Journal of clinical hypertension (Greenwich, Conn.)最新文献_第2页

Apnea-Hypopnea Index Versus Hypoxic Burden as Predictors of Blood Pressure Response to Continuous Positive Airway Pressure Treatment in Patients With Obstructive Sleep Apnoe. 阻塞性睡眠呼吸暂停患者持续气道正压治疗后血压反应的预测因素：呼吸暂停低通气指数与缺氧负担

IF 2.5

Journal of clinical hypertension (Greenwich, Conn.) Pub Date : 2026-05-01 DOI: 10.1111/jch.70262

Sebastian Bertram, Diana Racovitan, Adrian Doevelaar, Felix S Seibert, Nina Babel, Simon Wang, Timm H Westhoff, Maximilian Seidel

{"title":"Apnea-Hypopnea Index Versus Hypoxic Burden as Predictors of Blood Pressure Response to Continuous Positive Airway Pressure Treatment in Patients With Obstructive Sleep Apnoe.","authors":"Sebastian Bertram, Diana Racovitan, Adrian Doevelaar, Felix S Seibert, Nina Babel, Simon Wang, Timm H Westhoff, Maximilian Seidel","doi":"10.1111/jch.70262","DOIUrl":"10.1111/jch.70262","url":null,"abstract":"Obstructive sleep apnea (OSA) is associated with increased cardiovascular risk and hypertension. While continuous positive airway pressure (CPAP) therapy reduces blood pressure (BP), its effect shows substantial interindividual variability. Hypoxic burden (HB) has been proposed as a potentially superior predictor of cardiovascular outcomes compared to the apnea-hypopnea index (AHI). In this retrospective study, 141 patients with OSA underwent in-laboratory polysomnography and initiated CPAP therapy. Office BP and clinical parameters were assessed at baseline and follow-up (median 200 days). Receiver operating characteristic (ROC), correlation, multiple linear and logistic regression analyses were performed to compare the predictive value of HB and AHI for BP reduction. CPAP therapy resulted in a modest, non-significant reduction in systolic BP(-2.3 mmHg ±17.7,0.1237), while diastolic BP remained unchanged. Higher AHI and HB levels were associated with higher baseline systolic BP and numerically greater BP reductions, particularly in individuals with a higher than the median HB ≥57.5%min/h or median AHI ≥34.3/h. However, neither HB nor AHI predicted a systolic BP reduction ≥5 mmHg (AUC values≈0.5), and no relevant correlations between AHI, HB and blood pressure response were observed. HB is associated with OSA severity and higher baseline BP. However, it is not superior to AHI in the prediction of a CPAP-associated reduction of BP in patients with OSA.","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 5","pages":"e70262"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147990742","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}

引用次数: 0

Insulin Resistance is Associated With Skin Microvascular Dysfunction and Reduced Circulating Endothelial Progenitor Cells in Hypertensive Patients. 高血压患者胰岛素抵抗与皮肤微血管功能障碍和循环内皮祖细胞减少有关

IF 2.5

Journal of clinical hypertension (Greenwich, Conn.) Pub Date : 2026-05-01 DOI: 10.1111/jch.70281

Ya-Wen Lu, Chun-Chin Chang, Ruey-Hsing Chou, Chin-Sung Kuo, Shih-Hung Tsai, Po-Hsun Huang

{"title":"Insulin Resistance is Associated With Skin Microvascular Dysfunction and Reduced Circulating Endothelial Progenitor Cells in Hypertensive Patients.","authors":"Ya-Wen Lu, Chun-Chin Chang, Ruey-Hsing Chou, Chin-Sung Kuo, Shih-Hung Tsai, Po-Hsun Huang","doi":"10.1111/jch.70281","DOIUrl":"10.1111/jch.70281","url":null,"abstract":"Microvascular dysfunction is an early manifestation of vascular damage in patients with hypertension and cardiometabolic disorders. Insulin resistance (IR) is linked closely to vascular dysfunction, and the triglyceride-glucose (TyG) index is a practical proxy marker of IR. Circulating endothelial progenitor cells (cEPCs) and microvascular reactivity have been proposed as markers of vascular health, but their relationships to IR and high-density lipoprotein functionality, assessed using the cholesterol efflux capacity (CEC), remain incompletely understood. We performed a cross-sectional study of coronary angiography registry data from 259 hypertensive patients with fasting glucose levels ≤ 125 mg/dL. cEPC [cluster of differentiation (CD) 34+/kinase insert domain receptor+/CD133+] levels, microvascular function [reflected by post-occlusive reactive hyperemia (PORH)], the CEC, and the TyG index were measured before catheterization. Weighted multivariable linear regression analyses were performed to examine variable associations. Higher TyG index values were associated independently with lower cEPC levels and impaired microvascular reactivity after adjustment for conventional cardiovascular risk factors. Each 1 standard deviation increase in the TyG index was associated with an 11% decrease in cEPCs and a 6.3% reduction in PORH. The TyG index was not associated with the CEC. These findings were consistent across diabetes and coronary artery disease subgroups. The association of the IR, as reflected by the TyG index, with reduced cEPC levels and impaired microvascular function in this high-risk hypertensive population supports a link between metabolic dysfunction and microvascular impairment; however, causal relationships could not be inferred.","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 5","pages":"e70281"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147985037","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}

