Journal of Clinical Hypertension最新文献

{"title":"Directional Temporal Relationship Between Hypertension and Non-Alcoholic Fatty Liver Disease: A Cross-Lagged Cohort Study","authors":"Jianmin Tang,&nbsp;Halengbieke Aheyeerke,&nbsp;Xuetong Ni,&nbsp;Tengrui Cao,&nbsp;Xuan Wang,&nbsp;Shuo Chen,&nbsp;Yumei Han,&nbsp;Linrun Kong,&nbsp;Xinghua Yang","doi":"10.1111/jch.70012","DOIUrl":"https://doi.org/10.1111/jch.70012","url":null,"abstract":"<p>The temporal relationship between non-alcoholic fatty liver disease (NAFLD) and hypertension (HTN) remains unclear despite their known association. Using data from the Beijing Health Management Cohort (BHMC) with a 5-year follow-up, we investigated these bidirectional links through Cox proportional hazards regression and a cross-lagged panel model (CLPM), adjusting for confounders. Systolic/diastolic blood pressure (SBP/DBP) and hepatic steatosis index (HSI) were treated as continuous variables to enhance biological interpretability. Cox regression revealed that HTN increased the risk of NAFLD (hazard ratio [HR]: 1.15, 95% confidence interval [CI]: 1.01–1.30, <i>p</i> &lt; 0.05) among participants without NAFLD at baseline, while NAFLD elevated the risk of HTN (HR: 1.11, 95% CI: 1.02–1.21, <i>p</i> &lt; 0.05) among those without HTN at baseline. However, CLPM involving 7349 participants identified a unidirectional temporal relationship from HTN to NAFLD, regression coefficients <i>β</i>_{SBP2017→HSI2022}: 0.036 (95% CI: 0.012, 0.059), <i>β</i>_{DBP2017→HSI2022}: −0.044 (95% CI: −0.068, −0.020), both <i>p</i> &lt; 0.05; but not from NAFLD to HTN, regression coefficients <i>β</i>_{HSI2017→SBP2022}: 0.017 (95% CI: −0.003,0.037), <i>β</i>_{HSI2017→DBP2022}:0.006 (95% CI: −0.016,0.028), both <i>p</i> &gt; 0.05. Overall, our study demonstrates a unidirectional temporal association from HTN to NAFLD. However, a bidirectional relationship was also observed in individuals under 60 years and in those without central obesity. These findings highlight the importance of considering age and central obesity to manage HTN to reduce the risk of future NAFLD and to manage NAFLD to reduce the risk of future HTN.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481316","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":"Antihypertensive Drug Use and COVID-19 Disease Severity in Hospitalized US Veterans: A Retrospective Cohort Study","authors":"Merodean Huntsman,&nbsp;Jessica L. Marquez,&nbsp;Gregory J. Stoddard,&nbsp;Guo Wei,&nbsp;Aaron J. Miller,&nbsp;Jayant P. Agarwal,&nbsp;Sujee Jeyapalina","doi":"10.1111/jch.70021","DOIUrl":"https://doi.org/10.1111/jch.70021","url":null,"abstract":"<p>This research investigated associations between hypertensive patients with COVID-19 who did and did not use specific antihypertensive medications and had incurred hospital ventilation/death in the US Veterans Hospital System. This study included de-identified medical records of 572 994 hypertensive US veterans who were diagnosed with COVID-19 and hospitalized between March 1, 2020, and February 28, 2022, with a 60-day follow-up period. Mechanical ventilation and/or death within 60 days of COVID-19 hospitalization served as the outcome variables. On multivariable analysis, CCB use was associated with a 9% increased risk of mechanical ventilation, while ACE inhibitors (HR: 0.90), alpha blockers (HR: 0.92), and CCB (HR: 0.93) users were associated with a significantly decreased risk of death. Additional multivariable analysis on those with and without additional comorbidities, such as chronic kidney disease (CKD), heart failure, and diabetes, revealed that in those with at least one additional comorbidity, CCB uses led to a 9% increased deleterious risk for ventilation. In contrast, the use of ACE inhibitors (HR: 0.86), alpha blockers (HR: 0.92), and CCB (HR: 0.93) demonstrated a moderate protective effect against mortality. Lastly, in hypertensive veterans without any additional comorbidities, there was a lack of significant association between hypertensive medication usage and mechanical ventilation and/or death. In summary, although CCB use was associated with an increased risk of requiring mechanical ventilation, it also demonstrated a protective effect against mortality. At the same time, ACEI, alpha blocker, and CCB usage led to a significantly decreased risk for death within all hypertensive hospitalized COVID-19 veteran cohorts.