Journal of Clinical Hypertension最新文献

{"title":"Effect of Age on Aldosterone–Renin Ratio in Screening Primary Aldosteronism","authors":"Ning Peng,&nbsp;Zhen Zhang,&nbsp;Yao Xiao,&nbsp;Qianwen Ye,&nbsp;Geru Liu,&nbsp;Mengling Zhen,&nbsp;Yanqing Zheng,&nbsp;Min Luo,&nbsp;Tiejian Jiang","doi":"10.1111/jch.70014","DOIUrl":"https://doi.org/10.1111/jch.70014","url":null,"abstract":"<p>Primary aldosteronism (PA) is the most common endocrine cause of hypertension. The plasma aldosterone-to-renin ratio (ARR) is the most recommended screening tool for PA, but previous studies showed controversy regarding the influence of age on ARR. The aim of the study was to evaluate the impact of age on ARR measured using direct renin concentration (DRC) and its diagnostic value in patients with PA. We retrospectively collected patients with hypertension who attended Xiangya Hospital for PA screening using plasma aldosterone concentration (PAC)/DRC from January 1, 2017 to November 1, 2023. The patients were divided into the groups of PA and essential hypertension (EH) by confirmatory tests. We performed separate correlation analyses of age and DRC, PAC, and ARR, the patients were then further subdivided into four age groups: &lt; 40, 40–49, 50–59, and ≥ 60 years old. Receiver operating characteristic curve and area under the curve (AUC) were used to determine age-specific ARR cutoff values for screening PA. We screened a total of 478 patients, comprising 255 diagnosed with PA (53.35%) and 176 with EH (36.82%). In patients with EH, PAC and DRC decreased with increasing age (<i>p</i> &lt; 0.001, <i>r</i> = –0.34; <i>p</i> &lt; 0.001, <i>r</i> = –0.28), whereas ARR increased with age (<i>p</i> = 0.002, <i>r</i> = 0.22). However, in patients with PA, DRC, PAC, and ARR did not show significant association with age (<i>p</i> = 0.40, 0.54, 0.33). The cutoff values of ARR for screening PA in four groups were 17.49, 20.79, 21.01, and 18.22. The optimal ARR cutoff was 22.52 in the all-ages, with an AUC of 0.948 (95% CI: 0.929, 0.966), sensitivity of 89.4%, and specificity of 85.2%. There was no significant correlation between age and DRC or PAC in patients with PA. Compared to the consensus-recommended cutoff of 37 (pg / mL)/(μIU/mL), a lower ARR cutoff may be more appropriate for screening PA.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595118","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":"Drug-Related Hypertension: A Disproportionality Analysis Leveraging the FDA Adverse Event Reporting System","authors":"Hao Zhu,&nbsp;Linwei Pan,&nbsp;Hannah Lui,&nbsp;Jing Zhang","doi":"10.1111/jch.70029","DOIUrl":"https://doi.org/10.1111/jch.70029","url":null,"abstract":"<p>Hypertension exerts a significant global disease burden, adversely affecting the well-being of billions. Alarmingly, drug-related hypertension remains an area that has not been comprehensively investigated. Therefore, this study is designed to utilize the adverse event reports (AERs) from the US Food and Drug Administration's Adverse Event Reporting System (FAERS) to more comprehensively identify drugs that may potentially lead to hypertension. Specifically, a total of 207 233 AERs were extracted from FAERS, spanning the time period from 2004 to 2024. Based on these reports, this study presented the top 40 drugs most frequently reported to be associated with post-administration hypertension in different genders. Furthermore, we employed four disproportionality analysis methods, including Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Empirical Bayes Geometric Mean (EBGM), to pinpoint the top three drugs with strongest signals in relation to hypertension across different age and gender subgroups. Some drugs, such as rofecoxib, lenvatinib, and celecoxib, were found to appear on both the frequency and signal strength lists. These results contribute to a more comprehensive understanding of the cardiovascular safety profiles of pharmacological agents, suggesting the necessity of blood pressure monitoring following administration.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595117","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":"Aldosterone-to-Renin Ratio Changes in Patients With Renal Artery Stenosis and Aldosteronism","authors":"Qian Wang,&nbsp;Hui Dong,&nbsp;Hongwu Li,&nbsp;Yujie Zuo,&nbsp;Yubao Zou,&nbsp;Xiongjing Jiang","doi":"10.1111/jch.70031","DOIUrl":"https://doi.org/10.1111/jch.70031","url":null,"abstract":"<p>We conducted a retrospective cohort study to investigate changes in the aldosterone-to-renin ratio (ARR) and other influencing factors in patients with renal artery stenosis (RAS) and primary aldosteronism (PA). Patients with RAS and PA admitted to our hospital between January 2016 and December 2021 were retrospectively selected. Based on the standardized PA screening results, the patients were divided into aldosterone-to-renin ratio-positive and -negative groups. The clinical features of the patients were compared. Binary logistic regression analysis was performed to identify the factors contributing to the comorbidity of RAS with false-negative PA. A total of 78 patients (mean age: 60.2 ± 10.2 