Journal of Clinical Hypertension最新文献_第5页

Blood Pressure in Young Adults in Iowa 爱荷华州年轻人的血压

IF 2.5 3区医学

Journal of Clinical Hypertension Pub Date : 2025-08-22 DOI: 10.1111/jch.70119

Esra'a I. Khader, Linnea A. Polgreen

{"title":"Blood Pressure in Young Adults in Iowa","authors":"Esra'a I. Khader, Linnea A. Polgreen","doi":"10.1111/jch.70119","DOIUrl":"https://doi.org/10.1111/jch.70119","url":null,"abstract":"Hypertension (HTN) is common among young adults, but often undiagnosed. Early diagnosis and management are crucial to prevent cardiovascular events. However, young adults are less aware of their HTN and are diagnosed less frequently. This study aims to identify adults aged 18–40 in Iowa with high blood pressure (HBP) and determine the percentage diagnosed with HTN and associated risk factors. This retrospective observational study analyzed electronic health records from the University of Iowa Healthcare outpatient, inpatient, and emergency departments between 2016 and 2022. We included adults aged 18–40 with at least three elevated BP readings (systolic ≥140 or diastolic ≥90). Patients were followed for 2 years to identify those diagnosed with HTN. Summary statistics were calculated, and a Cox regression model assessed the time to HTN diagnosis. We identified 22,299 adults with at least three HBP readings. Among 7,523 young adults with at least three elevated BP readings, only 17.4% received a HTN diagnosis within 2 years. Most diagnoses occurred in outpatient (57.2%), followed by emergency (24%) and inpatient (17.5%) settings. Young adults had a significantly longer time to diagnosis than older populations. Young males, African Americans, Hispanics, patients with diabetes or dyslipidemia, and patients with more healthcare visits had shorter times to diagnosis. In conclusion, 7,523 out of 22,299 (33.7%) patients with HBP were young adults, with only 17.4% diagnosed with HTN within 2 years. The low diagnosis rate is concerning, given the potential for long-term cardiovascular complications. Improved screening protocols and targeted interventions are needed to address age-related underdiagnosis.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891778","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}

引用次数: 0

Does Ideal Blood Pressure Vary by Cognitive Domain? A UK Biobank Study 理想血压是否因认知领域而异？一项英国生物银行研究

IF 2.5 3区医学

Journal of Clinical Hypertension Pub Date : 2025-08-22 DOI: 10.1111/jch.70129

Matthew J. Lennon, Jan Willem Van Dalen, Jessica W. Lo, Anbupalam Thalamuthu, John D. Crawford, Aletta E. Schutte, Perminder S. Sachdev

{"title":"Does Ideal Blood Pressure Vary by Cognitive Domain? A UK Biobank Study","authors":"Matthew J. Lennon, Jan Willem Van Dalen, Jessica W. Lo, Anbupalam Thalamuthu, John D. Crawford, Aletta E. Schutte, Perminder S. Sachdev","doi":"10.1111/jch.70129","DOIUrl":"https://doi.org/10.1111/jch.70129","url":null,"abstract":"High blood pressure (BP) is a risk factor for cognitive decline. Increasingly, studies have found the relationship to be nonlinear, with low BP also indicating higher risk. This UK Biobank study examines the nonlinear relationships between BP and cognitive function, including whether the relationships differ by cognitive domain. Systolic (SBP) and diastolic BP (DBP) were measured at baseline. Cognitive domains included fluid intelligence, attention, and reaction time, measured at baseline and over time. Nonlinear mixed-effects regression models, including natural spline terms for SBP and DBP, were used to assess the relationships. Additional models evaluated interactions with age, sex, and hypertension history/antihypertensive use. There were 439 301 (mean age = 56.3, SD = 8.1, 45.1% male) included participants. Baseline SBP had significant inverted U-shaped relationships with fluid intelligence (p < 0.0001), attention (p < 0.0001), and reaction time (p < 0.0001), with substantially different ideal SBPs for each domain (118, 127.5, and 150.5 mmHg, respectively). Baseline DBP had significant relationships with fluid intelligence (p < 0.0001) and attention (p < 0.0001), again with varying ideal DBPs (57.5 and 74.5 mmHg, respectively). Higher baseline SBP had a small, inverse relation with trajectories of attention during the study (p < 0.0001), but no relationship with trajectories of either fluid intelligence or reaction time. Older, male, and untreated hypertension subgroups had significantly poorer reaction time at lower baseline SBP and DBP (p < 0.0001). The relationship between BP and cognitive function is nonlinear with the three domains optimal at differing BP levels. Older persons, males, or hypertensive patients may be particularly susceptible to negative cognitive effects of low BP.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891648","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}

