Journal of Clinical Hypertension最新文献

{"title":"Circulating Levels of Angiotensinogen, Sex Hormones, and Hormone Therapy—The Multi-Ethnic Study of Atherosclerosis (MESA)","authors":"Karita C. F. Lidani,&nbsp;Patrick J. Trainor,&nbsp;Robert Buscaglia,&nbsp;Kristoff Foster,&nbsp;Sophia Jaramillo,&nbsp;Kirolos Michael,&nbsp;Alexander P. Landry,&nbsp;Erin D. Michos,&nbsp;Pamela Ouyang,&nbsp;Erin S. Morgan,&nbsp;Sotirios Tsimikas,&nbsp;Andrew P. DeFilippis","doi":"10.1111/jch.70083","DOIUrl":"https://doi.org/10.1111/jch.70083","url":null,"abstract":"<p>Angiotensinogen, the unique precursor of all angiotensin hormones of the renin-angiotensin-aldosterone system (RAAS), is now a potential target in a novel pharmacological approach to hypertension. Investigating the factors that influence angiotensinogen levels, including sex hormones, may have important therapeutic implications. Plasma angiotensinogen and sex hormones levels were measured in 5171 Multi-Ethnic Study of Atherosclerosis (MESA) participants. Linear models were employed to determine the associations of angiotensinogen with sex hormones. Angiotensinogen levels were significantly higher in postmenopausal women receiving hormone therapy (HT, <i>n</i> = 760) compared to women not receiving HT (<i>n</i> = 1675) and in men (<i>n</i> = 2736). A positive association was present between angiotensinogen and estrogen levels that differed in magnitude between sexes and by HT status among postmenopausal women (women on HT: <i>r</i> = 0.44, <i>p</i> &lt; 0.0001; women not on HT: <i>r</i> = 0.09, <i>p</i> = 0.0002; and men: <i>r</i> = 0.07, <i>p</i> = 0.0003). The type of HT formulation (estrogen or estrogen/progesterone) and its duration of use did not significantly affect angiotensinogen levels. This study suggests a significant role of sex, estrogen, and HT in the pathophysiology of angiotensinogen, which is important given the development and testing of angiotensinogen-targeting therapeutics.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 6","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473170","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":"Analysis of the Accuracy of Unattended Automated Blood Pressure Measurements and Control of Blood Pressure Thresholds: A Multicenter Cross-Sectional Study","authors":"Shijie Yang,&nbsp;Zhanyang Zhou,&nbsp;Huanhuan Miao,&nbsp;Zhen Yin,&nbsp;Xiaochun Duan,&nbsp;Yuqing Zhang","doi":"10.1111/jch.70070","DOIUrl":"https://doi.org/10.1111/jch.70070","url":null,"abstract":"<p>Accurate blood pressure measurement is fundamental for the diagnosis and management of hypertension. The emergence of u-AOBP has been proposed as a potential alternative or complementary approach for assessing patients’ blood pressure status within clinical settings. However, robust evidence is lacking to determine its application in diagnosing hypertension within the clinical practice in China. The study involved participants recruited from October 2023 to February 2024 at three different hospitals. Participants were provided with comprehensive study information, and informed consent was obtained. Standardized, validated upper arm blood pressure monitors were used to measure blood pressure. Baseline demographic data, anthropometric measurements, u-AOBP, and standard office blood pressure data were collected, along with additional examination results, including echocardiograms and 24-h ambulatory blood pressure monitoring. The optimal cutoff values for diagnosing elevated blood pressure using u—AOBP, determined by ROC curve analysis with the awake ambulatory blood pressure threshold of 135/85 mmHg as the gold standard, were 130.75/83.75 mmHg (sensitivity 89.73%, specificity 27.27%). In participants with a dipper blood pressure diurnal rhythm, there was no statistically significant difference between standard office blood pressure and u-AOBP measurements (<i>p</i> &gt; 0.05). In conclusion, unattended automated office blood pressure measurement with the optimal cut-off values for diagnosing elevated blood pressure being 130.75/83.75 mmHg, and in the population with a normal dipper circadian rhythm, the standardized u-AOBP values can be equivalent to standard office blood pressure, but the low specificity of u-AOBP may affect the accuracy of identifying nonhypertensive individuals.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 6","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70070","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367569","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":"Large Variation in Adherence to Diagnostic Guidelines in Hypertension Management in Swedish Primary Healthcare","authors":"Mikko Hellgren,&nbsp;Kristina Bengtsson Boström,&nbsp;Katarina Hedin,&nbsp;Stefan Jansson,&nbsp;Staffan Nilsson,&nbsp;Gunnar Nilsson,&nbsp;Per Wändell,&nbsp;Patrik Wennberg","doi":"10.1111/jch.70079","DOIUrl":"https://doi.org/10.1111/jch.