Journal of Clinical Hypertension最新文献

{"title":"Physical Activity and Arterial Stiffness: A Narrative Review","authors":"Jinyu Yang,&nbsp;Xiaoqian Chen,&nbsp;Xiang Chen,&nbsp;Lihua Li","doi":"10.1111/jch.14941","DOIUrl":"10.1111/jch.14941","url":null,"abstract":"<p>Arterial stiffness is a significant predictor of cardiovascular disease and mortality. Physical activity (PA) has been extensively studied for its potential to reduce arterial stiffness, but the relationship between different types, durations, and intensities of PA and arterial stiffness remains a topic of ongoing research. Therefore, in this narrative review, we evaluated the current evidence focusing on the effect of PA on arterial stiffness and vascular health and discussed the known underlying physiological mechanisms. PA, irrespective of its intensity or pattern, is consistently associated with lower arterial stiffness. Aerobic exercise, particularly at higher intensities, is the most effective strategy for reducing arterial stiffness. These benefits are especially significant in populations with higher cardiovascular risk, such as those with type 2 diabetes mellitus and hypertension. Therefore, maintaining an active lifestyle into older age is crucial for vascular health and may contribute to healthy aging.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649448","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 Pan-Immune Inflammation Value and Sarcopenia in Hypertensive Patients, NHANES 1999–2018","authors":"Lu Long,&nbsp;Bingquan Xiong,&nbsp;Zhidan Luo,&nbsp;Haiyan Yang,&nbsp;Qiang She","doi":"10.1111/jch.14944","DOIUrl":"10.1111/jch.14944","url":null,"abstract":"<p>Sarcopenia worsens the prognosis in hypertensive patients, leading to complications such as proteinuria, osteoporosis, disability, and cognitive impairment. Early screening and intervention for sarcopenia in these patients may improve outcomes. This cross-sectional study utilized data from 9253 hypertensive patients in the 1999–2018 National Health and Nutrition Examination Survey (NHANES). We used logistic and linear regression models, restricted cubic splines (RCS), and subgroup analyses to evaluate the relationship between pan-immune-inflammation value (PIV) and sarcopenia. Patients were divided into quartiles based on PIV levels. After controlling for confounding factors, our study found that those in the highest PIV quartile faced a 36% greater risk of developing sarcopenia compared to those in the lowest quartile (OR = 1.36, 95% confidence interval [CI]: 1.04–1.77). The RCS analysis indicated a linear increase in sarcopenia risk as PIV levels rose (non-linear <i>p</i> = 0.130). Subgroup analysis demonstrated that diabetes synergistically increased sarcopenia risk (<i>p</i> for interaction = 0.007). Elevated PIV levels were identified as an independent risk factor for sarcopenia, with diabetes amplifying this risk. These findings highlight the importance of early identification and management of elevated PIV levels to improve outcomes for hypertensive patients at risk of sarcopenia.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649443","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":"Selecting Transfemoral Access or Upper Extremity Access for Renal Denervation Based on Vascular Morphology: Long-term Results","authors":"Yujie Zuo,&nbsp;Hui Dong,&nbsp;Hongwu Li,&nbsp;Wentao Ma,&nbsp;Yubao Zou,&nbsp;Xiongjing Jiang","doi":"10.1111/jch.14937","DOIUrl":"10.1111/jch.14937","url":null,"abstract":"<p>To evaluate the long-term efficacy and safety of transfemoral access (TFA) versus upper extremity access (UEA) for renal denervation (RDN) based on vascular morphology. This study retrospectively enrolled patients with resistant hypertension who underwent RDN treatment via TFA and UEA (brachial, radial, and ulnar artery) at the Fuwai Hospital between February 2012 and November 2019. Follow-up was conducted at 6 months, 1 year, and 3 years after RDN, and the last visit was June 2023. A total of 85 patients were enrolled, 58 (68.2%) of them were treated via TFA, and 27 patients (31.8%) via UEA. The fluoroscopy time was less in the TFA group (12.2 ± 5.7 min vs. 15.2 ± 7.2 min; <i>p</i> = 0.038). The procedure time (TFA group: 40.8 ± 14.9 min vs. UEA group: 38.6 ± 11.6 min; <i>p</i> = 0.506), contrast volume (TFA group: 78.2 ± 25.9 mL vs. UEA group: 91.9 ± 39.7 mL; <i>p</i> = 0.061) were similar between two