引用次数: 0

Association of Plasma Aldosterone Concentration With Early Renal Injury Biomarkers in Primary Aldosteronism: A Propensity-Matched Comparative Study 血浆醛固酮浓度与原发性醛固酮增多症早期肾损伤生物标志物的关联：一项倾向匹配的比较研究

IF 2.5 3区医学

Journal of Clinical Hypertension Pub Date : 2025-08-22 DOI: 10.1111/jch.70124

Hai-Long Liu, Qing-Tian Zeng, Yuan-Yuan Xu, Xiang-Tao Zhang, Ning Li, Ning-Peng Liang, Yi-Fei Dong

{"title":"Association of Plasma Aldosterone Concentration With Early Renal Injury Biomarkers in Primary Aldosteronism: A Propensity-Matched Comparative Study","authors":"Hai-Long Liu, Qing-Tian Zeng, Yuan-Yuan Xu, Xiang-Tao Zhang, Ning Li, Ning-Peng Liang, Yi-Fei Dong","doi":"10.1111/jch.70124","DOIUrl":"https://doi.org/10.1111/jch.70124","url":null,"abstract":"Primary aldosteronism (PA) independently increases renal impairment risk beyond blood pressure effects. Although hyperaldosteronism is known to mediate renal injury, associations between plasma aldosterone concentration (PAC) and early kidney damage biomarkers such as retinol-binding protein (RBP) and β2-microglobulin (β2-MG) remain insufficiently explored. We investigated the association of PAC with renal function indicators—including RBP, β2-MG, albumin-to-creatinine ratio (ACR), and estimated glomerular filtration rate (eGFR)—comparing matched patients with PA and essential hypertension (EH). In this cross-sectional study, 546 PA patients and 546 propensity score-matched EH patients were assessed. Spearman correlations and multivariate regression analyses assessed PAC-renal marker associations, with interactions tested to determine differences between PA and EH groups. In PA, PAC strongly correlated with lower eGFR (r = −0.597, p < 0.001) and higher RBP (r = 0.559), β2-MG (r = 0.632), and ACR (r = 0.583), persisting after adjustment. In contrast, EH patients showed only weak correlations between PAC and eGFR (r = −0.204, p < 0.001), without links with other markers. Interaction analysis confirmed stronger PAC-biomarker associations in PA than EH (all p < 0.05). This study is the first to demonstrate robust associations between PAC and sensitive early renal damage biomarkers, especially RBP, in PA patients, distinct from matched EH patients. It highlights hyperaldosteronism's unique pathogenic role in renal impairment in PA, suggesting early biomarker monitoring and aldosterone-targeted interventions could reduce chronic kidney disease risk in PA populations.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70124","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891719","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}

引用次数: 0

Characteristics, Management, and Outcomes of Hospitalized Patients with Orthostatic Hypotension 直立性低血压住院患者的特点、处理和结局

IF 2.5 3区医学

Journal of Clinical Hypertension Pub Date : 2025-08-18 DOI: 10.1111/jch.70118

Benjamin A. Wagner, Emily Rose, Adam C. Strauss, Somal Khan, Timothy S. Anderson, Stephen P. Juraschek

