Journal of Clinical Hypertension最新文献

{"title":"Precise risk-prediction model including arterial stiffness for new-onset atrial fibrillation using machine learning techniques","authors":"Hiroshi Kanegae BSc,&nbsp;Kentaro Fujishiro MD, PhD,&nbsp;Kyohei Fukatani MBA,&nbsp;Tetsuya Ito MEng,&nbsp;Kazuomi Kario MD, PhD","doi":"10.1111/jch.14848","DOIUrl":"10.1111/jch.14848","url":null,"abstract":"<p>Atrial fibrillation (AF) is the most common clinically significant cardiac arrhythmia and is an important risk factor for ischemic cerebrovascular events. This study used machine learning techniques to develop and validate a new risk prediction model for new-onset AF that incorporated the use electrocardiogram to diagnose AF, data from participants with a wide age range, and considered hypertension and measures of atrial stiffness. In Japan, Industrial Safety and Health Law requires employers to provide annual health check-ups to their employees. This study included 13 410 individuals who underwent health check-ups on at least four successive years between 2005 and 2015 (new-onset AF, <i>n</i> = 110; non-AF, <i>n</i> = 13 300). Data were entered into a risk prediction model using machine learning methods (eXtreme Gradient Boosting and Shapley Additive Explanation values). Data were randomly split into a training set (80%) used for model construction and development, and a test set (20%) used to test performance of the derived model. The area under the receiver operator characteristic curve for the model in the test set was 0.789. The best predictor of new-onset AF was age, followed by the cardio-ankle vascular index, estimated glomerular filtration rate, sex, body mass index, uric acid, γ-glutamyl transpeptidase level, triglycerides, systolic blood pressure at cardio-ankle vascular index measurement, and alanine aminotransferase level. This new model including arterial stiffness measure, developed with data from a general population using machine learning methods, could be used to identify at-risk individuals and potentially facilitation the prevention of future AF development.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293865","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":"Telephone follow-up based on artificial intelligence technology among hypertension patients: Reliability study","authors":"Siyuan Wang BM,&nbsp;Yan Shi MPH,&nbsp;Mengyun Sui PhD,&nbsp;Jing Shen BM,&nbsp;Chen Chen BM,&nbsp;Lin Zhang BM,&nbsp;Xin Zhang MD,&nbsp;Dongsheng Ren MD,&nbsp;Yuheng Wang MPH,&nbsp;Qinping Yang MPH,&nbsp;Junling Gao PhD,&nbsp;Minna Cheng MPH","doi":"10.1111/jch.14823","DOIUrl":"10.1111/jch.14823","url":null,"abstract":"<p>Artificial intelligence (AI) telephone is reliable for the follow-up and management of hypertensives. It takes less time and is equivalent to manual follow-up to a high degree. We conducted a reliability study to evaluate the efficiency of AI telephone follow-up in the management of hypertension. During May 18 and June 30, 2020, 350 hypertensives managed by the Pengpu Community Health Service Center in Shanghai were recruited for follow-up, once by AI and once by a human. The second follow-up was conducted within 3–7 days (mean 5.5 days). The mean length time of two calls were compared by paired <i>t</i>-test, and Cohen's Kappa coefficient was used to evaluate the reliability of the results between the two follow-up visits. The mean length time of AI calls was shorter (4.15 min) than that of manual calls (5.24 min, <i>P </i>&lt; .001). The answers related to the symptoms showed moderate to substantial consistency (<i>κ</i>:.465–.624, <i>P </i>&lt; .001), and those related to the complications showed fair consistency (<i>κ</i>:.349, <i>P </i>&lt; .001). In terms of lifestyle, the answer related to smoking showed a very high consistency (<i>κ</i>:.915, <i>P </i>&lt; .001), while those addressing salt consumption, alcohol consumption, and exercise showed moderate to substantial consistency (<i>κ</i>:.402–.645, <i>P </i>&lt; .001). There was moderate consistency in regular usage of medication (<i>κ</i>:.484, <i>P </i>&lt; .001).