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481318","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":"Associations of microRNA Gene Polymorphisms With Salt Sensitivity, Longitudinal Blood Pressure Changes, and Hypertension Incidence in the Chinese Population","authors":"Xi Zhang,&nbsp;Shi Yao,&nbsp;Yang Wang,&nbsp;Chao Chu,&nbsp;Mingfei Du,&nbsp;Jianjun Mu","doi":"10.1111/jch.70019","DOIUrl":"https://doi.org/10.1111/jch.70019","url":null,"abstract":"<p>MicroRNAs (miRNAs) are small endogenous RNA molecules that play an essential role in various disease processes including elevated blood pressure (BP). Although the effects of dietary salt and potassium intake on BP regulation have been established, their co-interaction with miRNAs are still unclear. The purpose of the current study was to explore the connection between miRNA gene polymorphisms and BP response to salt and potassium intake, and the relationship between miRNA gene polymorphisms and long-term BP changes and hypertension development. A total of 333 participants underwent a chronic sodium-potassium dietary intervention trial, which included a 3-day normal diet, followed by a 7-day low-salt diet, then a 7-day high-salt diet, and finally a 7-day high-salt with potassium-supplemented diet. This cohort was subsequently followed for up to 14 years. Single-nucleotide polymorphisms (SNPs) rs115254818 in miR-26b-3p, rs11191676 and rs2292807 in miR-1307-5p, and rs4143957 in miR-382-5p were significantly correlated with systolic BP (SBP) and mean arterial pressure (MAP) responses to high-salt intake, whereas rs11191676 and rs2292807 in miR-1307-5p exhibited significant associations with SBP response to potassium-supplemented diet. Furthermore, SNPs rs2070960 in miR-3620-5p and rs12364149 in miR-210-3p demonstrated significant correlations with diastolic BP and MAP alterations at 14 years of follow-up. Generalized linear mixed model analysis revealed a significant association between rs2070960 in miR-3620-5p and hypertension development over a 14-year period. Our study indicates that miRNA gene polymorphisms are pivotal in the salt and potassium sensitivity of BP, as well as in the longitudinal BP progression and hypertension incidence.</p><p><b>Trial Registration</b>: ClinicalTrials.gov identifier: NCT02734472</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481317","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 a New Model of Insulin Sensitivity and Hypertension in Patients With Type 2 Diabetes: A Cross-Sectional Study","authors":"Baolan Ji,&nbsp;Shuwei Shi,&nbsp;Guanqi Gao,&nbsp;Yangang Wang,&nbsp;Bo Ban","doi":"10.1111/jch.70008","DOIUrl":"https://doi.org/10.1111/jch.70008","url":null,"abstract":"<p>Type 2 diabetes (T2D) and hypertension often coexist, and insulin resistance (IR) plays an important role in their pathological progression. An increasing number of studies have focused on the relationship between different IR indices and hypertension. A natural log transformation of the glucose disposal rate (log_e GDR) has been proposed as a new model for insulin sensitivity in patients with T2D. The study aimed to explore the relationship between log_e GDR and hypertension in T2D patients. This cross-sectional study included 1544 Chinese T2D patients. Clinical and biochemical characteristics were collected. The log_e GDR was calculated based on triglycerides, urinary albumin to creatinine ratio, gamma-glutamyl transferase, and body mass index. Patients were categorized into hypertension and nonhypertension groups stratified by gender. Among both females and males, compared with the nonhypertension group, the level of log_e GDR was significantly decreased in the hypertension group (both <i>p</i> &lt; 