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <p>High blood pressure (BP) is a frequent cause for visits to primary healthcare centers (PHCCs) in Sweden. Guidelines on methods for BP measurements for diagnosis of hypertension have recently been updated. We aimed to study adherence to diagnostic guidelines in hypertension management and evaluate whether adherence to guidelines was related to organizational or sociodemographic characteristics. Interviews with representatives from 76 randomly selected PHCCs from eight regions in Sweden were conducted. PHCCs’ use of 24-h ambulatory BP monitoring (ABPM), home BP monitoring (HBPM) and BP measurements in both arms for the diagnosis of hypertension were chosen as proxy markers for adherence to diagnostic guidelines. An adherence index was created as a composite score of these diagnostic methods. The proportion of PHCCs stating they “often use” ABPM and HBPM were 13.7% and 16.0%, respectively, and 57.3% stated they performed BP measurements in both arms. Two PHCCs did not use ABPM, HBPM or BP measurements in both arms to diagnose hypertension. None of the organizational or sociodemographic characteristics (number of listed patients, Care Need Index (CNI), geographical location, ownership, investigation primarily led by doctor/nurse, dedicated team management, special training for hypertension and local routines) were associated with the adherence index. This study shows that adherence to diagnostic guidelines vary largely between PHCCs. No organizational characteristic, not even team-based management, was associated with adherence to diagnostic guidelines. The variation raises questions about inequity healthcare and novel strategies that may be needed to improve PHCCs’ adherence to diagnostic guidelines in hypertension management. Trial Registration: ClinicalTrials.gov identifier: 263351 [www.researchweb.org]</p>\u0000 </section>\u0000 </div>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 6","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70079","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367568","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 Allisartan on Uric Acid, Left Atrial, Left Ventricular, and Artery Stiffness in Mild-to-Moderate Essential Hypertension","authors":"Yancui Sun,&nbsp;Hanqiong Wu,&nbsp;Ying Zhang,&nbsp;Yan Liu,&nbsp;Minghui Gong,&nbsp;Wei Song,&nbsp;Yinong Jiang","doi":"10.1111/jch.70076","DOIUrl":"https://doi.org/10.1111/jch.70076","url":null,"abstract":"<p>This study aimed to explore the effects of allisartan in mild-to-moderate essential hypertension. This is a randomized, double-blind, crossover design involving 98 patients with mild-to-moderate essential hypertension. Participants were randomized and divided into two groups: Group A (baseline—olmesartan—allisartan) and Group B (baseline—allisartan—olmesartan). Each treatment phase included 12 weeks, and participants were administered allisartan (240 mg) or olmesartan (20 mg) once daily. After treatment, both allisartan and olmesartan led to a significant decrease in systolic blood pressure (SBP) levels from baseline (Δ = 6.50 mmHg, <i>p </i>&lt; 0.001 and Δ = 5.64 mmHg, <i>p </i>= 0.002, respectively), with no significant difference between the two drugs. Notably, allisartan led to a significant decrease in diastolic blood pressure (DBP) levels from baseline (Δ = 3.39 mmHg, <i>p </i>= 0.016), while olmesartan did not (Δ = 2.09 mmHg, <i>p </i>= 0.126), allisartan exhibited a more pronounced reduction in DBP compared to olmesartan (Δ = 3.66 mmHg, <i>p </i>= 0.001). Allisartan significantly dropped serum UA levels (Δ = 26.37 µmol/L, <i>p </i>&lt; 0.001), whereas olmesartan did not achieve a significant reduction compared to allisartan (Δ = −7.26 µmol/L, <i>p </i>= 0.991). In terms of cardiac and artery stiffness, allisartan demonstrated significant reductions in left atrial volume index (LAVI; Δ = 2.86 mL/m², <i>p </i>&lt; 0.001), left ventricular mass index (Δ = 4.82 g/m², <i>p </i>= 0.010) and ankle-brachial pulse wave velocity (baPWV) (Δ = 154.49 cm/s, <i>p </i>&lt; 0.001), all-surpassing olmesartan significantly (all <i>p </i>&lt; 0.01). In Conclusion, allisartan 240 mg and olmesartan 20 mg once daily achieve broadly similar reductions in blood pressure, improving left heart structure and function, mitigating arterial stiffness in individuals with mild-to-moderate essential hypertension. Compared to olmesartan, allisartan demonstrates significant reductions in serum UA.