Journal of Clinical Hypertension最新文献

{"title":"Exercise interventions for the effect of endothelial function in hypertensive patients: A systematic review and meta-analysis","authors":"Chao Liang PhD,&nbsp;Zhenpeng Song MM,&nbsp;XiaoZhi Yao PhD,&nbsp;Qian Xiao MM,&nbsp;Hehui Fu MM,&nbsp;Lixu Tang PhD","doi":"10.1111/jch.14818","DOIUrl":"10.1111/jch.14818","url":null,"abstract":"<p>Endothelial dysfunction is crucial factor to the hypertension occurrence, and controversy remains regarding the effect of exercise on improving endothelial function in hypertensive patients. The authors used meta-analysis to evaluate the intervention effect of exercise on endothelial function in hypertensive patients and to investigate exercise protocols that may have a greater intervention effect. A total of 37 studies and a total of 2801 participants were included. The results were as follows: endogenous nitric oxide (NO)[SMD = .89, 95% CI (.48, 1.30), <i>p</i> &lt; .0001], endothelin-1 (ET-1): [SMD = −.94, 95% CI (−1.15, −.73), <i>p</i> &lt;. 0001], flow-mediated dilation (FMD) [SMD = −.57, 95% CI (.36, .79), <i>p</i> &lt; .000001]. In subgroup analysis, high-intensity aerobic exercise, with a single exercise duration of 35–50 min, 3–4 times/week for a total of 10–12 weeks, had the largest amount of intervention effect on NO, and moderate-intensity resistance exercise, with a single exercise duration of ≥60 min, 6 times/week for a total of 15–18 weeks, had the largest amount of intervention effect on ET-1. In conclusion, exercise can improve NO levels, FDM levels, and reduce ET-1 secretion of hypertension patients, thereby improve their endothelial function. The ideal intervention effect of improving NO level was more likely to be obtained by taking the exercise prescription of high-intensity aerobic exercise with a single exercise duration of 35–50 min, 3–4 times/week for 10–12 weeks; the ideal intervention effect of improving ET-1 was more likely to be obtained by taking the exercise prescription of oderate -intensity resistance exercise with a single exercise duration of ≥60 min, 6 times/week for 15–18 weeks.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11180684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873184","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 association between blood pressure variability and renal damage in patients with primary aldosteronism","authors":"Siying Wu MM,&nbsp;Sen Li MM,&nbsp;Jing Huang BS,&nbsp;Jie Yu BS,&nbsp;Chaoping Wei BS,&nbsp;Lixia Wei BS,&nbsp;Shuangbei Zhu BS,&nbsp;Shanshan Chen BS,&nbsp;Meilan Chen BS,&nbsp;Jianling Li MD","doi":"10.1111/jch.14824","DOIUrl":"10.1111/jch.14824","url":null,"abstract":"<p>This research examines the association between blood pressure variability (BPV) and renal damage in a cohort of 129 primary aldosteronism (PA) patients, employing ambulatory blood pressure monitoring (ABPM) for comparative analysis with individuals diagnosed with essential hypertension (EH). The study reveals that PA patients exhibited significantly elevated levels of cystatin C and urine microalbumin/creatinine ratio (UACR). Additionally, a higher prevalence of non-dipping blood pressure patterns in PA patients suggests an increased risk of circadian blood pressure regulation disturbances. Notably, while most BPV indices were comparable between the two groups, the standard deviation of 24-h weighted diastolic blood pressure was markedly lower in the PA cohort, distinguishing it as a unique variable. Through multiple linear regression analysis, the duration of hypertension, angiotensin II concentrations, and daytime systolic blood pressure standard deviation emerged as significant determinants of estimated glomerular filtration rate (eGFR) in PA patients. Furthermore, UACR was significantly influenced by variables including the 24-h weighted standard deviation (wSD) of systolic BP, glycosylated hemoglobin levels, nocturnal systolic BP peaks, aldosterone-renin ratio (ARR), and total cholesterol, with the most pronounced association observed with the 24-h wSD of systolic BP (β = 0.383).The study also found significant correlations between the 24-h wSD of systolic BP, ARR, HbA1c, serum potassium levels, and 24-h urinary microalbumin, underscoring the critical role of the 24-h wSD of systolic BP (β = 0.267). These findings underscore the imperative of an integrated management strategy for PA, addressing the intricate interconnections among metabolic abnormalities, blood pressure variability, and renal health outcomes.