Journal of Clinical Hypertension最新文献

{"title":"A Risk Stratification Model for Predicting Benefits of Intensive Blood Pressure Treatment: Analysis of the Systolic Blood Pressure Intervention Trial","authors":"Na Li,&nbsp;Zhixin Yang,&nbsp;Quan Yuan,&nbsp;Wenli Cheng","doi":"10.1111/jch.70098","DOIUrl":"https://doi.org/10.1111/jch.70098","url":null,"abstract":"<p>Current hypertension guidelines lack personalized strategies for blood pressure control. While the Systolic Blood Pressure Intervention Trial (SPRINT) demonstrated benefits of intensive blood pressure lowering, identifying optimal candidates for such treatment remains challenging. We developed and validated a risk stratification model using data from 9139 SPRINT participants. The model incorporated 11 clinical variables through multivariable Cox regression analysis. Patients were stratified into low-, medium-, and high-risk groups. The study protocol was registered at ClinicalTrials.gov (NCT01206062). The model showed good discrimination with C-indices of 0.7354 (95% CI: 0.7065–0.7710) and 0.6894 (95% CI: 0.6545–0.7266) at 3 years for training and validation sets, respectively. Intensive treatment significantly reduced cardiovascular events in medium-risk (3.17% vs. 5.11%, <i>p</i> = 0.0376) and high-risk groups (9.34% vs. 11.86%, <i>p</i> = 0.0269), while showing a nonsignificant trend in the low-risk group (2.87% vs. 3.34%, <i>p</i> = 0.0870). The Rank-Weighted Average Treatment Effect analysis (16.06) supported potential benefits from individualized treatment allocation. No increased risk of severe adverse events was observed across risk groups. Our risk stratification model effectively identifies patients who derive significant cardiovascular benefits from intensive blood pressure lowering, particularly in medium- and high-risk groups. This approach could guide more personalized hypertension management strategies.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70098","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144758597","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 Estimated Pulse Wave Velocity and Carotid Plaques in Non-Dialysis CKD Stages 3–5: A Cross-Sectional Study","authors":"Li Wang,&nbsp;Yiqin Shi,&nbsp;Zhen Zhang,&nbsp;Fangfang Xiang,&nbsp;Yi Fang,&nbsp;Xiaoqiang Ding,&nbsp;Wuhua Jiang","doi":"10.1111/jch.70103","DOIUrl":"https://doi.org/10.1111/jch.70103","url":null,"abstract":"<p>Carotid plaques are common in CKD patients and serve as a key marker of cardiovascular risk. Arterial stiffness, assessed by estimated pulse wave velocity (ePWV), is a valuable non-invasive indicator of vascular health. However, the association between ePWV and carotid plaques in CKD stages 3–5 remains unclear. Of the 296 participants, 199 were included in the cross-sectional study after applying exclusion criteria. Carotid plaques were assessed using ultrasound, and ePWV was calculated based on established equations. Logistic regression models examined the association between ePWV and carotid plaques, while subgroup and mediation analyses evaluated the robustness of the association and mediating effects, respectively. ePWV was significantly associated with carotid plaques (OR: 1.85; 95% CI: 1.47–2.32; <i>p</i> &lt; 0.001) after adjusting for covariates. The highest ePWV tertile (ePWV ≥ 11.2 m/s) was associated with a markedly increased risk of carotid plaques compared to the lowest tertile (OR: 21.52; 95% CI: 7.09–65.36; <i>p</i> &lt; 0.001), and trends between tertiles have been observed. Subgroup analysis showed that diabetes influenced the robustness of the association between ePWV and carotid plaque. Mediation analysis revealed that ePWV accounted for 32.9% of the effect of diabetes on carotid plaques, indicating its potential role as a partial mediator. This study identified a robust association between ePWV and carotid plaques in CKD stages 3–5, with diabetes significantly influencing this relationship. The findings highlighted the clinical relevance of ePWV in cardiovascular risk assessment and underscored the importance of managing arterial stiffness in advanced CKD populations.