0.001). As the log_e GDR increased, the levels of systolic and diastolic blood pressure, and the prevalence of hypertension were obviously increased (all <i>p</i> &lt; 0.001). Univariate analysis displayed that log_e GDR was negatively related to hypertension (correlation coefficient: −0.243, <i>p</i> &lt; 0.001 in females; correlation coefficient: −0.181, <i>p</i> &lt; 0.001 in males). Furthermore, the logistic regression analysis showed that log_e GDR was independently associated with hypertension (OR: 0.456; 95% CI: 0.224–0.927 in females; OR: 0.544; 95% CI: 0.314–0.941 in males). This study revealed that log_e GDR was closely related to hypertension, which might help monitor and manage hypertension in T2D patients.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481611","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":"Meta-Analysis of Real-World Clinical Practice to Assess the Effectiveness of Riociguat in Treating Chronic Thromboembolic Pulmonary Hypertension","authors":"Esra Pamukçu,&nbsp;Mehmet Onur Kaya","doi":"10.1111/jch.70015","DOIUrl":"https://doi.org/10.1111/jch.70015","url":null,"abstract":"<p>Riociguat is a drug that improves hemodynamic parameters and increases the exercise capacity of patients with chronic thromboembolic pulmonary hypertension (CTEPH). This meta-analysis evaluated cohort studies that measured changes in parameters such as the 6-minute walk distance (6MWD), mean pulmonary arterial pressure (mPAP), pulmonary vascular resistance (PVR), cardiac output (CO), and pulmonary arterial wedge pressure (PAWP). The study utilized cohort studies with a paired samples group design to measure the changes in these parameters. We searched for articles containing the keywords “Riociguat” and “Chronic thromboembolic pulmonary hypertension” in their titles in PubMed, Web of Science, Scopus, and ScienceDirect databases until May 2024. We conducted five meta-analyses to combine the mean difference values. We identified nine studies that examine the effects of Riociguat on patients. Analyzing data from 565 patients revealed that Riociguat increases the distance walked during the 6MWD test by an average of 35.86 m. After analyzing data from 717 patients, it was found that Riociguat reduces mPAP by an average of 9.23 mm Hg. Analyzing data from 586 patients, it was found that Riociguat reduces PVR by an average of 220.11 <span></span><math>\u0000 <semantics>\u0000 <mrow>\u0000 <mi>dyn</mi>\u0000 <mo>.</mo>\u0000 <mi>s</mi>\u0000 <mo>.</mo>\u0000 <mi>c</mi>\u0000 <msup>\u0000 <mi>m</mi>\u0000 <mrow>\u0000 <mo>−</mo>\u0000 <mn>5</mn>\u0000 </mrow>\u0000 </msup>\u0000 </mrow>\u0000 <annotation>${mathrm{dyn}}.{mathrm{s}}.{mathrm{c}}{{{mathrm{m}}}^{ - 5}}$</annotation>\u0000 </semantics></math>. Moreover, analyzing data from 643 patients showed that Riociguat increases CO by an average of 0.49 L/min. Finally, after analyzing data from 645 patients, it was concluded that Riociguat treatment did not have a statistically significant effect on PAWP. Our findings indicate that Riociguat improved certain hemodynamic parameters and exercise capacity in CTEPH patients.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424301","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":"Comparison of Cardiovascular Outcomes Between Chlorthalidone and Hydrochlorothiazide in Hypertensive Patients","authors":"Subin Lim,&nbsp;Ju Hyeon Kim,&nbsp;Seungmi Oh,&nbsp;Soon Jun Hong,&nbsp;Cheol Woong Yu,&nbsp;Hyung Joon Joo,&nbsp;Yong Hyun Kim,&nbsp;Eung Ju Kim","doi":"10.1111/jch.70000","DOIUrl":"https://doi.org/10.1111/jch.70000","url":null,"abstract":"<p>Chlorthalidone (CLTD) and hydrochlorothiazide (HCTZ) are widely used thiazide diuretics for hypertension management. This study aimed to evaluate and compare the cardiovascular outcomes of patients treated with CLTD versus HCTZ. This multicenter, retrospective cohort study utilized data from the Korea University Medical Center, derived from electronic health records. A total of 14 257 hypertensive patients treated with either CLTD (<i>n</i> = 1920) or HCTZ (<i>n</i> = 12 