引用次数: 0

24-Hour Ambulatory Blood Pressure Monitoring during Ramadan Fasting: A Three-Year Cross-Sectional Study From a Tertiary Medical Center in Turkey. 斋月禁食期间24小时动态血压监测：土耳其三级医疗中心三年横断面研究

IF 2.5

Journal of clinical hypertension (Greenwich, Conn.) Pub Date : 2026-05-01 DOI: 10.1111/jch.70265

Mustafa Celik, Muhammed Fatih Kaleli, Mertcan Gezer, Nuraiym Moloshova, Meltem Uyaner Kan, Emirhan Feyzullahoglu, Serhat Kesriklioglu

{"title":"24-Hour Ambulatory Blood Pressure Monitoring during Ramadan Fasting: A Three-Year Cross-Sectional Study From a Tertiary Medical Center in Turkey.","authors":"Mustafa Celik, Muhammed Fatih Kaleli, Mertcan Gezer, Nuraiym Moloshova, Meltem Uyaner Kan, Emirhan Feyzullahoglu, Serhat Kesriklioglu","doi":"10.1111/jch.70265","DOIUrl":"10.1111/jch.70265","url":null,"abstract":"Ramadan fasting involves prolonged daily abstinence from food and water and may affect blood pressure (BP) regulation, particularly in individuals with chronic conditions. Evidence focusing specifically on ambulatory BP characteristics during Ramadan remains limited. This study evaluated 24-hour ambulatory BP monitoring (ABPM) parameters obtained during Ramadan in fasting and non-fasting individuals. In this prospective cross-sectional study, 231 adults underwent 24-hour ABPM during Ramadan between 2021 and 2023. Participants were classified as fasting or non-fasting and as hypertensive or non-hypertensive. Demographic characteristics, comorbidities, laboratory findings, and echocardiographic parameters were recorded. Ambulatory BP values were analyzed for 24-hour, daytime, and nighttime periods. Of the participants, 117 were fasting and 114 were non-fasting. Baseline demographic characteristics and cardiovascular comorbidities were similar between groups, although diabetes mellitus (DM) and chronic kidney disease (CKD) were more frequent in non-fasting individuals. No significant differences were observed in 24-hour or daytime systolic and diastolic BP values. Mean nighttime BP was lower in fasting participants (p = 0.032). Echocardiographic parameters were comparable. Fasting individuals had higher serum albumin levels (p = 0.027) and lower neutrophil counts (p = 0.030), while other biochemical markers did not differ significantly. Ramadan fasting was not associated with adverse ambulatory BP changes in hypertensive or normotensive individuals and may be considered safe in appropriately selected patients with well-controlled hypertension (HT).","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 5","pages":"e70265"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795072","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}

引用次数: 0

Curriculum Integration of an Interactive Blood Pressure Measurement Module to Improve Healthcare Students' Knowledge, Confidence, and Skills. 交互式血压测量模块的课程整合，以提高医疗保健学生的知识，信心和技能。

IF 2.5

Journal of clinical hypertension (Greenwich, Conn.) Pub Date : 2026-05-01 DOI: 10.1111/jch.70234