</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11180679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082767","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":"Relationship between morning blood pressure variability and cerebral microbleed burden in patients with hypertension","authors":"Dongsen Zhang MD,&nbsp;Hongying Ma MD,&nbsp;Chunqin Liu MD,&nbsp;Yongqiu Li MD","doi":"10.1111/jch.14831","DOIUrl":"10.1111/jch.14831","url":null,"abstract":"<p>Cerebral microbleeds (CMBs) can be understood as a type of target organ damage caused by hypertension. We aimed to explore the association of the CMB burden with morning blood pressure (BP) variability in patients with hypertension. We divided patients with hypertension into two groups: a group with 1–10 CMBs and a group with more than 10 CMBs. The duration, grade, medication, and control of hypertension were recorded in all patients. Morning home BP measurements were performed every 3 days for a month. A total of 791 patients were recruited. Full factor model analysis showed that higher morning home diastolic BP variability (standard deviation [SD], OR = 1.080, 95% CI: 1.024–1.140, <i>P</i> = .005; coefficient of variation [CV], OR = 1.076, 95% CI: 1.028–1.128, <i>P</i> = .002) was associated with more than 10 CMBs. Morning home systolic and diastolic blood pressure variability (SD, CV, average real variability) in more than 10 non-lobar CMBs group was significantly higher than that in 1–10 non-lobar CMBs group (<i>P</i> &lt; .05).The multivariate analysis showed higher morning home diastolic blood pressure variability (SD, OR = 1.124, 95% CI: 1.031–1.224, <i>P</i> = .008; CV, OR = 1.099, 95% CI: 1.019–1.186, <i>P</i> = .015; average real variability, OR = 1.055, 95% CI: 0.995–1.120, <i>P</i> = .075) was associated with more than 10 non-lobar CMBs. There was no significant relationship between morning home systolic blood pressure variability and more than 10 non-lobar CMBs (<i>P</i> &gt; .05). Higher morning home diastolic blood pressure variability was associated with more than 10 CMBs and more than 10 non-lobar CMBs.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11180696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077074","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 atherosclerosis indices, serum uric acid to high-density lipoprotein cholesterol ratio and triglycerides-glucose index with hypertension: A gender-disaggregated analysis","authors":"Rana Kolahi Ahari MD,&nbsp;Toktam Sahranavard MD,&nbsp;Amin Mansoori PhD,&nbsp;Zahra Fallahi BSc,&nbsp;Negin Babaeepoor BSc,&nbsp;Gordon Ferns MD, PhD,&nbsp;Majid Ghayour-Mobarhan MD, PhD","doi":"10.1111/jch.14829","DOIUrl":"10.1111/jch.14829","url":null,"abstract":"<p>This study assessed the association between atherosclerosis indices, serum uric acid to high-density lipoprotein cholesterol ratio (UHR) and triglyceride-glucose (TyG) index and the prevalence of hypertension among MASHAD cohort participants. In this cross-sectional study, the participants were divided into hypertensive and non-hypertensive subjects. The atherosclerosis indices, UHR and TyG index of the two groups were compared. Logistic regression analyses were used to determine the associations of these indices with hypertension in both sex. Receiver operating characteristic (ROC) curve analysis was used to establish the cut-off values for differentiating hypertensive from non-hypertensive subjects. <i>p</i>-values &lt; .05 were considered statistically significant. Data related to 9675 subjects (3035 hypertensive and 6640 non-hypertensive) were analyzed. The mean values of atherosclerosis indices, UHR and TyG index were significantly higher (<i>p</i> &lt; .001) in the hypertensives compared to non-hypertensives. After adjustment for potential confounders, among men, the TyG index (OR = 1.360; 95% CI: 1.210–1.530; <i>p</i> &lt; .001) remained an independent factor for hypertension. Among women, atherogenic index of plasma (OR = 1.005; 95% CI: 1.002–1.007; <i>p</i> &lt; .001), UHR (OR = 1.043; 95% CI: 1.026–1.060; <i>p</i> &lt; .001) and TyG index (OR = 1.519; 95% CI: 1.376–1.677; <i>p</i> &lt; .001) remained independent factors for hypertension. ROC curve analysis revealed that compare to the other indices, TyG index had a better predictive value for hypertension in both sex, especially in women.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11180701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140943730","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":"Antecubital vein combined with femoral vein pathway could shorten the learning curve of simultaneous bilateral adrenal vein sampling","authors":"Jiaqi Liu MM,&nbsp;Shuai Shao MD,&nbsp;Qiuli Wang MD,&nbsp;Zhiping Zhang MM,&nbsp;Xiaoying Ding MD, PhD,&nbsp;Li Zhao MD,&nbsp;Jinliang Wang MM,&nbsp;Xiaohong Ji MB,&nbsp;Qiuyan Dai MD, PhD,&nbsp;Mingli Du MD,&nbsp;Zhi Zhang MD, PhD","doi":"10.1111/jch.14828","DOIUrl":"10.1111/jch.14828","url":null,"abstract":"<p>During our previous bilateral adrenal vein sampling (AVS) procedure, the authors