiffness. This parameter is a recognized marker of vascular aging, reflecting the progressive decline in arterial elasticity which may be accelerated by the cumulative CV risk factors and other determinants. Automated oscillometric cuff-based PWV measurement could therefore be promising to identify individuals at high CV risk where asymptomatic CV risk factors have already cumulatively accelerated arterial degeneration [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;The results of the study presented by Celenk et al. in the current issue of the Journal [&lt;span&gt;4&lt;/span&gt;] provide seminal evidence in support of the hypothesis that automated PWV assessment could be useful as a screening tool to identify individuals at high CV risk. The authors analyzed the characteristics of a selected population of 209 participants from a cohort of subjects aged 40–69 years who attended a Family medicine clinic in Turkey. These clinics usually serve as primary points of contact for medical care, offering comprehensive primary healthcare services for individuals and families.&lt;/p&gt;&lt;p&gt;All participants underwent the assessment of their 10-year absolute risk of fatal and non-fatal CV events using both the Fr","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689974","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}