Mandeep K Patel, Lynn Timko-Swaim, Perrilynn Conklin, Wei-Hsin Lu

{"title":"Curriculum Integration of an Interactive Blood Pressure Measurement Module to Improve Healthcare Students' Knowledge, Confidence, and Skills.","authors":"Mandeep K Patel, Lynn Timko-Swaim, Perrilynn Conklin, Wei-Hsin Lu","doi":"10.1111/jch.70234","DOIUrl":"10.1111/jch.70234","url":null,"abstract":"Hypertension (HTN) is a global risk factor for death and a major contributor to cardiovascular disease. Accurate blood pressure measurement (BPM) is essential for accurate diagnosis and management, yet many healthcare providers and trainees lack adequate BPM knowledge and technique due to non-standardized education and limited reinforcement. This study evaluated the impact of a structured BPM training program integrated into the curricula of two health professional training programs. Participants completed the American Medical Association's BP Measurement Essentials: Student Edition e-learning module alongside their traditional coursework. To assess the program's effectiveness, we administered pre- and post-intervention surveys and Objective Structured Clinical Examinations (OSCEs), measuring changes in BPM knowledge, confidence, and technique proficiency. Both medical and PA student cohorts demonstrated statistically significant improvements in BPM knowledge and self-reported confidence. Post-training, students reported greater confidence in their technique and comfort in performing BPM on patients. Additionally, both groups showed improved ability to identify factors influencing BPM accuracy (medical students: p = 0.002; PA students: p = 0.035). Both cohorts showed significant gains in understanding proper BPM techniques (p < 0.001). OSCE results further validated improvements in technical accuracy and patient communication. Overall, structured BPM education significantly enhanced student proficiency, confidence, and clinical performance. These findings support the integration of standardized BPM training into healthcare education to strengthen BPM skills and improve HTN care outcomes.","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 5","pages":"e70234"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13239680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147985039","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}

引用次数: 0

Response to the Comment on "Effect of Modular Training on Self-Management, Disease, and Treatment Adaptation in Individuals With Hypertension". 对“模块化培训对高血压患者自我管理、疾病和治疗适应的影响”评论的回应

IF 2.5

Journal of clinical hypertension (Greenwich, Conn.) Pub Date : 2026-05-01 DOI: 10.1111/jch.70268

Esra Keşer, Derya Atik, Ulviye Özcan Yüce

引用次数: 0

Reversible Neurological Manifestations Preceding Biochemical Deterioration in Postpartum HELLP Syndrome-A Case Report and Literature Review. 产后HELLP综合征生化恶化前的可逆性神经学表现——1例报告及文献复习。

IF 2.5

Journal of clinical hypertension (Greenwich, Conn.) Pub Date : 2026-05-01 DOI: 10.1111/jch.70267

Dario Colacurci, Stefano Raffaele Giannubilo, Laura Sarno, Caterina Fulgione, Laura Letizia Mazzarelli, Angelo Sirico, Maria Liberata Meccariello, Andrea Albanese, Dayana Quintili, Irene Lubinski, Mario Ascione, Carla Riccardi, Giorgia D'Apice, Mariarosaria Motta, Sara Iannantuoni, Chiara Murolo, Giuseppe Bifulco, Costantino Di Carlo, Andrea Ciavattini, Giuseppe Maria Maruotti

{"title":"Reversible Neurological Manifestations Preceding Biochemical Deterioration in Postpartum HELLP Syndrome-A Case Report and Literature Review.","authors":"Dario Colacurci, Stefano Raffaele Giannubilo, Laura Sarno, Caterina Fulgione, Laura Letizia Mazzarelli, Angelo Sirico, Maria Liberata Meccariello, Andrea Albanese, Dayana Quintili, Irene Lubinski, Mario Ascione, Carla Riccardi, Giorgia D'Apice, Mariarosaria Motta, Sara Iannantuoni, Chiara Murolo, Giuseppe Bifulco, Costantino Di Carlo, Andrea Ciavattini, Giuseppe Maria Maruotti","doi":"10.1111/jch.70267","DOIUrl":"10.1111/jch.70267","url":null,"abstract":"Posterior reversible encephalopathy syndrome (PRES) is a rare but severe neurological complication associated with hypertensive disorders of pregnancy and HELLP syndrome. We report a postpartum case in which neurological manifestations preceded the full biochemical expression of HELLP syndrome. A 22-year-old primigravida was admitted at 36 + 0 weeks for premature rupture of membranes and fetal growth restriction, presenting with mild thrombocytopenia and elevated lactate dehydrogenase but normal liver enzymes. On postpartum day 1, she developed headache, visual disturbances, hypertensive crisis, and a generalized tonic-clonic seizure. Brain magnetic resonance imaging revealed bilateral cortical-subcortical T2/FLAIR hyperintensities consistent with PRES. At that time, laboratory findings were not yet diagnostic of HELLP syndrome; however, by postpartum day 3, severe thrombocytopenia and elevated transaminases confirmed the diagnosis. The patient was treated with magnesium sulfate, antihypertensive therapy, corticosteroids, and plasmapheresis, achieving complete clinical and radiological recovery. A narrative review of the literature indicated that neurological manifestations typically occur within 48 h postpartum. This case highlights that PRES may precede the full laboratory expression of HELLP syndrome and underscores the importance of early recognition, prompt neuroimaging, and multidisciplinary management to ensure favorable maternal outcomes.","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 5","pages":"e70267"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849148","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}