groups, without procedure-related complications. Fifty-eight participants completed the last visit with a 3–12 year of follow-up (9.5 ± 1.3 years). Compared with baseline, there were no significant differences in the change of office systolic blood pressure (−12.6 ± 21.6 mmHg vs. −13.1 ± 22.8 mmHg; <i>p</i> = 0.933), 24-h mean systolic blood pressure (−11.9 ± 14.2 mmHg vs. −11.3 ± 15.3 mmHg; <i>p</i> = 0.899), the number of antihypertensive drugs, and renal function between two groups. There were three adverse events in the TFA group (3 of 58 patients, 5.2%) versus one (1 of 27 patients, 3.7%) in the UEA group, without a significant difference between the two groups. The study showed RDN via UEA was feasible using a special-designed catheter, particularly in patients with illegal vascular morphology via TFA.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"26 12","pages":"1513-1520"},"PeriodicalIF":2.7,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14937","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649451","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 Nontraditional Lipid Profiles and the Risk of Type 2 Diabetes Mellitus in Chinese Adults With Hypertension: Findings From the China Hypertension Registry Study","authors":"Yu Tao,&nbsp;Tao Wang,&nbsp;Wei Zhou,&nbsp;Lingjuan Zhu,&nbsp;Chao Yu,&nbsp;Juxiang Li,&nbsp;Huihui Bao,&nbsp;Xiaoshu Cheng","doi":"10.1111/jch.14927","DOIUrl":"10.1111/jch.14927","url":null,"abstract":"<p>The relationship between nontraditional lipid profiles and type 2 diabetes mellitus (T2DM) remains ambiguous within the hypertension population. The objective of this study is to examine the association between nontraditional lipid profiles and T2DM in Chinese adults with hypertension. The current investigation encompassed 13 728 participants with hypertension from the China Hypertension Registry Study. Logistic regression analysis and smooth curve fitting were employed to evaluate the association between nontraditional lipid profiles and T2DM. The prevalence of T2DM was found to be 17.8%. In the fully adjusted model, atherogenic index of plasma (AIP) exhibited the highest odds ratios (ORs) for T2DM (OR: 2.71, 95% confidence interval [CI]: 2.26–3.26). Conversely, the fully adjusted ORs (95% CI) for total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)/HDL-C, and non-high-density lipoprotein cholesterol (Non-HDL-C) were 1.33 (1.25–1.41), 1.40 (1.29–1.51), and 1.41 (1.34–1.49), respectively. Additionally, the study demonstrated that AIP had a superior ability to identify T2DM. Subgroup analyses indicated that the relationship between AIP and Non-HDL-C with T2DM was more significant in the lighter weight population. In addition, the association of TC/HDL-C with LDL-C/HDL-C with T2DM was stronger in the lower homocysteine level population. Among the southern Chinese population with hypertension, all nontraditional lipid indices positively correlated with the risk of T2DM. Among these lipid indices, AIP exhibited superior discriminatory power in identifying T2DM compared to TC/HDL-C, LDL-C/HDL-C.</p><p><b>Trial Registration</b>: ChiCTR1800017274</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644382","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":"Higher Long-Term Visit-to-Visit Blood Pressure Variability Is Associated With Severe Cerebral Small Vessel Disease in the General Population","authors":"Xinyu Zhao,&nbsp;Ying Hui,&nbsp;Jing Li,&nbsp;Xian-Quan Shi,&nbsp;Shuohua Chen,&nbsp;Han Lv,&nbsp;Shouling Wu,&nbsp;Zhenchang Wang","doi":"10.1111/jch.14943","DOIUrl":"10.1111/jch.14943","url":null,"abstract":"<p>Long-term visit-to-visit blood pressure (BP) variability is linked to various diseases, but its impact on cerebral small vessel disease (cSVD) burden, and its features remains uncertain. We analyzed 1284 participants from the Kailuan cohort (2006–2022). Visit-to-visit systolic BP (SBP), diastolic BP (DBP), and pulse pressure (PP) variability were categorized into tertiles (low, middle, high). Magnetic resonance imaging identified white matter hyperintensities (WMH), lacunae of presumed vascular origin (LA), cerebral microbleeds (CMBs), and visible perivascular spaces (PVS). Total cSVD burden was classified as none (0), mild (1), moderate (2), or severe (3–4) based on the presence of these features. