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

{"title":"Associations of Cumulative Burden of Prehypertension, Prediabetes and Predyslipidemia With All-Cause and Cardiovascular Disease Mortality: A Retrospective Cohort Study.","authors":"Jiao Meng, Gang Wang, Wei Wang, Junnan Wu","doi":"10.1111/jch.70264","DOIUrl":"10.1111/jch.70264","url":null,"abstract":"<p><p>We aimed to examine the individual and combined impact of prehypertension, prediabetes, and predyslipidemia on all-cause and cardiovascular disease (CVD) mortality in community-dwelling adults. A retrospective cohort study of 11 986 US adults from the 1999-2018 National Health and Nutrition Examination Survey was conducted. Participants were categorized into four mutually exclusive groups based on the cumulative number of these conditions. Multivariate Cox proportional hazards models were applied to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality outcomes. The prevalences of no, one, two, and all three preclinical conditions were 37.20%, 38.39%, 19.86%, and 4.55%, respectively. Over a median follow-up of 10 years, 636 (3.83%) deaths occurred, including 170 (26.73%) from CVD. In a dose-response manner, the adjusted HRs (95%CIs) for all-cause mortality among those with one, two, and three conditions were 1.87 (1.38-2.52), 2.49 (1.80-3.44), and 2.62 (1.76-3.90), respectively, compared to those with none. The corresponding HRs (95%CIs) for CVD mortality were 3.09 (1.66-5.78), 3.89 (2.06-7.36), and 4.20 (2.04-8.69), respectively. Thus, an increasing cumulative number of preclinical conditions is associated with graded elevated risk of all-cause and CVD mortality, underscoring the potential for early intervention during the preclinical phase to improve long-term health outcomes.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 5","pages":"e70264"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13130149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795100","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":"Potential Value of Weight-Adjusted Waist Circumference Index in Estimating the Prevalence of Prehypertension and Hypertension in an Elderly Chinese Population.","authors":"Ruoyu Zhu, Zhi Du, Xuanhan Lin, Zhuolin Wang, Xiaogang Guo","doi":"10.1111/jch.70270","DOIUrl":"10.1111/jch.70270","url":null,"abstract":"<p><p>To determine the correlation between weight-adjusted-waist index (WWI) with prehypertension and hypertension in the general population. This cross-sectional study was conducted from September 13, 2023 to November 30, 2023 and included 4885 permanent residents in Zhejiang Province. The association between WWI with prehypertension and hypertension was carefully evaluated using logistic regression models and penalized spline functions. The category-free analysis was performed to corroborate whether WWI enhanced the ability to estimate prehypertension and hypertension. Multivariable logistic regression indicated that after adjustment for conventional risk factors, each standard deviation increase in WWI levels was associated with a 29% and 50% increased risk of prehypertension (hazard ratio, 1.29; 95% confidence interval, 1.14-1.45) and hypertension (1.50; 1.34-1.68), respectively. Referring to the participants in the lowest quartile of WWI, those in the highest quartile had a significantly increased risk of prehypertension (1.64; 1.17-2.30) and hypertension (2.47; 1.80-3.39). Smoothing curve fitting and trend logistic regression suggested a linear positive correlation, and the robustness of these findings was observed in interaction tests and subgroup analyses. The category-free analysis suggested that adding WWI levels to the traditional model ultimately improved the predictive ability of prehypertension and hypertension. The results of this study confirmed the significant correlation between WWI with prehypertension and hypertension, independent of conventional risk factors. More importantly, these findings suggested the potential usefulness of WWI levels to improve the risk stratification of hypertension and prehypertension.