observed that accessing the left adrenal vein through the antecubital vein was more feasible than the conventional femoral vein. Meanwhile, the femoral vein pathway facilitated access to the right adrenal vein than the antecubital vein pathway. Therefore, the authors hypothesized that simultaneous bilateral AVS via the antecubital combined with the femoral vein pathway could improve the success rate. A total of 94 cases of AVS via the antecubital combined with the femoral vein pathway were performed, while the remaining 20 cases employed the antecubital vein pathway at our center between August 2020 and April 2023. Furthermore, a meta-analysis was conducted in this study using 15 selected articles to determine the success rate of AVS in each center and pathway. The success rate of ACTH-stimulated simultaneous bilateral AVS via the antecubital vein combined with the femoral vein pathway was 92.85% (<i>P</i> = .503) on the right and 95.00% (<i>P</i> &lt; .001) on the left. In the antecubital vein pathway, the success rates were only 25.00% (<i>P</i> &lt; .001) on the right side and 80.00% (<i>P</i> = .289) on the left side. The results of meta-analysis demonstrated a success rate of 78.16% on the right and 94.98% on the left for ACTH-stimulated AVS via the femoral vein pathway. Based on our center's experience, simultaneous bilateral adrenal vein sampling via the combined pathway could improve the success rate of AVS in the short term and shorten the learning curve.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11180688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946477","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":"Physicians’ attitudes toward beta-blockers for the treatment of hypertension in Italy, Poland, and Turkey","authors":"Aleksander Prejbisz MD, PhD,&nbsp;Francesca Donnaloja PhD,&nbsp;Piotr Dobrowolski MD, PhD,&nbsp;Alessia Tettamanti MSc,&nbsp;Andrzej Januszewicz MD, PhD,&nbsp;Mehdi Zoghi MD,&nbsp;Claudio Ferri MD","doi":"10.1111/jch.14819","DOIUrl":"10.1111/jch.14819","url":null,"abstract":"<p>Despite substantial progress in understanding the complex pathophysiology, hypertension remains a serious public health challenge affecting over 1.2 billion adults aged 30–79 years worldwide. Appropriate knowledge of the different pharmaceutical classes of antihypertensive agents and an understanding of the characteristics of individual molecules are essential to optimize clinical outcomes in patients with hypertension. We conducted a computer-assisted web interviewing (CAWI) quantitative survey in Italy, Poland, and Turkey to investigate physicians’ prescriptions, knowledge, and perceptions of antihypertensive drugs with a focus on β-blockers, to assess antihypertensive usage patterns and the reasons underlying prescription choices. The survey findings show that β-blockers retain a pivotal role in the management of hypertension and are prescribed more often for patients with cardiovascular comorbidities than for patients with diabetic comorbidities. In all three countries, nebivolol is the only β-blocker among the ones analyzed which is consistently prescribed to 20% or more of patients and is overall the most prescribed one for the population with comorbid diabetes. In terms of specific β-blockers’ features, this study revealed knowledge gaps that underline the need for educational activities focused on the differences among β-blockers, which are important in choosing the most suitable agent for individualized antihypertensive therapy.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11180681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944290","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 masked hypertension in attended versus unattended office blood pressure measurement","authors":"Sebastian Bertram MD,&nbsp;Frederic Bauer MD,&nbsp;Roni Shadi MD,&nbsp;Maximilian Seidel MD,&nbsp;Adrian Doevelaar MD,&nbsp;Felix Seibert MD,&nbsp;Nina Babel MD,&nbsp;Timm H. Westhoff MD","doi":"10.1111/jch.14798","DOIUrl":"10.1111/jch.14798","url":null,"abstract":"<p>There is a controversial debate regarding whether unattended blood pressure (BP) measurement should be regarded as the new gold standard of office BP measurement. Unattended BP measurement eliminates the white-coat effect and reduces external influences on the patient. On the other hand, it might underestimate real-life BP. The present study compares the prevalence of masked hypertension using attended versus unattended office BP measurements. We performed a cross-sectional study on 213 patients in a general practitioner's outpatient clinic