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs). High SBP variability was associated with moderate cSVD burden (OR = 1.89, 95% CI: 1.09–3.29) and PVS (OR = 1.62, 95% CI: 1.10–2.39). High DBP variability was associated with LA (OR = 1.74, 95% CI: 1.06–2.84). High PP variability showed a significant risk for severe cSVD burden (OR = 2.49, 95% CI: 1.34–4.63). These associations were modified by age and hypertension status. Among young adults (age &lt; 60 years), high PP variability was associated with severe cSVD burden (OR = 3.33, 95% CI: 1.31–8.44), LA (OR = 3.02, 95% CI: 1.31–6.93), and PVS (OR = 1.86, 95% CI: 1.20–2.88). The risk effects of SBP and PP variability on cSVD burden were significant only in participants with hypertension. High long-term visit-to-visit BP variability (BPV), particularly in combination with hypertension, is a significant risk factor for total cSVD. Special attention should be given to PP variability in younger adults.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644645","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":"Assessing Associations of Nurse-Managed Hypertension Care on Pharmacotherapy, Lifestyle Counseling, and Prevalence of Comorbid Cardiometabolic Diseases in All Patients With Hypertension That Are Treated in Primary Care in Stockholm, Sweden","authors":"Charlotte Ivarsson,&nbsp;Monica Bergqvist,&nbsp;Per Wändell,&nbsp;Sebastian Lindblom,&nbsp;Anders Norrman,&nbsp;Julia Eriksson,&nbsp;Jan Hasselström,&nbsp;Christina Sandlund,&nbsp;Axel C. Carlsson","doi":"10.1111/jch.14940","DOIUrl":"10.1111/jch.14940","url":null,"abstract":"<p>The aim was to study if nurse-managed hypertension care was associated with differences in pharmacotherapy, lifestyle counseling, and prevalence of comorbid cardiometabolic diseases among patients receiving care at primary health care centers. To assess the extent of nurses' involvement in the hypertension care, a questionnaire was distributed to all primary health care centers in Region Stockholm. Age-adjusted logistic regression models were used to analyze the results, odds ratios with 99% confidence intervals. Data was acquired from VAL, the administrative databases of Region Stockholm in Sweden, encompassing all individuals 30 years or older with a registered hypertension diagnosis who attended to the primary health care center they were registered at. Our analysis comprised 119 267 patients diagnosed with hypertension registered in one of the 224 included primary health care centers. Of the 81 primary health care centers that responded to the questionnaire, 54 reported having nurse-managed hypertension care. Nurse-managed hypertension care was not significantly associated with differences in pharmacotherapy or patients’ comorbidity, except for diabetes. Primary health care centers with nurse-managed hypertension care had a 10% greater adherence to national guidelines for lifestyle counseling (33.5%) compared to those without nurse-managed hypertension care (22.5%). Regardless of the organizational form of hypertension care management, more men received lifestyle counseling according to guidelines compared to women. In-house routines for hypertension care, with designated nurses, and booking systems were associated with more lifestyle counseling, which has been associated with signs of better hypertension care.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644277","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":"Multidimensional Plasma Lipids Affect Preeclampsia/Eclampsia: A Mendelian Randomization Study","authors":"Shaole Shi,&nbsp;Fangyuan Wu,&nbsp;Shanshan Zhao,&nbsp;Zilian Wang,&nbsp;Yongqiang Fan","doi":"10.1111/jch.14939","DOIUrl":"10.1111/jch.14939","url":null,"abstract":"<p>Circulating lipids play a crucial role during pregnancy and may impact various pregnancy-related diseases. This study employed a two-sample Mendelian randomization (MR) framework to investigate the causal relationship between alterations in multidimensional plasma lipid levels and the risk of preeclampsia or eclampsia, offering deeper insight into this association. The inverse variance weighted (IVW) method was utilized as the main analysis. Summary statistics from plasma lipidomics of 7174 Finnish individuals and summary data on preeclampsia/eclampsia from the FinnGen consortium involving 219 817 European participants were employed. Sensitivity analyses were conducted to evaluate heterogeneity and pleiotropy. The study identified 17 lipid species from a total of 179 lipid species