{"title":"Characteristics, Management, and Outcomes of Hospitalized Patients with Orthostatic Hypotension","authors":"Benjamin A. Wagner, Emily Rose, Adam C. Strauss, Somal Khan, Timothy S. Anderson, Stephen P. Juraschek","doi":"10.1111/jch.70118","DOIUrl":"https://doi.org/10.1111/jch.70118","url":null,"abstract":"Orthostatic hypotension (OH) is a common inpatient condition associated with falls, syncope, and mortality. However, standardized approaches for inpatient management of OH are lacking and may vary across clinical specialties. In this retrospective observational cohort study, we reviewed the electronic medical records of patients admitted to Beth Israel Deaconess Medical Center between April 1, 2015 and June 1, 2021 with a diagnosis of OH or medication-related hypotension. Variables of interest included admitting service, presenting symptoms, suspected etiology, and management. Among the 400 inpatients with OH, one-third had OH documented on admission. Dizziness and lightheadedness were the most common symptoms; medical patients experienced dizziness, falls, and other symptoms more frequently than surgical patients. Volume depletion and medications were the leading suspected causes of OH. Surgical patients were less likely to have medication-related OH and were more likely to lack an identified etiology. Cardiovascular disease was more frequently implicated in cardiology patients. Volume depletion, neurodegenerative disease, and other conditions were more often suspected among medical patients. Management commonly involved volume resuscitation and medication adjustment, though medication changes were less frequent in surgical patients. Nonpharmacologic interventions were more common among medical patients. By discharge, OH had resolved in only one-third of patients. In summary, inpatient OH was most often identified after admission, attributed to hypovolemia, treated with fluids, and unresolved at discharge, with differences in symptoms, etiology, and management between specialties. Prospective studies are needed to formalize diagnostic and treatment strategies for OH in the hospital setting.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861765","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}

引用次数: 0

Closing the Gap: Standardizing Blood Pressure Measurement Training for all Healthcare Students 缩小差距：为所有医疗保健学生提供标准化的血压测量培训

IF 2.5 3区医学

Journal of Clinical Hypertension Pub Date : 2025-08-18 DOI: 10.1111/jch.70104

Rupinder Hayer, Lauren Fine, Kate Kirley, Michael Rakotz

{"title":"Closing the Gap: Standardizing Blood Pressure Measurement Training for all Healthcare Students","authors":"Rupinder Hayer, Lauren Fine, Kate Kirley, Michael Rakotz","doi":"10.1111/jch.70104","DOIUrl":"https://doi.org/10.1111/jch.70104","url":null,"abstract":"A common barrier to the timely treatment of hypertension is the accurate measurement of blood pressure (BP). Although measuring BP is a common procedure, training and retraining on this skill is often inadequate. A study led by the American Medical Association (AMA), found that the education system has failed to establish and maintain this skill among a sample of medical students who were tested. The AMA Student BP Measurement eLearning Series is designed to address this gap in training and ensure all students feel confident and competent in performing this critical skill. By creating a readily implementable eLearning Series and collaborating with 10 healthcare education institutions, significant strides have been made toward standardizing BP measurement training. However, to truly address both the gaps in training and the performance gaps in BP measurement skills, faculty across healthcare disciplines must take an active role in standardizing this essential skill for all students. We urge all healthcare faculty to adopt and champion this standardized approach, embedding it early in education, reinforcing it throughout training, and assessing proficiency regularly. A universal commitment to standardization will equip the next generation of healthcare professionals with the competence and confidence needed to measure BP accurately, ultimately improving hypertension diagnosis, treatment, and health outcomes for patients nationwide.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861790","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}

引用次数: 0

Mitophagy in Hypertensive Cardiac Hypertrophy: Mechanisms and Therapeutic Implications 高血压性心肌肥厚的线粒体自噬：机制和治疗意义