引用次数: 0

Regional Variations and Risk Factors of Raised Total Cholesterol Among Ethiopian Adults: Evidence From the 2024 STEPS Survey. 埃塞俄比亚成年人总胆固醇升高的地区差异和危险因素：来自2024年STEPS调查的证据

IF 2.5

Journal of clinical hypertension (Greenwich, Conn.) Pub Date : 2026-05-01 DOI: 10.1111/jch.70283

Getachew Tollera, Aderajew Mekonnen Girmay, Girum Taye Zeleke, Asmamaw Bezabeh Workneh, Selamawit Ayele, Hiwot S Taffese, Dereje Duguma

{"title":"Regional Variations and Risk Factors of Raised Total Cholesterol Among Ethiopian Adults: Evidence From the 2024 STEPS Survey.","authors":"Getachew Tollera, Aderajew Mekonnen Girmay, Girum Taye Zeleke, Asmamaw Bezabeh Workneh, Selamawit Ayele, Hiwot S Taffese, Dereje Duguma","doi":"10.1111/jch.70283","DOIUrl":"10.1111/jch.70283","url":null,"abstract":"Raised total cholesterol (RTC) is a major global public health issue although research on geographical variations and factors associated with raised total cholesterol are limited. A nationwide population-based cross-sectional study was conducted. Data were collected through face-to-face interviews using structured questionnaires. Participants aged 18 to 69 years were selected randomly. A total of 9467 household samples were included. Multilevel logistic regression analysis was employed to identify the determinants of raised cholesterol. In this study, the national prevalence of raised total cholesterol was found to be 5.2%. This investigation identified regional variations in the prevalence of raised total cholesterol, with Somalia reporting the highest percentage at 17.3%, followed by Dire Dawa at 12%. In contrast, the Sidama and South Ethiopia regions had the lowest percentages of raised total cholesterol, each at 1%. Female participants (Adjusted Odds Ratio (AOR) = 2.2, 95% Confidence level (CI): 1.62-3.04), participants aged 30-44 years (AOR = 2.1, 95% CI: 1.39-3.09), participants aged 45-59 years (AOR = 2.9, 95% CI: 1.83-4.46), participants aged 60-69 years (AOR = 2.7, 95% CI: 1.58-4.51), urban residents (AOR = 1.4, 95% CI: 1.07-1.91), obese participants (AOR = 2.2, 95% CI: 1.02-4.64), and participants with raised blood glucose (AOR = 2.4, 95% CI: 1.59-3.52) were significantly associated with raised total cholesterol. Although the prevalence of RTC is relatively low compared to global estimates, the presence of regional disparities and modifiable risk factors warrants public health attention.","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 5","pages":"e70283"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147960668","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}

引用次数: 0

Beyond "One-Size-Fits-All": Deconstructing the Hormonal Determinants of Sodium Sensitivity in Treated Hypertension. 超越“一刀切”：解构高血压治疗中钠敏感性的激素决定因素。

IF 2.5

Journal of clinical hypertension (Greenwich, Conn.) Pub Date : 2026-05-01 DOI: 10.1111/jch.70266

Dae-Hee Kim

引用次数: 0

Correction to "Hypertensive Disorders of Pregnancy and Midlife Maternal Cognition in a Prospective Cohort Study". 更正“妊娠期高血压疾病与中年产妇认知的前瞻性队列研究”。

IF 2.5

Journal of clinical hypertension (Greenwich, Conn.) Pub Date : 2026-05-01 DOI: 10.1111/jch.70273

引用次数: 0

Response to the Letter to the Editor: "Hypertensive Urgency: Which Patient will be Fine in a Quiet Room?" 对致编辑的信的回应：“高血压急迫性：哪个病人在安静的房间里会没事？”

IF 2.5