and compared attended and unattended office BP with 24h-ambulatory BP monitoring (24h-ABPM). Masked hypertension was defined as pressure ≥135/85 mmHg in daytime ABPM with office systolic BP &lt; 140/90 mmHg. Median attended and unattended office BPs were 140/86 and 134/80 mmHg with a median 24h-BP of 129/79 mmHg and daytime ABP of 133/82 mmHg. The number of patients with masked hypertension was 45/213 (21.2%) using unattended and 23/213 (10.8%) using attended office BP measurements (<i>p</i> &lt; .0001). Bland–Altman analysis revealed a 7.4 mmHg systolic and 6.2 mmHg diastolic bias between the attended versus unattended office BP, and two systolic and −1.7 mmHg diastolic biases between the unattended office BP and daytime ambulatory BP. In linear regression analysis, an unattended office BP of 134 mmHg corresponded to 140 mmHg in attended BP measurement. Using a cut-off of 135/85 mmHg instead of 140/90 mmHg in unattended office BP measurement, the rate of masked hypertension was 26/213 (12.2%). Thus, unattended office BP measurement results in a substantial increase in the prevalence of masked hypertension using the traditional definition of hypertension. The present findings suggest that it might be reasonable to use a definition of 135/85 mmHg.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11180678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944299","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":"Target organ damage in untreated hypertensive patients with primary aldosteronism","authors":"Shi-Min Li MD,&nbsp;Jia-Yi Huang MD,&nbsp;Ching-Yan Zhu MD,&nbsp;Ming-Yen Ng MD,&nbsp;Qing-Shan Lin MD,&nbsp;Min Wu MD,&nbsp;Ming-Ya Liu MD, PhD,&nbsp;Run Wang MD,&nbsp;Gao-Zhen Cao MD,&nbsp;Cong Chen MD, PhD,&nbsp;Mei-Zhen Wu MD, PhD,&nbsp;Qing-Wen Ren MD,&nbsp;Hung-Fat Tse MD, PhD,&nbsp;Kai-Hang Yiu MD, PhD","doi":"10.1111/jch.14794","DOIUrl":"10.1111/jch.14794","url":null,"abstract":"<p>An increased risk of target organ damage (TOD) has been reported in patients with primary aldosteronism (PA). However, there is relatively little related research on the correlation between the degree of TOD and those with and without PA in newly diagnosed hypertensive patients. The aim of this study was to assess the association between PA and TOD among patients with newly diagnosed hypertension. Newly diagnosed hypertensive patients were consecutively recruited from January 2015 to June 2020 at the University of Hong Kong-Shenzhen Hospital. Patients were stratified into those with and without PA. Data for left ventricular mass index (LVMI), carotid intima-media thickness (CIMT) and plaque, and microalbuminuria were systematically collected. A total of 1044 patients with newly diagnosed hypertension were recruited, 57 (5.5%) of whom were diagnosed with PA. Patients with PA had lower blood pressure, serum lipids, body mass index, and plasma renin activity and a higher incidence of hypokalemia than those without PA. In contrast, the prevalence of left ventricular hypertrophy, increased CIMT, and microalbuminuria was higher in patients with PA than in those without PA. Multivariable regression analysis demonstrated that PA was independently associated with increased LVMI, CIMT and microalbuminuria. Among patients with newly diagnosed hypertension, those with PA had more severe TOD, including a higher LVMI, CIMT and microalbuminuria, than those without PA. These findings emphasize the need for screening TOD in newly diagnosed hypertension due to underlying PA.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The double burden of hypertension and frailty in the aging population: Does lowering blood pressure improve outcomes?","authors":"Meiling Piao MD,&nbsp;Vipin Kumar MD,&nbsp;Chunzi Jin MD, PhD,&nbsp;Xian Wu Cheng MD, PhD, FAHA","doi":"10.1111/jch.14830","DOIUrl":"10.1111/jch.14830","url":null,"abstract":"<p>Frailty, a geriatric syndrome characterized by multiple declining physiological reserves, reduced resistance to stressors, increased vulnerability, and impaired homeostatic maintenance is associated with increased risks of disability, hospitalization, and mortality in older adults.<span>¹</span> The recognition of frailty as a health concern has led to increased research regarding the relationship between frailty and hypertension, and emerging evidence suggests a reciprocal relationship between frailty and hypertension in older adults. Chronic conditions such as hypertension are significant contributors to frailty, and cardiovascular complications resulting from hypertension have been identified as factors that contribute to the onset of frailty.