IF 2.5 3区医学

Journal of Clinical Hypertension Pub Date : 2025-08-18 DOI: 10.1111/jch.70127

Shijun Li, Xiaoying Li

{"title":"Mitophagy in Hypertensive Cardiac Hypertrophy: Mechanisms and Therapeutic Implications","authors":"Shijun Li, Xiaoying Li","doi":"10.1111/jch.70127","DOIUrl":"https://doi.org/10.1111/jch.70127","url":null,"abstract":"Hypertensive cardiac hypertrophy (HCH) is a compensatory response to chronic pressure overload, ultimately progressing to heart failure if left unmanaged. Emerging evidence highlights the critical role of mitochondrial dysfunction in HCH pathogenesis, with impaired mitophagy—a selective autophagic process that removes damaged mitochondria—contributing to cardiomyocyte death, oxidative stress, and fibrosis. Protective mitophagy eliminates damaged mitochondria, averting reactive oxygen species (ROS)/calcium overload in HCH. Conversely, its dysregulation—either insufficient clearance or excessive removal—exacerbates mitochondrial dysfunction, driving pathological hypertrophy, fibrosis, and bioenergetic crisis. This dual nature presents a therapeutic paradox demanding contextual modulation. This review comprehensively examines the molecular mechanisms underlying mitophagy dysregulation in HCH, focusing on key pathways such as PINK1/Parkin, BNIP3/NIX, and FUNDC1. We also discuss the interplay between mitophagy and other cellular processes, including mitochondrial biogenesis, inflammasome activation, and metabolic remodeling. Furthermore, we explore potential therapeutic strategies targeting mitophagy to ameliorate HCH, including pharmacological agents, lifestyle interventions, and gene therapy approaches. Understanding the dual role of mitophagy in HCH—both protective and detrimental—may pave the way for novel precision medicine strategies in cardiovascular disease.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861789","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}

引用次数: 0

Effect of Ramadan Fasting on Blood Pressure and Kidney Functions in Newly Diagnosed Hypertensive Patients: A Study in Konya, Turkey 斋月禁食对新诊断高血压患者血压和肾功能的影响：土耳其科尼亚的一项研究

IF 2.5 3区医学

Journal of Clinical Hypertension Pub Date : 2025-08-18 DOI: 10.1111/jch.70125

Hüseyin Tezcan, Zafer Büyükterzi

{"title":"Effect of Ramadan Fasting on Blood Pressure and Kidney Functions in Newly Diagnosed Hypertensive Patients: A Study in Konya, Turkey","authors":"Hüseyin Tezcan, Zafer Büyükterzi","doi":"10.1111/jch.70125","DOIUrl":"https://doi.org/10.1111/jch.70125","url":null,"abstract":"Ramadan fasting involves abstaining from food and drink from dawn to sunset, yet its impact on blood pressure (BP) and kidney function in newly diagnosed hypertensive patients remains unclear. This retrospective study examined 200 newly diagnosed hypertensive patients from Konya, Turkey, during Ramadan 2023. Half of the patients (n = 100) observed daily fasting throughout Ramadan, while the other half (n = 100) did not. All patients received a diuretic-containing regimen consisting of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker combined with hydrochlorothiazide. Baseline clinical and laboratory data, including serum creatinine and estimated glomerular filtration rate (eGFR), were compared with those obtained at a one-month follow-up (end of Ramadan). Both fasting and non-fasting groups exhibited significant reductions in systolic and diastolic BP from baseline to the first month, with no statistically significant difference in final BP between the two groups. Kidney function, as indicated by creatinine levels and eGFR, remained stable in both groups, suggesting that Ramadan fasting did not adversely affect renal parameters. Modest improvements in lipid profiles were also observed in both cohorts. These findings indicate that, among newly diagnosed hypertensive patients on diuretic-containing therapy, Ramadan fasting may be safe if accompanied by individualized clinical advice. However, larger and more prolonged studies are warranted to validate these results and explore potential variations in other hypertensive populations.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861766","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}

引用次数: 0

PCSK9 gene Polymorphism and Assessment of Cardiovascular Risk and Prognosis in Patients With Hyperlipidemia: A Retrospective Cohort Study PCSK9基因多态性与高脂血症患者心血管风险和预后的评估：一项回顾性队列研究