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 6","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70076","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367570","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 Salt Intake and Cardiovascular Disease","authors":"Fuzhou Han,&nbsp;Wenqiang Li,&nbsp;Ning Duan,&nbsp;Xinlong Hu,&nbsp;Nan Yao,&nbsp;Guoyong Yu,&nbsp;Jun Qu","doi":"10.1111/jch.70078","DOIUrl":"https://doi.org/10.1111/jch.70078","url":null,"abstract":"<p>Cardiovascular disease (CVD) is a predominant global health issue, with dietary salt intake recognized as a crucial modifiable risk factor. This review elucidates the multifaceted relationship between salt consumption and CVD, exploring both its direct and indirect effects. While early research emphasized salt's influence on blood pressure, contemporary studies highlight the combined effects of dietary habits and genetic factors on CVD risk. The paper underscores the complex biological mechanisms linking high salt intake to CVD, including its impact on blood pressure, direct cardiovascular effects, immune responses, the role of prostanoids, epigenetic changes, and gut microbiome. Additionally, the review delves into the concept of salt sensitivity and its genetic underpinnings, emphasizing the heightened CVD risk in salt-sensitive individuals. The potential benefits and challenges of salt substitutes are also discussed. Drawing from various study designs, including epidemiological studies and randomized controlled trials, the review provides a comprehensive understanding of the detrimental effects of excessive salt intake on cardiovascular health, emphasizing the need for refined dietary guidelines and targeted interventions.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 6","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367571","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":"Cardioprotective and Anti-Hypertensive Effects of Epigallocatechin Gallate: Novel Insights Into Biological Evidence","authors":"Reza Eshraghi,&nbsp;Ashkan Bahrami,&nbsp;Faraz Tayyar Iravanlou,&nbsp;Mehdi Karimi,&nbsp;Mohammad Saeed Soleimani,&nbsp;Mohammad Hossein Paknahad,&nbsp;Mohammad Yaghoubi,&nbsp;Arman Beheshtirooy,&nbsp;Fatemeh Qasemi Talouki,&nbsp;Javad Shaabanzadeh,&nbsp;Fatemeh Hasani,&nbsp;Alireza Rafi,&nbsp;Mohammad Hossein Pourhanifeh","doi":"10.1111/jch.70036","DOIUrl":"https://doi.org/10.1111/jch.70036","url":null,"abstract":"<p>Epigallocatechin gallate (EGCG), the major catechin in green tea, is of considerable interest principally due to its proposed antihypertensive and cardioprotective properties. New research shows that EGCG can help relax the circulation of blood vessels, reduce arterial stiffness of arteries, and promote antioxidant activity promotion, which results in lowering blood pressure (BP) and better-improving heart health. It also affects signaling pathways related to nitric oxide (NO) production, inflammation, and oxidative stress, which are crucial for vascular homeostasis. Although animal research and clinical trials demonstrate that regular intake of EGCG significantly decreases BP and improves lipid profiles, further studies are needed to confirm these benefits in diverse populations. This review highlights the relevant biological data supporting these effects and the mechanisms by which EGCG impacts cardiovascular health. This review provides a new perspective on the many favorable effects of EGCG, such as its potential role in cardiovascular disease prevention, essential hypertension (HTN), and atherosclerosis. These results point to the need for more clinical trials aimed at determining whether EGCG may be used as a natural approach to reducing HTN and its cardiovascular complications through dietary interventions to enhance public health.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 6","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256319","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":"Efficacy and Safety of Catheter-Based Renal Denervation for Patients With Hypertension: A Systematic Review and Meta-Analysis","authors":"Xiao Chen,&nbsp;Jie Meng,&nbsp;Qiufeng Zhou,&nbsp;Yuehua Ni,&nbsp;Changyang Zuo,&nbsp;Yanfang Zhang","doi":"10.1111/jch.70080","DOIUrl":"https://doi.org/10.1111/jch.70080","url":null,"abstract":"<p>This meta-analysis evaluates the efficacy and safety of renal denervation (RDN) for patients with hypertension. PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov were systematically searched to identify relevant studies published before December 31, 2024. Review Manager 5.3 software was used to assess the results of the