<span>²</span> Conversely, frailty has been suggested to be a risk factor for cardiovascular disease including hypertension.<span>³</span> The management of hypertension in frail older adults requires a comprehensive, multidimensional approach that focuses on improving overall health, effective blood pressure control, and physical function. However, the management of hypertension in frail older adults remains a challenge as several investigations have indicated that while treatment may provide cardiovascular benefits, antihypertensive medications may also increase the risk of adverse events such as hypotension, falls, and related injuries.<span>^{4, 5}</span></p><p>An evolving concept in the management of hypertension in frail older adults is the “Blood Pressure Time in Target Range (BP-TTR),” which indicates the percentage of time that an individual's BP remains within a predefined target range (Figure 1). The post hoc analysis of the Systolic Blood Pressure Intervention Trial (SPRINT) by Zhu et al. provides valuable insights into the relationship between maintaining BP-TTR and reducing cardiovascular risks in patients with both hypertension and prefrailty or frailty.<span>⁶</span> The Zhu et al. study highlights the critical importance of monitoring and controlling both the systolic blood pressure (SBP)-TTR and the diastolic blood pressure (DBP)-TTR to reduce cardiovascular risks, and they obtained four important findings: (<i>i</i>) The maintenance of SBP in the target range is crucial, as lower SBP-TTR values were correlated with an increased incidence of the study's primary outcome, that is, cardiovascular events; (<i>ii</i>) higher SBP-TTR values were associated with a reduced risk of cardiovascular outcomes, highlighting the protective effect of maintaining SBP within a higher target range; (<i>iii</i>) similar patterns were observed for the DBP-TTR, suggesting that the careful management of both SBP and DBP is critical in this patient population; and (<i>iv</i>) a subgroup analysis suggested that the protective effect of higher SBP-TTR values was less pronounced at lower DBP-TTR values, highlighting the interplay between SBP and DBP management","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11180687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867075","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":"A meta-analysis of left ventricular dysfunction in ankylosing spondylitis","authors":"Olayiwola Bolaji MD, MSc,&nbsp;Osejie Oriaifo MD, MSc,&nbsp;Olanrewaju Adabale MD, MA,&nbsp;Arthur Dilibe MD,&nbsp;Krishna Kuruvada MD,&nbsp;Faizal Ouedraogo MD, MPH,&nbsp;Ebubechukwu Ezeh MD,&nbsp;Ambica Nair MD,&nbsp;Titilope Olanipekun MD, MPH,&nbsp;Sula Mazimba MD, MPH,&nbsp;Chadi Alraies MD, MPH","doi":"10.1111/jch.14827","DOIUrl":"10.1111/jch.14827","url":null,"abstract":"<p>Ankylosing spondylitis (AS) is a chronic inflammatory arthritis affecting the spine, presenting a considerable morbidity risk. Although evidence consistently indicates an elevated risk of ischemic heart disease among AS patients, debates persist regarding the likelihood of these patients developing left ventricular dysfunction (LVD). Our investigation aimed to determine whether individuals with AS face a greater risk of LVD compared to the general population. To accomplish this, we identified studies exploring LVD in AS patients across five major databases and Google Scholar. Initially, 431 studies were identified, of which 30 met the inclusion criteria, collectively involving 2933 participants. Results show that AS patients had: (1) poorer Ejection Fraction (EF) [mean difference (MD): −0.92% (95% CI: −1.25 to −0.59)], (2) impaired Early (E) and Late (atrial—A) ventricular filling velocity (E/A) ratio [MD: −0.10 m/s (95% CI: −0.13 to −0.08)], (3) prolonged deceleration time (DT) [MD: 12.30 ms (95% CI: 9.23–15.36)] and, (4) a longer mean isovolumetric relaxation time (IVRT) [MD: 8.14 ms (95% CI: 6.58–9.70)] compared to controls. Though AS patients show increased risks of both systolic and diastolic LVD, we found no significant differences were observed in systolic blood pressure [MD: 0.32 mmHg (95% Confidence Interval (CI): −2.09 to 2.73)] or diastolic blood pressure [MD: 0.30 mmHg (95% CI: −0.40 to 1.01)] compared to the general population. This study reinforces AS patients' susceptibility to LVD without a notable difference in HTN risk.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11232451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856792","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}