IF 2.5 3区医学

Journal of Clinical Hypertension Pub Date : 2025-08-17 DOI: 10.1111/jch.70120

Aibibanmu Aizezi, Fanhua Meng, Xiaolei Li, Yanpeng Li, Jialin Abuzhalihan, Fen Liu, Mintao Gai, Dilare Adi, Yi-tong Ma

{"title":"PCSK9 gene Polymorphism and Assessment of Cardiovascular Risk and Prognosis in Patients With Hyperlipidemia: A Retrospective Cohort Study","authors":"Aibibanmu Aizezi, Fanhua Meng, Xiaolei Li, Yanpeng Li, Jialin Abuzhalihan, Fen Liu, Mintao Gai, Dilare Adi, Yi-tong Ma","doi":"10.1111/jch.70120","DOIUrl":"https://doi.org/10.1111/jch.70120","url":null,"abstract":"Proprotein convertase subtilisin/kexin type 9 (PCSK9) polymorphisms exhibit ethnic-specific associations with cardiovascular risk. However, their prognostic value for major adverse cardiovascular and cerebrovascular events (MACCE) in Asian populations remains undefined. This prospective cohort study enrolled 1969 patients (mean age 54.5 ± 10.7 years, 60.2% male) with hyperlipidemia and followed them for a median of 62 months (IQR 24–89 months). We evaluated the association of three PCSK9 polymorphisms (rs2483205, rs2495477, and rs562556) with metabolic parameters and MACCE. A genotype-integrated nomogram was developed using Least Absolute Shrinkage and Selection Operator (LASSO) – selected predictors and validated in an independent cohort. The rs2483205 TT, rs2495477 GG, and rs562556 GG genotypes were significantly associated with atherogenic dyslipidemia (elevated triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and lipoprotein(a) [Lp(a)], all p < 0.001) and predicted MACCE risk independently of conventional factors (HR = 2.94, 95% CI: 1.80–4.80 for rs2483205 TT). The nomogram demonstrated excellent discrimination (3 and 4 year area under the curve (AUC) = 0.989, concordance index (C-index) = 0.868) and calibration (slope = 1.02, 95% CI: 0.98–1.06), with decision curve analysis confirming clinical utility across risk thresholds (20%–75%). Net Reclassification Improvement (NRI) increase of 0.059 and an Integrated Discrimination Improvement (IDI) increase of 0.022. PCSK9 genotyping provides independent prognostic value for MACCE risk stratification in hyperlipidemia, with genotype-specific effects on cardiovascular outcomes. The developed nomogram offers a precision medicine tool for individualized risk prediction and therapeutic decision-making.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861938","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}

引用次数: 0

Evaluation of Population-Based Sodium Reduction Strategies in China: Protocol for a Study Using a Combined Quantitative and Qualitative Approach 中国以人群为基础的减钠策略评价：一项采用定量和定性结合方法的研究方案

IF 2.5 3区医学

Journal of Clinical Hypertension Pub Date : 2025-08-10 DOI: 10.1111/jch.70123

Yuze Xin, Jianwei Xu, Zhifang Li, Xuejun Yin, Tengyi Wang, Beike Wu, Shuangjie Peng, Anqi Ge, Xinyan Liu, Min Liu, Hueiming Liu, Lei Si, Stephen Jan, Jixiang Ma, Yangfeng Wu, Jing Wu, Laura Cobb, Bruce Neal, Katrina Kissock, Maoyi Tian