meta-analyses and the risk of bias plot. We pooled 2208 participants from 13 studies. The RDN was superior to the sham surgery group in the change in 24 h ambulatory systolic blood pressure (ASBP) and the change in 24 h ambulatory diastolic blood pressure (ADBP) (MD: −4.55 mmHg, 95% CI: −5.65 to −3.44; MD: −2.37 mmHg, 95% CI: −3.06 to −1.68, respectively). For the change in daytime ASBP and ADBP, significant differences were found between the RDN group and the sham group (MD: −6.21 mmHg, 95% CI: −7.61 to −4.80; MD: −2.96, 95% CI: −3.85 to −2.07). Compared to the sham surgery group, the RDN group showed better results in the change in night-time ASBP and ADBP (MD: −4.67 mmHg, 95% CI: −6.32 to −3.03; MD: −2.28 mmHg, 95% CI: −3.33 to −1.24). No significant differences were found between the RDN group and the sham group in terms of adverse events (AEs) and serious adverse events (SAEs) (<i>p</i> = 0.39 and 0.07). Subgroup analyses showed that RDN remains effective at long-term follow-up, and both ultrasound and radiofrequency RDN were effective. Current evidence shows that RDN is an effective treatment for patients with hypertension and does not increase the risk of AEs and SAEs.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 6","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144232341","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":"Neutrophil Percentage to Albumin Ratio Is Associated With In-Hospital Mortality in Patients With Acute Type A Aortic Dissection","authors":"Xuecui Zhang,&nbsp;Lingyu Lin,&nbsp;Yanchun Peng,&nbsp;Sailan Li,&nbsp;Xizhen Huang,&nbsp;Liangwan Chen,&nbsp;Yanjuan Lin","doi":"10.1111/jch.70067","DOIUrl":"https://doi.org/10.1111/jch.70067","url":null,"abstract":"<p>The neutrophil percentage to albumin ratio (NPAR) has been associated with prognosis of various cardiovascular diseases, but its role in acute type A aortic dissection (AAAD) mortality remains unclear. The aim of this study was to investigate the relationship between preoperative NPAR and in-hospital mortality in AAAD patients. Clinical data from patients who underwent AAAD surgery at the Cardiac Medical Center of Fujian Province between January 2020 and April 2024 were retrospectively analyzed. Patients were categorized into three groups based on NPAR tertiles. Univariate and multivariate logistic regression analyses were employed to identify factors contributing to in-hospital mortality. The predictive performance of NPAR was assessed using ROC curve analysis. The results revealed that out of 813 AAAD patients meeting the inclusion criteria, 137 (16.9%) died in hospital. Multivariate logistic regression analysis indicated that compared to the low tertile group, the odds ratios (95% CI) for in-hospital mortality in the middle and high tertile groups were (OR 3.041, 95% CI: 1.502–6.158, <i>p</i> = 0.002) and (OR 6.586, 95% CI: 3.324–13.049, <i>p</i>&lt;0.001), respectively. Additionally, cardiopulmonary bypass time (OR 1.010, 95% CI: 1.007-1.013, <i>p</i>&lt;0.001) and mechanical ventilation time (OR 1.115, 95% CI: 1.082–1.150, <i>p</i>&lt;0.001) were also independently associated with in-hospital mortality in AAAD patients. The area under the curve for NPAR was 0.708 (95% CI: 0.676–0.739) (<i>p</i>&lt;0.001), with an optimal cut-off value of 24.105, yielding a sensitivity of 73.7% and a specificity of 64.8%. In conclusion, higher preoperative NPAR may be independently associated with increased in-hospital mortality, suggesting its potential as a novel indicator for monitoring AAAD patients.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206493","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":"Reducing the Risk of Developing Diabetes: The Role of Angiotensin Receptor Blockers and Angiotensin Converting Enzyme Inhibitors in Patients With Hypertension Combined Prediabetes","authors":"Chenyu Yang,&nbsp;Zhiping Hu,&nbsp;Rina Sa,&nbsp;Rongjing Li,&nbsp;Yi Li,&nbsp;Youwei Wu,&nbsp;Guoshuai Shi,&nbsp;Lin Qiu,&nbsp;Chao Li","doi":"10.1111/jch.70025","DOIUrl":"https://doi.org/10.1111/jch.70025","url":null,"abstract":"<p>Diabetes has emerged as a pressing public health crisis in numerous nations, with individuals afflicted by hypertension exhibiting an elevated susceptibility to diabetes. Our main objective was to investigate the risk of developing new-onset diabetes in hypertensive patients with pre-diabetes undergoing treatment with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), thereby furnishing valuable evidence for informed clinical decision-making. Our study was a retrospective cohort study in which individuals with hypertension and meeting other inclusion criteria were enrolled into the cohort. The