337) were identified. Patients were matched 1:1 using propensity scores, resulting in 1606 patients in each treatment group. Demographic and clinical characteristics, incidence of major adverse cardiovascular events (MACE), and safety profiles were analyzed. Baseline characteristics after propensity score matching were well balanced between the two groups. The average age was 61.8 ± 14.6 years for CLTD users, with 59.3% being male. The 3-year MACE occurred in 1.2% of the CLTD group compared with 1.4% of the HCTZ group (hazard ratio 0.91, <i>p</i> = 0.77). For secondary outcomes, cardiovascular mortality was 0.2% in both groups (<i>p</i> = 0.92). Myocardial infarction occurred in 0.3% of CLTD users and 0.4% of HCTZ users (<i>p</i> = 0.65). The incidence of hypokalemia was 19.2% in the CLTD group versus 16.7% in the HCTZ group (<i>p</i> = 0.07). In conclusion, in hypertensive patients, CLTD and HCTZ showed comparable cardiovascular outcomes and safety profiles.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424300","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":"Cardiac Baroreflex Is Preserved After the Recovery From COVID-19 Men and Women","authors":"Roberto Souza,&nbsp;Beatriz Divino,&nbsp;Helena N. M. Rocha,&nbsp;Jocemir R. Lugon,&nbsp;Natalia G. Rocha,&nbsp;Antonio C. L. Nobrega,&nbsp;Eliza Prodel","doi":"10.1111/jch.70006","DOIUrl":"https://doi.org/10.1111/jch.70006","url":null,"abstract":"<p>We sought to investigate whether mild COVID-19 impairs cardiac baroreflex sensitivity (cBRS), using the modified Oxford protocol, in young healthy men and women 12–14 weeks after recovering from the infection. Participants were distributed into two groups: Non-COVID-19 group (NCG: men <i>n</i> = 6 [30 ± 3years; 26 ± 1 kg/m²] and women <i>n</i> = 5 [25 ± 1 years; 25 ± 1 kg/m²]) and recovered from COVID-19 group (RCG: men <i>n</i> = 6 [29 ± 3 years; 25 ± 1 kg/m²] and women <i>n</i> = 10 [32 ± 4 years; 22 ± 1 kg/m²]), the RCG tested positive (RT-PCR) 12 to 14 weeks before the protocol. Beat-to-beat finger blood pressure (BP) and heart rate (HR) were measured during a bolus of sodium nitroprusside (SNP) and phenylephrine (PHE), in a control condition and during cold pressor test (CPT) and moderate dynamic handgrip exercise (GRIP). Resting systolic BP was higher in the RCG (135 ± 14 mmHg vs. 122 ± 12 mmHg, <i>p</i> = 0.01). Both CPT and GRIP maneuvers increased HR and BP; the bolus of SNP diminished BP and evoked a reflex-mediated increase in HR; PHE increased BP, resulting in a reflex-mediated decrease in HR. Of note, cBRS for decrease or increase of BP did not differ between groups under the studied conditions: control (SNP, <i>p</i> = 0.39; PHE, <i>p</i> = 0.50); CPT (SNP, <i>p</i> = 0.09; PHE: <i>p</i> = 0.82); and GRIP (SNP, <i>p</i> = 0.35; PHE, <i>p</i> = 0.53). In conclusion, mild COVID-19 did not seem to impair cBRS in healthy young men and women 12–14 weeks after recovering from the infection.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424299","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":"Predictive Value of an Early Diagnosis of Orthostatic Hypotension on Cardiovascular Events","authors":"Fosca Quarti-Trevano,&nbsp;Cesare Cuspidi,&nbsp;Guido Grassi","doi":"10.1111/jch.70018","DOIUrl":"https://doi.org/10.1111/jch.70018","url":null,"abstract":"&lt;p&gt;A large number of prospective studies carried out during the past 20 years, some of them included in a recent meta-analysis, have conclusively shown that clinically overt orthostatic hypotension represents a pathological condition associated with an increase in fatal and non-fatal cardiovascular events and in all-cause mortality [&lt;span&gt;1-8&lt;/span&gt;]. Whether and to what extent this is the case in the advanced full manifest clinical condition only or it is also detectable in the initial clinical phases of the disease is much less clearly defined, however.