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14824","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833228","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 and risk factors for isolated systolic hypertension among the oldest-old population in southwestern China: A community-based cross-sectional study","authors":"Xiaobo Huang MD,&nbsp;Lingli Qiu MBBS,&nbsp;Tzung-Dau Wang PhD,&nbsp;Qian Yao MBBS,&nbsp;Jianxiong Liu MM,&nbsp;Ronghua Xu MM,&nbsp;Qingkun Zheng MM,&nbsp;Xingping Zhang MM,&nbsp;Jinhui Wu MD","doi":"10.1111/jch.14826","DOIUrl":"10.1111/jch.14826","url":null,"abstract":"<p>The prevalence of isolated systolic hypertension (ISH) has doubled between 2002−2005 and 2014 among the oldest-old population in China. However, the prevalence and characteristics of ISH among the oldest-old population in southwestern China remain less known. This study aimed to investigate the prevalence of ISH among the oldest-old population in Chengdu and identify associated factors to provide valuable information for disease etiology and prevention. We recruited 1,312 participants aged over 80 years by using a stratified cluster sampling method between September 2015 and June 2016, from three districts (Jinjiang, Qingyang, and Longquanyi) of Chengdu, the largest city of southwest China. A structured questionnaire, anthropometric data, and blood pressure were collected according to the standard method. Blood pressure was measured three times by using a standardized mercury sphygmomanometer after a 10-minute seated rest. Of 1312 participants, 53.0% (<i>n </i>= 695) had ISH. The prevalence of ISH in men and women was 54.7% and 51.3%, respectively, with no significant sex difference (<i>P</i> = .222). The prevalence of ISH increased with advanced age in men (<i>P</i> for trend = 0.029), 52.5% for the 80−84 years group, 55.2% for the 85−89 years group, and 70.4% for the 90–98 years group, respectively. Multivariable logistic regression analyses found that drinking (<i>OR </i>= 1.85, 95%<i>CI </i>= 1.26−2.71), being overweight (<i>OR </i>= 1.88, 95%<i>CI </i>= 1.19−2.96), and having a higher heart rate (<i>OR </i>= 0.66, 95%<i>CI </i>= 0.51−0.86) were associated with ISH. Stratified by sex, these three factors remained significant in men. Our work highlights that the burden of ISH is substantial among the oldest-old population in southwestern China.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14826","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833227","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 between brachial-ankle pulse wave velocity and hypertensive retinopathy in treated hypertensive adults: Results from the China Stroke Primary Prevention Trial (CSPPT)","authors":"Ying Meng MD,&nbsp;Lishun Liu PhD,&nbsp;Xuling Chen MD,&nbsp;Liang Zhao MD,&nbsp;Haicheng She MD,&nbsp;Wenbo Zhang MD,&nbsp;Jing Zhang MD,&nbsp;Xianhui Qin PhD,&nbsp;Jianping Li MD, PhD,&nbsp;Xiping Xu PhD,&nbsp;Binyan Wang MD, PhD,&nbsp;Fanfan Hou MD, PhD,&nbsp;Genfu Tang MD,&nbsp;Rongfeng Liao MD,&nbsp;Yong Huo MD,&nbsp;Jun Li MD,&nbsp;Liu Yang MD, PhD","doi":"10.1111/jch.14820","DOIUrl":"10.1111/jch.14820","url":null,"abstract":"<p>Although the association between persistent hypertension and the compromise of both micro- and macro-circulatory functions is well recognized, a significant gap in quantitative investigations exploring the interplay between microvascular and macrovascular injuries still exists. In this study, the authors looked into the relationship between brachial-ankle pulse wave velocity (baPWV) and hypertensive retinopathy in treated hypertensive adults. The authors conducted a cross-sectional study of treated hypertensive patients with the last follow-up data from the China Stoke Primary Prevention Trial (CSPPT) in 2013. With the use of PWV/ABI instruments, baPWV was automatically measured. The Keith-Wagener-Barker classification was used to determine the diagnosis of hypertensive retinopathy. The odds ratio (OR) and 95% confidence interval (CI) for the connection between baPWV and hypertensive retinopathy were determined using multivariable logistic regression models. The OR curves were created using a multivariable-adjusted restricted cubic spline model to investigate any potential non-linear dose-response relationships between baPWV and hypertensive retinopathy. A total of 8514 (75.5%) of 11,279 participants were diagnosed with hypertensive retinopathy. The prevalence of hypertensive retinopathy increased from the bottom quartile of baPWV to the top quartile: quartile 1: 70.7%, quartile 2: 76.1%, quartile 3: 76.7%, quartile 4: 78.4%. After adjusting for potential confounders, baPWV was positively associated with hypertensive retinopathy (OR = 1.05, 95% CI, 1.03–1.07, <i>p</i> &lt; .001). Compared to those in the lowest baPWV quartile, those in the highest baPWV quartile had an odds ratio for hypertensive retinopathy of 1.61 (OR = 1.61, 95% CI: 1.37–1.89, <i>p</i> &lt; .001). Two-piece-wise logistic regression model demonstrated a nonlinear relationship between baPWV and hypertensive retinopathy with an inflection point of 17.1 m/s above which the effect was saturated\u0000.