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 8","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70103","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144758603","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":"Intensive Blood Pressure Control in Patients With Diabetes and Previous Stroke: A Post-Hoc Analysis of ACCORD-BP Trial","authors":"Zhixian Wang,&nbsp;Jue Wang,&nbsp;Liu He,&nbsp;Chao Jiang,&nbsp;Yufeng Wang,&nbsp;Ting Shen,&nbsp;Meiqi Zhao,&nbsp;Enze Li,&nbsp;Ning Zhou,&nbsp;Caihua Sang,&nbsp;Xin Du,&nbsp;Jianzeng Dong,&nbsp;Changsheng Ma","doi":"10.1111/jch.70095","DOIUrl":"https://doi.org/10.1111/jch.70095","url":null,"abstract":"<p>Intensive systolic blood pressure (SBP) control reduces cardiovascular outcomes in hypertensive patients, but its effects in those with diabetes and prior stroke need further evidence. Among 4733 patients with elevated SBP enrolled in the ACCORD-BP (Action to Control Cardiovascular Risk in Diabetes–Blood Pressure) trial, this post-hoc analysis focused on 307 patients with type 2 diabetes and prior stroke to evaluate intensive versus standard SBP control. The primary outcome was major adverse cardiovascular events (MACE), a composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. Inverse probability of treatment weighting (IPTW)-adjusted Kaplan-Meier and Cox regression analyses were performed with a 3-year conditional landmark. Multivariable Cox regression models and overlap weighting models were constructed in sensitivity analysis. In landmark analysis at the 3-year time point, intensive SBP control was associated with a significantly lower risk of MACE (hazard ratio [HR] 0.55, 95% CI, 0.32–0.95) using the IPTW Cox model. The associations remained consistent across multivariable Cox regression model (HR 0.53, 95% CI, 0.31–0.90) and overlap weighting model (HR 0.55, 95% CI, 0.32–0.94). Patients in the intensive SBP control group showed a trend toward lower recurrent stroke risk, though it was not statistically significant (HR 0.65, 95% CI, 0.30–1.37). Similar trends were observed in subgroup analyses. In conclusion, targeting an SBP below 120 mmHg in patients with diabetes and prior stroke is associated with a lower risk of major cardiovascular events without increasing the risk of recurrent stroke.</p><p><b>Trial Registration</b>: ClinicalTrials.gov identifier: NCT00000620</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 7","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666364","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":"Bring It Down: A Formative Evaluation of Reach and Effectiveness of a Blood Pressure Reduction Program in Detroit, Michigan USA","authors":"Bethany Foster,&nbsp;Michael J. Twiner,&nbsp;Samantha J. Bauer,&nbsp;Steven J. Korzeniewski,&nbsp;Mallory A. Lund,&nbsp;Jordan Gould,&nbsp;Katee Dawood,&nbsp;Sahil Bhatia,&nbsp;Kristina Dawkins,&nbsp;Michelle Byrd,&nbsp;Robert D. Brook,&nbsp;Phillip Levy","doi":"10.1111/jch.70082","DOIUrl":"https://doi.org/10.1111/jch.70082","url":null,"abstract":"<p>Hypertension is the most important contributor to the development of cardiovascular disease. The objective of the Bring it Down program was to examine the reach and effectiveness of linkage to primary care via community health workers (CHWs) to improve blood pressure control among people with undiagnosed or uncontrolled hypertension. Adults with systolic blood pressures ≥130 mmHg were initially recruited from four urban emergency departments that serve high-risk, socially vulnerable populations. Due to the COVID-19 pandemic, we also enrolled participants in the community who presented to mobile health units. CHWs facilitated follow-up blood pressure assessment within 1 year. Of 153 630 ED patient encounters during the evaluation period, 61% were eligible to participate in the BID program; of these, 3% were approached, and 16% (395/2476) agreed to participate. Compared to ED encounters, fewer patients presenting to MHUs were eligible to participate (42%, 1780/4211), all of whom were approached, and 7% (124/1780) agreed to participate in the BID program. Among participants with at least one follow-up encounter (<i>n</i> = 158), there was a statistically significant reduction in mean systolic BP (mean difference: −16 mmHg, 99% confidence intervals (CI): −21, −12 mmHg) with a median time between SBP measurements of 20 days (interquartile range [IQR]: 8, 53 days). Clinical and community recruitment paired with CHW connections to primary care may be a viable quality improvement strategy for improving blood pressure control in high-risk, socially vulnerable populations. However, additional research is needed to understand and improve participation and follow-up rates to establish program effectiveness.