associated with susceptibility to preeclampsia/eclampsia. Notably, ten species, including six triacylglycerols (TAGs) (50:1, 48:1, 56:4, 49:2, 48:2, 54:3), a diacylglycerol (DAG) (16:1_18:1), and three sphingomyelins (SMs) (d36:1, d34:1, d38:1), were found to increase the risk of preeclampsia/eclampsia. Conversely, seven species, including five phosphatidylcholines (PCs) (16:1_20:4, O-18:1_20:4, 18:1_20:4, 16:0_20:4, 17:0_20:4) and two phosphatidylethanolamines (PEAs) (18:0_20:4, 16:0_20:4), all containing arachidonic acid (ARA) in the sn-2 position, were associated with a reduced risk of preeclampsia/eclampsia (all <i>p</i> &lt; 0.05). The results of the stratified analysis were consistent with these findings. Furthermore, reverse MR analysis indicated that preeclampsia/eclampsia does not causally affect plasma levels of these lipids. Our findings established a causal relationship between specific plasma lipid species and modulation of preeclampsia/eclampsia risk, providing improved resolution for risk assessment and potential therapeutic targets in the disease.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644650","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":"Correlations of the Circadian Rhythmicity of Blood Pressure With Erectile Dysfunction","authors":"Ajar Koçak,&nbsp;Cem Şenol,&nbsp;Onur Yıldırım,&nbsp;Bilgesu Arıkan Ergün","doi":"10.1111/jch.14935","DOIUrl":"10.1111/jch.14935","url":null,"abstract":"<p>Erectile dysfunction (ED) and cardiovascular diseases (CVD) share common pathophysiological mechanisms. This study aimed to assess the relationship between ED and its severity with the risk of developing CVD by analyzing changes in the circadian blood pressure (BP) rhythm. In the study, 24-h BP levels of 192 (94 with ED and 98 controls) participants with no history of CVD were evaluated using an ambulatory blood pressure monitoring (ABPM) device. The International Index of Erectile Function (IIEF) questionnaire was used to assess the ED severity in the study group. ABPM measurements revealed higher BP values among the ED group. The nondipper pattern was significantly more frequent in the ED group compared to the controls (56.2% vs. 77.1%, <i>p</i> &lt; 0.01). Blood pressure variability parameters, including systolic standard deviation (SD) and average real variability (ARV), were notably higher in the ED group (16.3 ± 3.9 vs. 14.6 ± 4.3, <i>p</i> &lt; 0.01 and 13.39 ± 7.24 vs. 11.5 ± 2.1, <i>p</i> &lt; 0.01, respectively). Furthermore, parameters reflecting arterial stiffness including pulse pressure index (PPI) and ambulatory arterial stiffness index (AASI) were higher in the ED group (0.81 ± 0.33 vs. 0.73 ± 0.18, <i>p</i> = 0.03 and 0.71 ± 0.09 vs. 0.59 ± 0.17, <i>p</i> = 0.014, respectively). Both AASI and ARV were significantly correlated with the severity of ED. This study suggests a significant association between ED severity and altered blood pressure patterns which in part explains the increased risk of CVD among individuals with ED.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640173","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":"Hypertension in Adults With Diabetes in Southeast Asia: A Systematic Review","authors":"Wei Jin Wong,&nbsp;Tan Van Nguyen,&nbsp;Fahed Ahmad,&nbsp;Huyen Thi Thanh Vu,&nbsp;Angela S. Koh,&nbsp;Kit Mun Tan,&nbsp;Ying Zhang,&nbsp;Christopher Harrison,&nbsp;Mark Woodward,&nbsp;Tu Ngoc Nguyen","doi":"10.1111/jch.14936","DOIUrl":"10.1111/jch.14936","url":null,"abstract":"<p>Diabetes is one of the most pressing health issues in the Southeast Asian region, and hypertension has been commonly reported as a comorbidity in adults with diabetes. This systematic review aimed to synthesize evidence on the prevalence and management of hypertension in adults with diabetes in Southeast Asian countries. A literature search was conducted in Ovid MEDLINE and Embase Classic + Embase from database inception until March 15, 2024. Studies were included if (1) they were conducted in Southeast Asian countries, (2) the study populations were adults with diabetes, and (3) there was information related to hypertension or blood pressure (BP) in the study results. Of the 7486 abstracts found, 90 studies qualified for this review. Most studies reported a hypertension prevalence of 70% or higher (ranging from 29.4% to 93.4%). Despite this high prevalence, a substantial proportion of these populations did not receive adequate BP control, with most studies indicating a control rate of less than 40%. There was limited evidence on the prescription of antihypertensive therapies and medication adherence. There was a lack of studies from 4 of the 11 countries in the region. This review highlights that BP control in adults with diabetes remains a significant challenge in Southeast Asia. Given the ongoing epidemiological transition, and the increasing older population in this region who are likely to accumulate multiple chronic conditions complicating medication strategies, this review highlights the urgent need to improve BP management in those with diabetes.