&lt;/p&gt;&lt;p&gt;In the present issue of the &lt;i&gt;Journal&lt;/i&gt;, a group of Chinese investigators reports the results of a retrospective study [&lt;span&gt;9&lt;/span&gt;] aimed at investigating the occurrence of major adverse cardiovascular events (MACE), defined as cardiovascular death, myocardial infarction, angina pectoris, heart failure, or atrial fibrillation in patients aged more than 50 years with a diagnosis of an initial orthostatic hypotensive condition and followed, on average, for more than 5 years. Early diagnosis was founded on the detection of a transient decrease in systolic blood pressure of magnitude greater than 40 mmHg and/or in diastolic blood pressure greater than 20 mmHg within 15 s of active standing, with a blood pressure recovery between 15 s and 3 min of standing [&lt;span&gt;10&lt;/span&gt;]. A group of patients with a full-blown orthostatic hypotensive disease served as a control to compare the data collected in the patients displaying the initial stage of the clinical condition. Results show that not only sustained but also initial orthostatic hypotension increases the risk of cardiovascular events, the mortality risk is, however, augmented in the advanced clinical condition only.&lt;/p&gt;&lt;p&gt;Several intriguing findings of the study deserve to be mentioned and discussed. First, the study makes the diagnosis of orthostatic hypotension on the basis of the blood pressure responses to standing detected during the initial 15 s of the maneuver. Does this approach guarantee an accurate and careful assessment of the disease? Based on current guidelines [&lt;span&gt;10&lt;/span&gt;], the approach seems accurate enough, given the notion that the circulatory responses characterizing the first 15 s of the maneuver are more likely to detect the blood pressure drop in this very initial time period. To assess such short-lasting blood pressure changes appropriately, the Authors correctly have made use of the continuous non-invasive arterial blood pressure monitoring device, which allows to properly detect short-lasting blood pressure changes occurring in this temporal window of very short duration. Another issue, which is important from a methodological but also a diagnostic viewpoint, refers to the within-subject variability of the hemodynamic responses to standing [&lt;span&gt;11, 12&lt;/span&gt;]. In other words, should the diagnosis of the condition be based only on a single evaluation or should it be based on the average of the responses repea","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424302","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":"Impact of Hyperuricemia on Incident Hypertension When Hypertension Definition Changes From 140/90 to 130/80 mmHg in a Large Taiwanese Population Follow-Up Study","authors":"Yi-Hsueh Liu,&nbsp;Wei-Yu Su,&nbsp;Chih-Yi Lin,&nbsp;Chun-Chi Tsai,&nbsp;Ho-Ming Su,&nbsp;Szu-Chia Chen","doi":"10.1111/jch.70013","DOIUrl":"https://doi.org/10.1111/jch.70013","url":null,"abstract":"<p>A lower blood pressure threshold (≥130/80 mmHg) to define hypertension has been proposed in several hypertension guidelines. This study assessed the relationship between hyperuricemia and incident hypertension, examining serum uric acid (SUA) cut-offs using both traditional and new definitions in a large Taiwanese cohort. This observational cohort study enrolled 26 973 participants from the Taiwan Biobank (TWB), followed for a median of 4 years. Regarding traditional definition (140/90 mmHg), hyperuricemia (odds ratio [OR], 1.297), quartile 3 of SUA (OR, 1.211), quartile 4 of SUA (OR, 1.495), and high SUA (OR, 1.127) were significantly associated with incident hypertension in males, and hyperuricemia (OR, 1.198), quartile 4 of SUA (OR, 1.359), and high SUA (OR, 1.099) were significantly associated with incident hypertension in females. As for new definition (130/80 mmHg), hyperuricemia (OR, 1.376), quartile 3 of SUA (OR, 1.229), quartile 4 of SUA (OR, 1.554), and high SUA (OR, 1.139) were associated with incident hypertension in males, and hyperuricemia (OR, 1.249), quartile 3 of SUA (OR, 1.253), quartile 4 of SUA (OR, 1.429), and high SUA (OR, 1.096) were associated with incident hypertension in females. The interaction between hyperuricemia and sex on incident hypertension was significant for both traditional (140/90, <i>p</i> &lt; 0.001) and new (130/80, <i>p</i> = 0.001) definitions. Hyperuricemia was significantly associated with incident hypertension under both traditional and new definitions. A significant interaction between hyperuricemia and sex was noted, although the differences were not so great.