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 7","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666440","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":"Effects of Sacubitril/Valsartan on Blood Pressure and Proteinuria in Hypertensive Patients With Chronic Kidney Disease","authors":"Maki Murakoshi,&nbsp;Takashi Kobayashi,&nbsp;Masao Kihara,&nbsp;Seiji Ueda,&nbsp;Yusuke Suzuki,&nbsp;Tomohito Gohda","doi":"10.1111/jch.70089","DOIUrl":"https://doi.org/10.1111/jch.70089","url":null,"abstract":"<p>The effects of the angiotensin receptor–neprilysin inhibitor sacubitril/valsartan (Sac/Val) on blood pressure (BP) and proteinuria in patients with advanced chronic kidney disease and hypertension remain unclear. This retrospective study evaluated the effect of Sac/Val on BP, the urinary protein-to-creatinine ratio (UPCR), and the estimated glomerular filtration rate (eGFR) in 66 patients with hypertension and proteinuria (UPCR ≥ 0.15 g/g) who received renin–angiotensin system inhibitors at 1, 3, and 6 months. At baseline, the median eGFR and UPCR were 28.4 mL/min/1.73 m² and 1.18 g/g, respectively. Significant reductions in systolic and diastolic BP, the eGFR, and the UPCR were observed over time (<i>p</i> values ranged from 0.03 to &lt; 0.0001). At 1 month, 59% of patients showed a transient increase in the UPCR, and 21% had a ≥10% decline in the eGFR, with both metrics returning closer to baseline by 6 months. The percent change in the UPCR at 1 month was positively correlated with the percent change in the eGFR (<i>r</i> = 0.55, <i>p</i> &lt; 0.0001). In conclusion, Sac/Val showed considerable BP-lowering efficacy even in patients with impaired renal function and proteinuria. Early changes in the eGFR were positively correlated with changes in the UPCR, and patients with an early decline in the eGFR or an increase in proteinuria did not experience further worsening.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 7","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70089","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666439","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":"Adipose Composition Before and After Primary Aldosteronism Treatment Depends on Primary Aldosteronism Subtypes and Plasma Aldosterone Concentration Before the Treatment","authors":"Eriko Nakano,&nbsp;Kosuke Mukai,&nbsp;Koichi Yamamoto,&nbsp;Michio Otsuki,&nbsp;Atsunori Fukuhara,&nbsp;Iichiro Shimomura","doi":"10.1111/jch.70097","DOIUrl":"https://doi.org/10.1111/jch.70097","url":null,"abstract":"<p>The abdominal and ectopic fats increase after primary aldosteronism (PA) treatment in aldosterone-producing adenoma (APA) but not idiopathic hyperaldosteronism (IHA) has been reported. Additionally, the relationship of these fats to plasma aldosterone concentration remains unclear. This retrospective study aimed to elucidate the influence of aldosterone on body composition. We compared the body composition parameters of APA and IHA patients at baseline and after PA treatment. APA patients tended to have a smaller subcutaneous fat area (SFA) than IHA patients at baseline. The SFA, visceral fat area (VFA) and dyslipidemia prevalence of APA patients but not IHA patients significantly increased after PA treatment. The SFA and the VFA change after adrenalectomy were positively correlated with the baseline plasma aldosterone concentration (PAC) in APA patients. At baseline, APA patients' intramuscular adipose tissue content (IMAC) was significantly less than that of IHA patients. The IMAC of PA patients at baseline was negatively correlated with PAC. The IMAC of APA patients but not IHA patients significantly increased after PA treatment. This study demonstrated that SFA, VFA and IMAC increased after PA treatment in APA patients but not in IHA patients, thereby suggesting a relationship between body composition and aldosterone.