years) were selected, among whom 46 (59%) were male. Overall, 69 patients had Stage 3 hypertension (88.5%) and 57 had hypokalemia (73.1%). Additionally, 42 (53.8%) and 36 (46.2%) patients were aldosterone-to-renin ratio-positive and -negative, respectively. The aldosterone-to-renin ratio-positive group showed significant differences in malignant hypertension (2.4% vs. 27.8%; <i>p </i>= 0.002), Stage 3 hypertension (81.0% vs. 97.2%; <i>p </i>= 0.033), and RAS degree (64.3 ± 16.4% vs. 71.8 ± 14.4%; <i>p </i>= 0.032). Malignant hypertension (odds ratio, 15.250; 95% confidence interval, 1.787–130.132; <i>p </i>= 0.013) and RAS degree (odds ratio, 1.034; 95% confidence interval, 1.002–1.068; <i>p </i>= 0.036) influenced the comorbidity of RAS with false-negative PA. Malignant hypertension and severe RAS can contribute to false-negative PA results. Therefore, PA screening test results should be carefully analyzed and rechecked following RAS treatment to confirm the presence of PA.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595119","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":"Prevalence of Undiagnosed Hypertension in Bangladesh: A Systematic Review and Meta-Analysis","authors":"Nourin Sultana,&nbsp;Zeba Afia,&nbsp;Shamsuz Zoha,&nbsp;Md. Parvez Mosharaf,&nbsp;Md. Golam Hossain,&nbsp;Md. Kaderi Kibria","doi":"10.1111/jch.70026","DOIUrl":"https://doi.org/10.1111/jch.70026","url":null,"abstract":"<p>Undiagnosed hypertension (UHTN) remains a significant public health concern in Bangladesh, leading to severe complications due to delayed diagnosis and management. This systematic review and meta-analysis examined the prevalence of UHTN among adults aged 18 years and older, using data from studies conducted in Bangladesh and published between 2010 and 2024. A comprehensive search of major databases yielded 1028 records, from which nine relevant studies, encompassing a total of 28949 participants, were selected and evaluated for quality using the Newcastle–Ottawa Scale, providing valuable insights into the prevalence of UHTN within the Bangladeshi population. The pooled prevalence of UHTN was 11% (95% CI: 6%–19%) based on a random-effects model, with substantial heterogeneity (<i>I</i>² = 99.5%, <i>p</i> &lt; 0.0001). Subgroup analyses revealed higher prevalence in rural areas (13%; 95% CI: 4%–35%) compared to urban areas (12%; 95% CI: 1%–54%) and elevated occupational risk among bankers (17%; 95% CI: 0%–94%). While funnel plot asymmetry was noted, Egger's test (<i>p</i> = 0.3113) indicated no significant publication bias. Sensitivity analyses, including Leave-One-Out Analysis, affirmed the robustness of the pooled estimate. The findings underscore notable geographic, occupational, and sociodemographic disparities in UHTN prevalence, highlighting the need for nationwide screening programs and targeted community awareness campaigns, particularly in underserved rural areas. Further research is imperative to explore causal factors and inform effective prevention and management strategies.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555033","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":"Sarcopenia and Cardiovascular Diseases in Individuals With Diabetes or Prediabetes","authors":"Xia Wang,&nbsp;Qingyue Zeng,&nbsp;XiJie Yu,&nbsp;Shuangqing Li","doi":"10.1111/jch.70024","DOIUrl":"https://doi.org/10.1111/jch.70024","url":null,"abstract":"<p>Sarcopenia is a known risk factor for cardiovascular disease (CVD) in individuals with diabetes or prediabetes, but the impact of changes in sarcopenia status on CVD risk remains unclear. This study aimed to examine how changes in sarcopenia status between baseline and the second follow-up survey, conducted 2 years later, influence the risk of developing incident CVD. Incident CVD was identified based on self-reported physician diagnoses of heart disease, such as angina, myocardial infarction, heart failure, or stroke. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounders. The results showed that participants who progressed from non-sarcopenia to possible sarcopenia or sarcopenia had a higher risk of developing CVD. Their risk was significantly greater compared to those who remained non-sarcopenic (HR 1.37, 95% CI 1.08–1.73). Conversely, individuals who recovered from sarcopenia to non-sarcopenia or possible sarcopenia had a lower risk of CVD. Their risk was lower than those who remained sarcopenic (HR 0.40, 95% CI 0.20–0.82). Among individuals with possible sarcopenia at baseline, those who recovered to non-sarcopenia had a reduced CVD risk. This reduction was significant compared to those who remained in possible sarcopenia (HR 0.62, 95% CI 0.46–0.84). These findings suggest that changes in sarcopenia status have a significant impact on CVD risk, with worsening sarcopenia increasing the likelihood of CVD and recovery lowering the risk in individuals with diabetes or prediabetes.</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.70024","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521867","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 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}