Journal of clinical hypertension (Greenwich, Conn.)最新文献

{"title":"Nonlinear Association of the Triglyceride-Glucose Index With Hyperuricemia Among Young Chinese Adults.","authors":"Ri Liu, Huian Ge, Chen Qiu, Zetao Wu","doi":"10.1111/jch.70261","DOIUrl":"https://doi.org/10.1111/jch.70261","url":null,"abstract":"<p><p>The triglyceride-glucose (TyG) index is a practical surrogate of insulin resistance, but evidence on its association with hyperuricemia (HUA) in young adults is limited. We examined the nonlinear association between TyG and HUA in a young Chinese population. This cross-sectional study included 6343 adults aged 18-45 years who underwent routine health examinations at the Chinese PLA General Hospital. Participants were categorized into TyG quartiles. Multivariable logistic regression with stepwise adjustment for demographic, body composition, and metabolic covariates was used to evaluate the association between TyG and prevalent HUA. Restricted cubic splines (RCSs) assessed potential nonlinearity, and stratified analyses were performed across subgroups. The mean age was 33.7±7.1 years, and 73.5% were male; the prevalence of HUA was 28.4%. The proportion of HUA increased across TyG quartiles from 14.0% in Q1 to 51.3% in Q4 (p < 0.001). In fully adjusted models, the highest TyG quartile was associated with higher odds of HUA compared with Q1 (adjusted odds ratio [OR] 2.26, 95% confidence interval [CI] 1.46-3.51). RCS analysis demonstrated a significant nonlinear relationship (p for nonlinearity < 0.001) with a change in the slope around TyG = 8.278. Below this threshold, the association was not significant (OR 0.629, 95% CI 0.24-1.652), whereas above it the odds increased sharply (OR 5.846, 95% CI 3.718-9.193). Findings were consistent in stratified analyses. Overall, TyG is independently and nonlinearly associated with HUA in young adults, supporting its potential utility for early risk identification.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 5","pages":"e70261"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction of a Postoperative Complication Risk Model for Patients With Stanford Type A Aortic Dissection.","authors":"Xiaohui Liu, Wenjun Zhou, Wan Peng, Kai Lu, Jun Yang, Jia Yang, Jin Chen","doi":"10.1111/jch.70248","DOIUrl":"https://doi.org/10.1111/jch.70248","url":null,"abstract":"<p><p>To identify risk factors for postoperative complications in Stanford Type A aortic dissection (TAAD) patients, a risk prediction model was developed and validated. The study included a specific cohort of TAAD patients (aged 32-66 years) who underwent surgery with general anesthesia and cardiopulmonary bypass. A risk model was created using multivariate logistic regression analysis. Of the 522 patients, 174 (33.33%) experienced at least one major postoperative complication, including neurological, respiratory, renal, or other organ dysfunction. Univariate analysis identified several preoperative and intraoperative factors significantly associated with complications. Five independent predictors-age, BMI, stroke history, aortic cross-clamp time, and deep hypothermic circulatory arrest time-were retained in the multivariate logistic regression model as risk factors for postoperative complications in TAAD patients. Based on the logistic regression equation, logistic (P) = -7.458 + 0.056 × 1 + 0.102 × 2 + 0.374 × 3 + 0.018 × 4 + 0.026 × 5, a multivariate logistic regression risk model was developed to calculate the risk of postoperative complications, p = 1/1 + exp (-7.458 + 0.056 × 1 + 0.102 × 2 + 0.374 × 3 + 0.018 × 4 + 0.026 × 5). Model validation results showed that the area under the ROC curve was 0.879, the Hosmer-Lemeshow test p-value was 0.178, with a sensitivity of 77.59% and specificity of 85.34%.The incidence of postoperative complications following surgery for TAAD is relatively high. Both patient physical condition and surgical factors are associated with these complications. Establishing a risk model can help assess the risk of major postoperative complications in TAAD, providing clinically relevant information for perioperative monitoring and early intervention. Due to the specific age distribution of the study population, the results should be applied with caution to elderly patients (> 66 years).