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 7","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70097","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666365","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":"Clinical and Biochemical Outcomes of Super-Selective Adrenal Artery Embolization in Primary Aldosteronism: A Systematic Review and Meta-Analysis","authors":"Qinxian Tu,&nbsp;Yizhuo Duan,&nbsp;Xiongjing Jiang,&nbsp;Hui Dong,&nbsp;Yubao Zou","doi":"10.1111/jch.70088","DOIUrl":"https://doi.org/10.1111/jch.70088","url":null,"abstract":"<p>This systematic review and meta-analysis study evaluated the clinical and biochemical efficacy of super-selective adrenal artery embolization (SAAE) in patients with primary aldosteronism (PA). The primary outcome was the change in office blood pressure, while secondary outcomes included changes in plasma aldosterone and serum potassium levels following the procedure. A systematic search of Embase, PubMed, Ovid, Web of Science, China National Knowledge Infrastructure, Wanfang, and SinoMed was conducted through December 14, 2024. Seventeen studies involving 650 patients (aged 28–65 years) with a median follow-up of 6 months were included. Meta-analysis, subgroup analysis, publication bias assessment, and sensitivity analysis were performed using RevMan 5.3 and R 4.2.3. The results showed that SAAE significantly reduced systolic (MD = −19.84 mmHg, 95% CI: −22.87 to −16.82 mmHg) and diastolic blood pressure (MD = −10.62 mmHg, 95% CI: −12.61 to −8.64 mmHg), lowered plasma aldosterone levels (MD = −90.99 pg/mL, 95% CI: −119.36 to −62.63 pg/mL), and increased serum potassium levels (MD = 0.59 mmol/L, 95% CI: 0.49–0.70 mmol/L). Subgroup analyses confirmed benefits in patients with both idiopathic hyperaldosteronism and aldosterone-producing adenoma. These findings support SAAE as an effective treatment for improving clinical outcomes and correcting biochemical abnormalities in PA.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 7","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70088","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666217","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":"Superselective Adrenal Artery Embolization as a Novel Alternative Treatment for Aldosterone-Producing Adenomas: A Case of Refractory Hypertension With Concomitant Autonomous Cortisol Secretion","authors":"Zhixin Xu,&nbsp;Li Tao,&nbsp;Rui Xiang,&nbsp;Jing Chang,&nbsp;Jiayi Liu,&nbsp;Min Mao","doi":"10.1111/jch.70099","DOIUrl":"https://doi.org/10.1111/jch.70099","url":null,"abstract":"<p>Primary aldosteronism (PA) is characterized by an overproduction of aldosterone, leading to hypertension and hypokalemia. Although surgery is an effective treatment for unilateral PA, some patients may be unwilling or unable to undergo this invasive procedure. This case report presents a 51-year-old female patient with refractory hypertension, diagnosed with right-sided hypersecretion of aldosterone and concomitant with autonomous cortisol secretion. The patient declined surgery and was treated with spironolactone as an alternative. Despite optimized medication over 3 months, her blood pressure remained poorly controlled, and she continued to experience hypokalemia and muscle weakness. The patient subsequently underwent right-sided superselective adrenal artery embolization (SAAE). The procedure led to significant reductions in aldosterone and cortisol levels, achieving long-term blood pressure control and biochemical remission with minimal doses of antihypertensive drugs and no need for potassium supplementation. Two years of follow-up confirmed sustained clinical and biochemical improvements, along with evidence of ameliorated target organ damage. This case highlights the potential of SAAE as a feasible treatment option for aldosterone-producing adenomas, offering an alternative therapeutic approach beyond current guidelines.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 7","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70099","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666366","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":"Hidden Cardiovascular Risk: Arterial Stiffness and Left Ventricular Remodeling as Potential Indicators of Masked Hypertension","authors":"Chengjie Zhu,&nbsp;Yanna Lei,&nbsp;Vipin Kumar,&nbsp;Xueling Yue,&nbsp;Qingsong Cui,&nbsp;Xian Wu Cheng","doi":"10.1111/jch.70077","DOIUrl":"https://doi.org/10.1111/jch.70077","url":null,"abstract":"<p>Masked hypertension (MH), characterized by normal office blood pressure (OBP) but elevated out-of-office readings, carries significant cardiovascular risks comparable to those of sustained hypertension, but remains difficult to detect in clinical practice. This review examines the emerging evidence on screening for MH, highlighting recent findings from the PAMELA study demonstrating the clinical utility of combined vascular and cardiac assessments for the detection of MH. Particularly noteworthy is the observation that patients with both an elevated cardiac-ankle vascular index (CAVI) and left ventricular hypertrophy (LVH) or