{"title":"Evaluation of Population-Based Sodium Reduction Strategies in China: Protocol for a Study Using a Combined Quantitative and Qualitative Approach","authors":"Yuze Xin, Jianwei Xu, Zhifang Li, Xuejun Yin, Tengyi Wang, Beike Wu, Shuangjie Peng, Anqi Ge, Xinyan Liu, Min Liu, Hueiming Liu, Lei Si, Stephen Jan, Jixiang Ma, Yangfeng Wu, Jing Wu, Laura Cobb, Bruce Neal, Katrina Kissock, Maoyi Tian","doi":"10.1111/jch.70123","DOIUrl":"https://doi.org/10.1111/jch.70123","url":null,"abstract":"Sodium intake in China is among the highest in the world, particularly in rural areas. A government-led national sodium reduction program has been implemented but evaluations of its implementation and effectiveness remain limited. The study will use a combined qualitative and quantitative approach and a before-after design, to monitor and evaluate the implementation and effectiveness of the sodium reduction program in the rural areas of four provinces geographically distributed throughout China: Heilongjiang, Shanxi, Guizhou, and Guangdong. Baseline data collected in 2021–2023 will be compared to follow-up data collected in 2024–2025. Population surveys will quantify changes in community knowledge, behaviors, dietary patterns, and sodium intake. Food retail surveys will assess changes in the sodium content of packaged food products, while stakeholder interviews will assess the extent to which the program has been implemented as planned across government, industry, health, and community organizations. The study has received funding and ethics committee approvals though timelines and study processes were significantly delayed by COVID-19. Baseline surveys of 2790 community members have now been completed, food composition data for 20 240 products has been collected, and there have been 37 stakeholders interviewed to date. This project will provide a robust evaluation of progress with implementation of China's national sodium reduction program in rural areas of the country. It will quantify impact to date and provide insight into what has worked, as well as what has not, and inform future sodium reduction strategies.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811175","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}

引用次数: 0

Association of 24-h Blood Pressure Pattern With Mortality in ICU Patients: A Multicenter Retrospective Study ICU患者24小时血压模式与死亡率的关系：一项多中心回顾性研究

IF 2.5 3区医学

Journal of Clinical Hypertension Pub Date : 2025-08-10 DOI: 10.1111/jch.70116

Xiao Zhao, Hao Li, Feng Liu, Yuanyuan Ren, Feng Gao

{"title":"Association of 24-h Blood Pressure Pattern With Mortality in ICU Patients: A Multicenter Retrospective Study","authors":"Xiao Zhao, Hao Li, Feng Liu, Yuanyuan Ren, Feng Gao","doi":"10.1111/jch.70116","DOIUrl":"https://doi.org/10.1111/jch.70116","url":null,"abstract":"Blood pressure (BP) is a crucial component of the APACHE II scoring system for assessing the severity of illness in ICU patients, and it plays a pivotal role in predicting patient mortality. Based on fluctuations, the 24-h BP patterns of ICU patients can be categorized into dippers (10% ≤ the fall < 20%), extreme-dippers (fall ≥ 20%), non-dippers (0% ≤ the fall < 10%), and reverse-dippers (fall < 0%). This study aims to investigate whether there are statistically significant differences in ICU mortality, in-hospital mortality, 28-day mortality, and 1-year mortality among the dipper, non-dipper, extreme-dipper, and reverse-dipper groups. We enrolled all adult patients with continuous BP monitoring within 24 h of ICU admission. Using Navicat Premium 16 software, we extracted the first 24-h BP values of 10462 patients from the MIMIC IV v2.2 database. Patients were then classified into the dipper group (n = 1244), non-dipper group (n = 6162), reverse-dipper group (n = 2940), and extreme-dipper group (n = 116). Among ICU patients, the non-dipper pattern group constituted the largest proportion (58.90%), followed by the reverse-dipper pattern group (28.10%). After adjusting for relevant confounding factors, we found that the reverse-dipper group had the strongest correlation with in-hospital mortality (OR: 1.592, p < 0.05), 28-day mortality (OR: 1.607, p < 0.01), 90-day mortality (OR: 1.402, p < 0.01), 180-day mortality (OR: 1.403, p < 0.01), and 1-year mortality (OR: 1.525, p < 0.001), with statistical significance observed for all these associations. In the ICU setting, the non-dipper BP pattern is the most prevalent. However, the reverse-dipper pattern is the most significantly associated with mortality.","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811173","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}

引用次数: 0