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14820","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833350","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":"An educational intervention for improving knowledge, attitude, and practice of dietary salt intake among individuals with hypertension in public sector secondary care facilities, Agra, India, 2021","authors":"Piyush Jain DNB,&nbsp;Sharan Murali MD,&nbsp;Quincy Mariam Jacob MD,&nbsp;Roopa Shivashankar MD,&nbsp;Arun Srivastava MD,&nbsp;Bency Joseph MPH,&nbsp;Mohankumar Raju MPH,&nbsp;Manikanda Nesan S MD,&nbsp;Albertino Damasceno MD, PhD,&nbsp;Prabhdeep Kaur DNB","doi":"10.1111/jch.14817","DOIUrl":"10.1111/jch.14817","url":null,"abstract":"<p>We conducted a pre-post intervention study to determine knowledge, attitude, and practice toward dietary salt intake before, immediately, and 1-month after nurse-led one-on-one counseling. We purposively selected three public health facilities in Agra, India, and enrolled all eligible hypertensive patients aged 18–60 under treatment for ≥6 months. Of the 153 patients at the 1-month follow-up, counseling improved knowledge (4% vs. 42%, <i>p</i> &lt; .001), a greater prioritization of a low salt diet (34% vs. 52%, <i>p</i> &lt; .001), and practice of adding less salt to the dough (48% to 41%, <i>p</i> &lt; .001). The counseling intervention improved knowledge, attitude, and practice toward dietary salt intake.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14817","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833400","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 optimal dosage of aspirin for preventing preeclampsia in high-risk pregnant women: A network meta-analysis of 23 randomized controlled trials","authors":"Xuemei Hu PhD,&nbsp;Dexin Chen MD,&nbsp;Hong Wang MD,&nbsp;Yinfeng Lv PhD,&nbsp;Yulong Wang MD,&nbsp;Xuelin Gao MD,&nbsp;Shuwen Li MD,&nbsp;Rongxia He PhD","doi":"10.1111/jch.14821","DOIUrl":"10.1111/jch.14821","url":null,"abstract":"<p>This study aimed to assess the effectiveness and optimal dosage of aspirin in preventing preeclampsia in high-risk pregnant women. Traditional and network meta-analyses were conducted on data from 23 randomized controlled trials involving 10 547 pregnant women. The findings demonstrated that aspirin significantly reduced the incidence of preeclampsia (OR = 0.66, 95%CI [0.58, 0.75]), with the best preventive effect observed at a dosage of 80–100 mg/day (OR = 0.51, 95%CI [0.36, 0.72]). No significant differences were found in the occurrence of postpartum hemorrhage (OR = 1.03, 95%CI [0.79, 1.33]), small for gestational age (OR = 0.83, 95%CI [0.50, 1.35]), placental abruption (OR = 0.96, 95%CI [0.53, 1.73]), and intrauterine growth restriction (OR = 0.63, 95%CI [0.45, 1.86]) between women taking aspirin and those taking placebos. Different doses of aspirin showed a reduction in preeclampsia incidence, but there was no significant difference in efficacy between the dosage groups. Side effects did not significantly differ between placebo and different aspirin dosage groups. SUCRA analysis suggested that 80–100 mg/day may be the optimal dosage, prioritizing both effectiveness and minimizing side effects. Sensitivity analysis confirmed the robustness of the findings. However, improvements are needed in addressing issues like loss to follow-up, reporting bias, and publication bias. In conclusion, a dosage of 80–100 mg/day is recommended for preventing preeclampsia in high-risk pregnant women, although individual circumstances should be considered for optimizing the balance between effectiveness and safety.