study population was divided into two groups: one group receiving ARBs or ACEIs as antihypertensive medications, and the other group receiving calcium antagonists, diuretics, beta-blockers, or alpha-blockers. Kaplan–Meier curve and Cox proportional hazard model were used to evaluate the cumulative incidence and hazard ratio (HR) of new-onset diabetes in the ARBs or ACEIs grouprespectively. Out of the 1373 hypertensive individualswith pre-diabetes included in the study, 385 were prescribed ARBs or ACEIs for hypertension management. Subsequent follow-up revealed that 24 new cases of diabetes emerged in the ARBs or ACEIs group, whereas 104 cases were reported in the comparison group. Utilization of ARBs or ACEIs as antihypertensive therapy was linked to a decreased risk of incident diabetes compared to the alternative regimen (HR: 0.51, 95% CI: 0.33, 0.79) and was statistically significant in the male population. In conclusion, antihypertensive drugs of the ACEIs and ARBs class reduce the risk of new-onset diabetes in patients with hypertension combinedwith pre-diabetes.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190866","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":"Machine Learning Prediction Model for Carotid-Femoral Pulse Wave Velocity in Cardiovascular Health Assessments","authors":"Minglong Xin,&nbsp;Vipin Kumar,&nbsp;Megumi Narisawa,&nbsp;Chunzi Jin,&nbsp;Wenhu Xu,&nbsp;Xian Wu Cheng","doi":"10.1111/jch.70049","DOIUrl":"https://doi.org/10.1111/jch.70049","url":null,"abstract":"<p>Cardiovascular disease (CVD) remains a major global health concern and consistently ranks as the leading cause of mortality worldwide. Among the key pathophysiological factors that drive the progression of CVD, vascular health and structural changes in the arterial wall play crucial roles [<span>1</span>]. Aortic stiffness, in particular, is known as a significant and independent predictor of cardiovascular events and mortality, retaining its prognostic value even after adjustment for traditional risk factors. Aortic stiffness refers to the loss of the aortic wall's elasticity, which occurs naturally with age but is accelerated by conditions such as hypertension, diabetes, dyslipidemia, and chronic inflammation [<span>2</span>]. The pathophysiological consequences of increased aortic stiffness are complex; the stiffness increases systolic blood pressure (SBP) while decreasing diastolic blood pressure (DBP), leading to increased pulse pressure and left ventricular afterload (Figure 1). These hemodynamic changes promote left ventricular hypertrophy and significantly increase the risk of cardiovascular events [<span>1</span>]. Monitoring arterial stiffness can detect changes in vascular function earlier and predict the risk of CVD, potentially allowing preventive interventions before clinical manifestations occur.</p><p>The development of CVD is a long-term process, and early detection and intervention can prevent disease progression, reduce medical costs, and lower mortality rates. In this context, machine learning methods offer a promising approach to the detection of early signs of CVD and potentially improve cardiovascular health. For example, an algorithm for estimating the size of an abdominal aortic aneurysm that uses deep learning models to analyze pressure waves from the carotid, brachial, and femoral arteries was proposed in 2021 [<span>3</span>]. In vascular aging research, an artificial neural network was used to estimate carotid-femoral pulse wave velocity (cf-PWV), but that approach required central carotid pressure wave data and additional medical information such as chronological age [<span>4</span>]. The cf-PWV, widely considered the gold standard for assessing atherosclerosis, plays a central role in estimations of the cf-PWV [<span>5</span>]. Guidelines issued by the European Society of Cardiology and the European Society of Hypertension incorporate the cf-PWV as a recommended parameter for cardiovascular risk assessments, with values &gt;10 m/s indicating an increased risk [<span>6</span>]. Elevated cf-PWV has been established as independently associated with increased risks of myocardial infarction, heart failure, and cardiovascular mortality over and above traditional cardiovascular risk factors [<span>1, 5</span>].</p><p>The study by Chen et al. in this issue of the <i>Journal of Clinical Hypertension</i> [<span>7</span>] presents a significant advance in cardiovascular risk assessment based on the development of machine le","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 5","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135799","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}