</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 5","pages":"e70248"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of 24-Hour Urinary Sodium, Potassium Excretion and Sodium-to-Potassium Ratio With Longitudinal Home Blood Pressure Control in Patients With Apparent Treatment-Resistant Hypertension.","authors":"Weikang Bian, Fanglu Wang, Hao Wang, Qiaoyu Shao, Shicheng Li, Shuyang Zhang, Xiaowei Yan","doi":"10.1111/jch.70263","DOIUrl":"https://doi.org/10.1111/jch.70263","url":null,"abstract":"<p><p>Dietary sodium and potassium intake are key determinants of blood pressure (BP) control in hypertensive patients. However, their associations with longitudinal home BP control in patients with apparent treatment-resistant hypertension (aTRH) remain unclear. In this prospective cohort study, baseline 24-hour urinary sodium and potassium excretion, objective biomarkers of dietary sodium and potassium intake, as well as urinary sodium-to-potassium (Na/K) ratio were evaluated as exposure variables. The primary outcome was longitudinal home BP control during follow-up. Mixed-effects models were used to assess these associations. A total of 172 patients were followed for a median of 39.3 months, contributing 7547 morning and 6640 evening home BP measurements. After multivariable adjustment, each 1-standard deviation (SD) increase in urinary sodium excretion (99.49 mmol) was associated with poorer home systolic BP (SBP) control (morning: odds ratio [OR] 0.59, 95% confidence interval [CI] 0.38-0.89; evening: OR 0.65, 95% CI 0.44-0.96). Each 1-SD increase in the urinary Na/K ratio (1.98 units) was associated with poorer morning (OR 0.68, 95% CI 0.48-0.97) and evening home SBP control (OR 0.69, 95% CI 0.51-0.94). A higher Na/K ratio was also associated with poorer overall evening home BP control (OR 0.73, 95% CI 0.54-0.98). Consistent associations were observed when BP was analyzed as a continuous outcome. Urinary potassium excretion alone was not significantly associated with home BP control. Dietary sodium restriction and maintenance of sodium-potassium balance may represent important strategies for improving home BP control in patients with aTRH. Trial Registration: Not applicable. This study was a prospective observational cohort study with no assignment of participants to any intervention; thereby clinical trial registration was not required.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 4","pages":"e70263"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedroom Air Filtration and Home Blood Pressures of Older Adults Living in a Residential Facility.","authors":"Robert D Brook, Yao Song, Robert L Bard, Lu Wang, Zachary M Klaver, Rosemary A Ziemba, Geoffrey D Barnes, Alec J Brook, Linda Keilman, Masako Morishita","doi":"10.1111/jch.70251","DOIUrl":"10.1111/jch.70251","url":null,"abstract":"<p><p>Portable air cleaners (PACs) can reduce blood pressure (BP) by decreasing fine particulate matter (PM_2.5) air pollution exposure. However, the effectiveness of a single PAC in a bedroom and the impact on self-measured home BPs over 4 weeks have not been evaluated. We conducted a randomized-order double-blind cross-over trial of active PAC (HEPA filter in-place) versus sham (no filter) intervention in the bedroom of older adults living in a senior residential facility from 1/11/2021-11/4/2024. Each study limb lasted 4 weeks with a 2-week washout period. Participants measured triplicate home BPs in the mornings and evenings during weeks 1 and 4. Bedroom PM_2.5 concentrations were continuously monitored, and 24-h personal exposures were determined during week 4. Results from 33 participants (74.9 ± 7.7 years old) completing the trial were analyzed. Active PAC intervention reduced bedroom PM_2.5 concentrations (1.3±1.5 vs. 8.3±12.8 µg/m³, p < 0.001) and 24-h personal exposures (5.1 ± 4.6 vs. 12.4±15.6 µg/m³, p < 0.001) versus sham. Average home systolic BP levels did not differ during active PAC versus sham intervention in the full study cohort (127.0 ± 16.2 vs. 126.5 ± 16.0 mm Hg, p = 0.59). However, having a larger body mass index plus higher baseline systolic BP, older age plus higher baseline systolic BP, and older age plus larger body mass index showed trends for modifying the benefits by active PAC. We showed for the first time that air filtration in the bedroom alone can successfully reduce PM_2.5 exposures. While systolic BPs were not lowered over 4 weeks in the entire cohort, some individuals may have benefited.