concentric remodeling had a 2.3-fold increased risk of MH, particularly in men, independent of age and antihypertensive treatment. CAVI offers distinct advantages as a screening parameter due to its independence from blood pressure fluctuations during measurement, its established prognostic value for cardiovascular outcomes, and its high reproducibility in primary care. We propose a stepwise screening approach, prioritizing CAVI assessment in patients with normal OBP but multiple cardiovascular risk factors, followed by echocardiographic assessment in those with elevated CAVI values. This strategy may facilitate earlier detection of MH, allowing timely intervention to reduce cardiovascular morbidity and mortality, although further validation in different age groups and cost-effectiveness analyses are warranted.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 7","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70077","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666438","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":"Lessons Learned From COVID-19: Never Lower the Guard in Promoting Hypertension Awareness","authors":"Giacomo Pucci,&nbsp;Chiara Giacinti,&nbsp;Guido Grassi","doi":"10.1111/jch.70100","DOIUrl":"https://doi.org/10.1111/jch.70100","url":null,"abstract":"<p>“The race against a silent killer” is the sub-title assigned to the 2023 World Health Organization Global Report on Hypertension, that synthetizes the complex challenges and interventions required to address the global burden of hypertension [<span>1</span>]. One of the most pressing challenges highlighted in this report is the ongoing need to raise awareness about hypertension, as a silent cardiovascular risk factor. Since more than one-third of people with hypertension are unaware of their status, blood pressure (BP) screening is vital and much emphasis should be put on regular BP monitoring. Public screening initiatives and health education campaign are other key strategies for addressing this issue, both at the individual and at population level.</p><p>In 2019, before the COVID-19 pandemic, a report from the Non-Communicable Disease (NCD) Risk Factor Collaboration [<span>2</span>] revealed a substantial and rather stable increase in hypertension awareness over the last four decades. Notably, each improvement in awareness was associated with a corresponding decline in the proportion of individuals with undiagnosed or untreated hypertension. Reasons of this success were multiple: broader implementation over time of clinical guidelines featuring simplified clinical recommendations; the availability of newer fixed-dose combination of antihypertensive drugs with improved efficacy, reduced treatment complexity and fewer side effects; the introduction of national programs focused on hypertension education and screening, as it was the case of the Canadian healthcare system [<span>3</span>]; and many other aspects.</p><p>During COVID-19 pandemics, such scenario was suddenly and dramatically reversed. Policies designed to limit person-to-person contact significantly altered patient's health-seeking behavior and reduced the frequency of in-person visits to general practitioners [<span>4</span>]. Many patients forgot routine care because of concerns about COVID-19 [<span>5</span>]. Physician-driven factors were also involved, such as offices closures and reduced availabilities for appointments, which were only in part mitigated by delivery of telehealth [<span>6</span>]. Health literacy developments including educational health campaigns raising awareness against non-communicable diseases, were often postponed [<span>7</span>], making way to informational campaigns focused on the risks associated with SARS-CoV-2 transmission. Finally, issues with the drug supply chain have been also reported during COVID-19 [<span>8</span>].</p><p>As a result, rates of hypertension diagnosis and treatment initiation dramatically fell during the COVID-19 pandemic, especially in the early phase [<span>9</span>] and BP control was reduced by on average 5%–7%, according to the results of a survey conducted by the BP Control Laboratory Surveillance System including 1.7 million patients from 24 US health system [<span>10</span>].</p><p>In the present issue of the Journal of","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 7","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666282","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}