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14821","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140833420","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":"Combined effect of time in target range and variability of systolic blood pressure on cardiovascular outcomes and mortality in patients with hypertension: A prospective cohort study","authors":"Zekun Feng MD,&nbsp;Yanjie Li MD,&nbsp;Chi Wang MD,&nbsp;Lu Tian MD,&nbsp;Siyu Yao MD,&nbsp;Miao Wang MD,&nbsp;Maoxiang Zhao MD,&nbsp;Lihua Lan MD,&nbsp;Shouling Wu MD,&nbsp;Hao Xue MD","doi":"10.1111/jch.14816","DOIUrl":"10.1111/jch.14816","url":null,"abstract":"<p>Time in target range (TTR) and blood pressure variability (BPV) of systolic blood pressure (SBP) are independent risk factors for major adverse cardiovascular events (MACE) and all-cause mortality in hypertensive patients. However, the association of the combination of low TTR and high BPV of SBP with the risk of MACE and all-cause mortality is unclear. This study sought to investigate the combined effect of the TTR and BPV on the risk of MACE and all-cause mortality in patients with hypertension. A total of 11 496 hypertensive patients from the Kailuan cohort study were included in our study. All participants were divided into four groups according to their TTR and BPV levels. Cox proportional hazards regression models were used to calculate the hazard ratios (HRs) and 95% confidence interval (CI) for incident MACE and all-cause mortality. During a median follow-up of 5.64 years, 839 MACEs (included 99 cases of myocardial infarction, 591 cases of stroke, and 191 cases of heart failure) and 621 deaths occurred. Compared with the high-TTR and low-BPV group, the HRs (95% CI) of MACE and all-cause mortality were 1.309 (1.025–1.671) and 1.842 (1.373–2.473) for the high-TTR and high-BPV group, 1.692 (1.347–2.125) and 1.731 (1.298–2.309) for the low-TTR &amp; low-BPV group, 2.132 (1.728–2.629) and 2.247 (1.722–2.932) for the low-TTR &amp; high-BPV group. Our study suggests that the combination of low TTR and high BPV of SBP was associated with a higher risk of MACE and all-cause mortality in patients with hypertension.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14816","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140670896","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":"Validation of the RBP-9801 oscillometric blood pressure monitor in the general population according to the association for the Advancement of Medical Instrumentation/European Society of Hypertension/ International Organization for Standardization Universal Standard","authors":"Shijie Yang MM,&nbsp;Zhanyang Zhou MM,&nbsp;Huanhuan Miao MM,&nbsp;Qiong Zhou MD, PhD,&nbsp;Mei Zhai MD, PhD,&nbsp;Yuqing Zhang MD, PhD","doi":"10.1111/jch.14812","DOIUrl":"10.1111/jch.14812","url":null,"abstract":"<p>The aim of this study was to evaluate the accuracy of the single upper-arm cuff oscillometric blood pressure (BP) monitor RBP-9801 developed for office and home BP measurement in the general population according to the Association for the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization (AAMI/ESH/ISO) Universal Standard (ISO 81060–2:2018). Subjects were recruited to fulfil the age, gender, BP and cuff distribution criteria of the AAMI/ESH/ISO Universal Standard in general population using the same arm sequential BP measurement method. A total of 105 subjects were recruited and 85 were analyzed. For validation criterion 1, the mean ± SD of the differences between the test device and reference BP readings was 2.3 ± 6.4/3.1 ± 5.8 mmHg (systolic/diastolic). For criterion 2, the SD of the mean BP differences between the test device and reference BP per subject was 5.24/5.03 mmHg (systolic/diastolic). The conclusion is that the RBP-9801 oscillometric device for office and home BP measurement fulfilled all the requirements of the AAMI/ESH/ISO Universal Standard (ISO 81060–2:2018) in the general population and can be recommended for clinic and self-use at home.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14812","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140672903","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":"How many blood pressure measurements should we take in the office?","authors":"Gülsüm Özkan MD,&nbsp;Şükrü Ulusoy MD,&nbsp;Rahmi Yılmaz MD,&nbsp;Serpil Müge Değer MD,&nbsp;Ülver Derici MD,&nbsp;Turgay Arınsoy MD,&nbsp;Yunus Erdem MD,&nbsp;Turkish Society of Hypertension and Renal Diseases","doi":"10.1111/jch.14825","DOIUrl":"10.1111/jch.14825","url":null,"abstract":"<p>No consensus has emerged among different guidelines concerning how many blood pressure (BP) measurements should be performed at office visits in the diagnosis of hypertension. The purpose of this study was to examine the compatibility of various multiple average office BP measurements and 24-h BP monitoring (ABPM) in patients followed up in the posthoc analysis of the Cappadocia hypertension cohort. A total 1158 office BP measurements