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 4","pages":"e70251"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13084707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedroom Air Purification and Home Blood Pressure.","authors":"Jia-Bo Zhu, Xiao-Fei Ye","doi":"10.1111/jch.70259","DOIUrl":"10.1111/jch.70259","url":null,"abstract":"","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 4","pages":"e70259"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of Neprilysin and Its Coding Gene Variation With Hypertension in Chinese Adults.","authors":"Junting Hu, Jing Duan, Jiexiang Jing, Qiu Zhang, Xianfeng Yu, Rongyan Zhang, Yuting Jia, Mingzhe Du, Penghao Wang, Xueyang Zhang, Yibing Jin, Xiangdong Yang, Mingzhi Zhang, Hao Peng, Yun Shen","doi":"10.1111/jch.70260","DOIUrl":"10.1111/jch.70260","url":null,"abstract":"<p><p>Neprilysin (NEP) degrades several vasoactive peptides and may contribute to blood pressure maintenance. This study aims to examine the associations between serum NEP levels and variants at its coding gene and hypertension in a general Chinese population. Leveraging the baseline blood specimens of the Gusu cohort, serum NEP was assayed, and 14 single-nucleotide polymorphisms (SNPs) in the MME gene were genotyped (10 passed the Hardy-Weinberg equilibrium test) by MassArray for 2286 participants (mean age 52 years, 61.4% females). The associations of serum NEP and SNPs with hypertension were examined by logistic regression. Major conventional risk factors, including lifestyle and metabolic factors, were adjusted for. We found that participants with a higher level of serum NEP were more likely to have prevalent hypertension (OR = 1.07, 95%CI: 1.02-1.13, p = 0.006 for log2-transformed NEP). The SNP rs9864287 was associated with hypertension susceptibility (P < 0.05), but this association was not significant after correction for multiple comparisons. These results suggested that there was a weak association between serum NEP and hypertension in Chinese adults, independent of conventional risk factors. The role of NEP in hypertension remains to be elucidated.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 4","pages":"e70260"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertensive Urgency: Which Patient Will be Fine in a Quiet Room?","authors":"Goran Koracevic, Milovan Stojanovic","doi":"10.1111/jch.70258","DOIUrl":"10.1111/jch.70258","url":null,"abstract":"","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 4","pages":"e70258"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Incidence of Abdominal Obesity and Cardiometabolic Risk in Early Adolescence.","authors":"Augusto César F De Moraes, Tiago A Oliveira, John Virostko, Marcus V Nascimento-Ferreira, Ethan T Hunt","doi":"10.1111/jch.70254","DOIUrl":"https://doi.org/10.1111/jch.70254","url":null,"abstract":"<p><p>Abdominal obesity and related cardiometabolic risk (CMR) factors frequently begin in adolescence and contribute to long‑term health burden, yet longitudinal trajectories in U.S. youth are poorly characterized. This study quantifies the prevalence and 2‑ and 4‑year incidence of emerging CMR, with emphasis on excess adiposity, in a diverse adolescent cohort. We analyzed longitudinal data from the Adolescent Brain Cognitive Development Study, collected at three time points: 2018-2020 (mean age, 12.1 years), 2020-2022 (mean age, 14.2 years), and 2022-2024 (mean age, 16.1 years). Adolescents (n = 4788 to 3313) with anthropometric and laboratory data were included. Abdominal obesity was defined as a waist-to-height ratio > 0.5. Additional CMR factors included elevated total cholesterol (≥ 145 mg/dL), glycated hemoglobin (HbA1c ≥ 5.7%), and high blood pressure (≥ 95th percentile for age, sex, and height). Weighted prevalence and 2- and 4-year incidence were calculated. At baseline, abdominal obesity affected 38.4% (95% CI: 36.4%-40.4%), followed by elevated cholesterol (17.6%), HbA1c (8.7%), and blood pressure (3.0%). Over a four-year period, new-onset abdominal obesity occurred in 10.5% of individuals, compared with 15.4% for cholesterol, 4.7% for HbA1c, and 3.1% for blood pressure. The steepest CMR progression was observed for lipid and adiposity markers. Abdominal obesity is highly prevalent by early adolescence, and new cardiometabolic risk develops rapidly, particularly for adiposity and dyslipidemia. These results highlight the need for early obesity screening and interventions to mitigate long‑term cardiometabolic risk in youth.