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11771803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640174","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":"Alcohol Consumption in Adolescence on Early-Adulthood Hypertension or Prehypertension","authors":"Lisa Hayibor,&nbsp;Jianrong Zhang","doi":"10.1111/jch.14928","DOIUrl":"10.1111/jch.14928","url":null,"abstract":"&lt;p&gt;The authors were pleased to read the recent study on the association between alcohol consumption in adolescence and early-adulthood hypertension or prehypertension in 1556 adolescent participants in China [&lt;span&gt;1&lt;/span&gt;]. Building on the findings from our previous work involving 5114 adolescents in the United States [&lt;span&gt;2&lt;/span&gt;], this new study reinforces the impact of heavy alcohol consumption on hypertension or prehypertension. Specifically, the study identified associations of hypertension or prehypertension with alcohol consumption: (1) equal to or over two times per week and (2) more than 96 mL per week. Additionally, the study found an association between hypertension or prehypertension and the intake of two or more types of alcohol (beer, wine, and liquor) [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Methodologically, the study adopted a novel approach by applying the restricted cubic spline model. Particularly when alcohol intake exceeded 25 mL per week, the model demonstrated a dose-response relationship, showing an increasing risk of hypertension or prehypertension as alcohol consumption increased [&lt;span&gt;1&lt;/span&gt;]. For males, the effect size—hazard ratio (HR)—remained above 1, suggesting a higher risk of health concerns regardless of the amount of alcohol consumed. Unfortunately, we could not find the effect size (HR) and the 95% confidence interval for the dose-response relationship derived from the restricted cubic spline model.&lt;/p&gt;&lt;p&gt;Statistically, we are curious as to why the Cox regression model was chosen to analyze the associations between alcohol consumption and health concerns rather than logistic regression, which is more commonly used when dealing with a binary outcome such as hypertension or prehypertension. Of note, the Cox regression model is typically applied to time-to-event scenarios; however, an important bias that needs to be addressed in such analyses is lead time bias. In the study, lead time bias could suggest that adolescent participants who consumed alcohol may have had a period of time that was not accounted for when analyzing the time to the development of hypertension or prehypertension in the Cox regression model. We point this out because, given the baseline comparison of age, the drinking group was significantly older than the non-drinking group (16 vs. 14 years old; &lt;i&gt;p&lt;/i&gt; &lt; 0.005) [&lt;span&gt;1&lt;/span&gt;]. To address this bias, researchers might need to examine and compare the follow-up periods between the groups. Even though nonsignificant findings may be found for the follow-up periods, the nondrinking group may not have reached the comparative age to develop hypertension/prehypertension as they were younger. This issue could also arise when using logistic regression. In addition to adjusting the statistical model for age, we wonder if propensity score matching could improve the validity of the analysis by matching baseline characteristics, including age, between the comparison groups.&lt;/p&gt;&lt;p&gt;This study makes important ","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"26 12","pages":"1533-1534"},"PeriodicalIF":2.7,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.14928","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640172","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}