by 207 patients were examined. The results were then classified as G1 (average of the 1^st and 2^nd BP), G2 (average of the 2^nd and 3^rd), G3 (average of the 2^nd, 3^rd, and 4^th), G4 (average of the 2nd, 3rd, 4^th, and 5^th), and G5 (average of all five measurements). Compatibility between the average values in the groups and concomitant 24-h ABPM data was examined. While a significant difference was observed between daytime 24-h ABPM SBP and G1 (<i>p</i> = .002), no difference was found in the other groups. Office DBP approached the daytime 24-h ABPM values as the number of measurements in the five groups increased, although average office DBP data in all groups were higher than daytime 24-h ABPM DBP (<i>p</i> = .000 for all). In light of our study results, we recommend that three office BP measurements be performed and that the average of the 2^nd and 3^rd measurements be used for SBP, while in terms of DBP, we recommend that as many measurements as possible be taken without the 1^st value being included in the average.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14825","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140676475","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":"Enhancing clinical decision-making: Optimizing ChatGPT's performance in hypertension care","authors":"Jing Miao MD, PhD,&nbsp;Charat Thongprayoon MD,&nbsp;Tibor Fülöp MD, PhD,&nbsp;Wisit Cheungpasitporn MD","doi":"10.1111/jch.14822","DOIUrl":"10.1111/jch.14822","url":null,"abstract":"<p>Artificial intelligence (AI), especially conversational models like ChatGPT developed by OpenAI, has significantly impacted fields globally, including healthcare.<span>¹</span> ChatGPT, capable of mimicking human conversation based on vast training data and sophisticated natural language processing, has been featured in 2349 PubMed publications as of February 8, 2024, highlighting its growing relevance in medical research and practice.<span>²</span> Its application in healthcare promises to revolutionize patient care, offering personalized health monitoring and recommendations.<span>^{2, 3}</span></p><p>Hypertension, a major risk factor for cardiovascular and chronic kidney diseases,<span>⁴</span> necessitates comprehensive management strategies.<span>⁵</span> Traditional approaches rely on clinical guidelines, physician expertise, and patient outcomes, challenging for nonspecialists.<span>⁶</span> AI, particularly through ChatGPT, introduces a new dimension to clinical decision-making.<span>⁷</span> Studies have demonstrated ChatGPT's efficacy in providing relevant advice for cardiovascular disease prevention and hypertension management,<span>^8-10</span> indicating its potential to improve clinical outcomes.</p><p>This perspective review explores the potential enhancements and optimizations that ChatGPT could contribute to hypertension management, taking into account its existing capabilities and future possibilities.</p><p>ChatGPT can quickly process vast information, including medical guidelines and patient data, helping healthcare providers improve diagnostic accuracy, tailor treatments, and enhance patient outcomes.<span>¹¹</span> This represents a move towards digital health, with AI like ChatGPT elevating care standards through insightful support (Figure 1).</p><p>To optimize ChatGPT's performance on hypertension care from a user's perspective, the following strategies can be considered (Figure 1).</p><p>Current ChatGPT utilization in hypertension management faces challenges including the reliance on outdated information, lack of personalization in treatment recommendations, absence of clinical judgment, and inadequate communication skills for patient interactions. These limitations necessitate careful consideration and mitigation strategies. When using ChatGPT in clinical settings, prioritizing ethical and privacy considerations is crucial for safeguarding patient confidentiality and data security. It is imperative to refrain from disclosing sensitive information and to comply strictly with regulatory standards governing AI utilization in healthcare decision-making.</p><p>To effectively use ChatGPT in hypertension management, a comprehensive strategy encompassing patient education, engagement, clinical support, and data analysis is crucial. Customizing interactions to meet individual patient needs, integrating with existing healthcare framew","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14822","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140674518","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}