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 4","pages":"e70254"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A National Hypertension Awareness and Early Screening Initiative: \"Act at 30 - It's Time for Heart Check\".","authors":"Uday M Jadhav, Tiny Nair, Jabir Abdullakutty, Rajeev Garg, T Govindan Unni, Smit Shrivastava, Rajeev Agarwala, P P Mohanan, Sandip Mitra","doi":"10.1111/jch.70203","DOIUrl":"https://doi.org/10.1111/jch.70203","url":null,"abstract":"<p><p>India is witnessing a growing burden of early-onset hypertension and cardiovascular disease, particularly among adults under the age of 40. Despite this trend, current national screening programs predominantly target individuals over 40, resulting in a significant gap in early detection and prevention efforts. This white paper addresses this gap by drawing on a mixed-methods approach that combines an extensive review of national and international literature, health surveys, and hypertension guidelines with qualitative insights from 25 expert consultations. These consultations included cardiologists, endocrinologists, and public health specialists, and were conducted through structured one-on-one interviews and focused group discussions. The findings revealed that nearly 25% of Indian adults aged 30-39 are already hypertensive or pre-hypertensive, with lifestyle-related risk factors such as chronic stress, unhealthy diets, physical inactivity, and obesity contributing to early cardiovascular risk. Experts unanimously emphasized the widespread underdiagnosis and lack of awareness in this age group, highlighting missed opportunities for early intervention. A strong consensus emerged around the urgent need to lower the current screening threshold to age 30 and introduce first-time cardiovascular assessments, including blood pressure, glucose, lipid profiles, and obesity metrics at this stage. The paper argues that implementing early screening through existing health infrastructure, workplace wellness initiatives, and digital health platforms is both epidemiologically sound and economically viable. A national policy shift in this direction could significantly improve early detection, reduce disease burden, and enhance long-term health outcomes for the Indian population.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 4","pages":"e70203"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Hypertension and Hematologic Abnormalities in Pseudoxanthoma Elasticum: A Pediatric Case Report.","authors":"Hana Flogelova, Dagmar Pospisilova, Lenka Bakaj-Zbrozkova, Lucie Sochorcova, Jirina Manakova, Eva Kriegova, Pavla Koralkova, Katarina Hlusickova Kapralova, Monika Horvathova","doi":"10.1111/jch.70249","DOIUrl":"10.1111/jch.70249","url":null,"abstract":"<p><p>Pseudoxanthoma elasticum (PXE) is a rare autosomal recessive disorder caused by pathogenic variants in ABCC6, leading to progressive calcification of elastic fibers. Although PXE typically presents in adolescence with dermatologic or ocular manifestations, early vascular involvement, including pediatric hypertension, is increasingly recognized. We report a 3-year-old boy referred for evaluation of persistent erythrocytosis of unclear etiology. Clinical, biochemical, and hematologic assessments revealed intermittent reticulocytosis, normal oxygen saturation, and suppressed/normal erythropoietin levels. Long-term zinc supplementation initiated in infancy for suspected dermatitis enteropathica preceded the onset of erythrocytosis. At age eight, severe systemic hypertension was diagnosed together with medullary nephrocalcinosis and splenic and pancreatic calcifications. Imaging excluded renal artery stenosis. Whole-exome sequencing identified compound heterozygous pathogenic ABCC6 variants, establishing the diagnosis of PXE. Ophthalmologic examination revealed peau d'orange. Blood pressure control required combination antihypertensive therapy and was associated with partial normalization of red blood cell (RBC) parameters and a marked increase in plasma renin activity. RBC enzymatic profiling demonstrated metabolic adaptations consistent with oxidative stress. This case illustrates an unusual clinical presentation of PXE in early childhood. We propose that erythrocytosis, potentially promoted by zinc supplementation, may have contributed to early vascular stress and hypertension. Later, renal microvascular calcification and renin-angiotensin-aldosterone system activation may have contributed to the persistence of elevated RBC counts despite low erythropoietin. These observations suggest that PXE may be considered in the differential diagnosis of children with unexplained hypertension, particularly when additional systemic findings are present.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 4","pages":"e70249"},"PeriodicalIF":2.5,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}