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362628","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":"High Heart Rate and Hypertension: Two Intertwined Cardiovascular Risk Factors","authors":"Paolo Palatini","doi":"10.1111/jch.70010","DOIUrl":"https://doi.org/10.1111/jch.70010","url":null,"abstract":"&lt;p&gt;A large number of studies have shown that high heart rate (HR) is correlated with many risk factors for atherosclerosis and cardiovascular events, including high blood pressure, dyslipidemia, hyperinsulinemia, hyperglycemia, and obesity [&lt;span&gt;1-3&lt;/span&gt;]. These associations have been observed in general populations as well as in patients with hypertension, diabetes, coronary artery disease, and heart failure, indicating that measurement of HR should be an important component of cardiovascular risk assessment. Although many prospective studies performed in general populations showed significant associations between the baseline office HR and subsequent blood pressure or hypertension, in only a few studies did the predictive power of HR remain significant after controlling for the baseline blood pressure level [&lt;span&gt;4, 5&lt;/span&gt;]. Furthermore, the confounding effect of physical fitness was considered only in the CARDIA study [&lt;span&gt;6&lt;/span&gt;] in the United States, in people aged 18 to 30 years. These results were later confirmed by the Kailuan prospective study [&lt;span&gt;7&lt;/span&gt;], which included a large number of participants aged 38 to 54 years, and by a prospective cohort study carried out in rural China in 39- to 59-year-old subjects [&lt;span&gt;8&lt;/span&gt;]. Finally, in a meta-analysis of 9 cohort studies encompassing 79 399 individuals, Shen et al. found a linear dose–response association between HR and incident hypertension in adults [&lt;span&gt;9&lt;/span&gt;]. All these studies were carried out in young or middle-aged people while little information was available for older individuals.&lt;/p&gt;&lt;p&gt;This knowledge gap was addressed by Lou and colleagues in an article published in this issue of Journal of Clinical Hypertension [&lt;span&gt;10&lt;/span&gt;]. These investigators showed that high HR was associated with an increased risk of developing hypertension also in older individuals, with a 6% increase in risk for every 10 beats/min increment in HR. This association may explain at least in part the higher risk of mortality found in elderly subjects with fast HR [&lt;span&gt;11&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;As hypothesized by Lou and colleagues, a heightened sympathetic activity may explain why subjects with high HR tend to develop sustained hypertension in later years [&lt;span&gt;10&lt;/span&gt;]. A high sympathetic activity causes an increase in cardiac output, peripheral vascular resistance, and sodium reabsorption in the kidney, which leads to an&lt;/p&gt;&lt;p&gt;Elevation of blood pressure [&lt;span&gt;12&lt;/span&gt;]. However, whether tachycardia in these individuals reflects a temporary reaction to the medical environment or is the consequence of a stable sympathetic activation is still a matter of debate. Results of the HARVEST Study showed that in most subjects with elevated HR at the initial visit, HR tends to return to normal values after baseline assessment, and that these subjects are not at increased risk of future hypertension [&lt;span&gt;5&lt;/span&gt;]. This suggests that a transient increase in sympathetic activity on a ba","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 2","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143362627","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}