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 5","pages":"e70270"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849204","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":"Comment on \"Effect of Modular Training on Self-Management, Disease, and Treatment Adaptation in Individuals With Hypertension: A Randomized Controlled Trial\".","authors":"Noor Fatima, Eman Fatima","doi":"10.1111/jch.70272","DOIUrl":"10.1111/jch.70272","url":null,"abstract":"","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 5","pages":"e70272"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849194","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":"Hypertension Incidence and Its Risk Factors in a Longitudinal Cohort of Middle-Aged Men and Women Living in Urban South Africa.","authors":"Boitumelo M Komane, Juliana Kagura, Julia H Goedecke, June Fabian, Lisa K Micklesfield","doi":"10.1111/jch.70286","DOIUrl":"10.1111/jch.70286","url":null,"abstract":"<p><p>Hypertension is a growing burden in rapidly urbanizing settings, yet longitudinal studies on its incidence and risk factors in urban populations living in resource-constrained settings in Africa are limited. This study aimed to determine the incidence of hypertension and associated risk factors in urban middle-aged South African men and women. Longitudinal data from the Middle-Aged Soweto Cohort were collected at four time points between 2011 and 2025 and included: blood pressure, sociodemographic, anthropometry, chronic disease status, and medication use. Participants were included if they had complete data for at least two time points and were normotensive at baseline. The incidence of hypertension was estimated using survival analysis and the significant risk factors were determined using Cox proportional hazard models. Of the 679 eligible participants, there were 332 incident hypertension cases, and an overall incidence of 6.4 cases per 100 person years, with no significant difference between men and women (p = 0.0977). In multivariable analyses in the whole cohort, older age (hazard ratio [HR]: 1.15, 95% CI: 1.04-1.28) and higher BMI (HR: 1.22, 95% CI: 1.11-1.35) were associated with a higher risk of incident hypertension. In sex stratified analysis, higher BMI (p < 0.001) and alcohol consumption (p < 0.001) were associated with incident hypertension in men, while higher BMI (p = 0.002) and older age (p = 0.025) were associated with incident hypertension in women. The study identifies modifiable risk factors associated with incident hypertension in urban South African men and women. Sex-specific interventions targeting ageing adults may be beneficial in resource constrained urban settings. Clinical Trial Registration: This study is not a clinical trial and does not require registration.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 5","pages":"e70286"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13175196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944613","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":"Reproducibility of Ambulatory Blood Pressure Variability in Untreated Hypertensive Patients.","authors":"Aikaterini Lykka, Ionas Papasotiriou, Gerasimos Barlas, Sotiria Spiliopoulou, Damianos Dragonas, Konstantinos Rizogiannis, Efstathios Manios","doi":"10.1111/jch.70277","DOIUrl":"10.1111/jch.70277","url":null,"abstract":"<p><p>Several studies have demonstrated that blood pressure variability (BPV) is associated with an increased risk of cardiovascular morbidity and mortality. However, the optimal BPV index in terms of prognosis and reproducibility remains unclear. In this study, we aimed to evaluate the reproducibility of ambulatory BPV indices in untreated hypertensive patients. A total of 100 never-treated hypertensive patients underwent two ambulatory BP recordings within a 4-week period. For each patient, we computed BPV indices, such as the standard deviation (SD), coefficient of variation (CV), weighted SD (wSD), average real variability (ARV), time rate (TR) of BP variation, and dipping for systolic and diastolic BP. Statistical analyses were performed using the intraclass correlation coefficient (ICC) and Cohen's kappa coefficient. Reliability analysis using ICC revealed moderate reproducibility (ICC from 0.540 to 0.715) for 24 h systolic SD, wSD, CV, ARV, TR, dipping, diastolic SD, wSD, CV, and ARV and poor reproducibility (ICC < 0.5) for the 24 h diastolic TR and dipping. The ICC values for daytime BPV revealed moderate reproducibility (ICC from 0.537 to 0.672) for daytime systolic SD, CV, diastolic SD, and CV but poor reproducibility (ICC < 0.5) for daytime systolic ARV, TR, diastolic ARV, and TR. All nighttime BPV indices exhibited poor reproducibility. This study demonstrated that most 24 h and daytime BPV indices showed moderate reproducibility, whereas nighttime BPV indices and diastolic BP dipping showed poor reproducibility. Additionally, systolic BPV was more reproducible than diastolic BPV.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 5","pages":"e70277"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147985044","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":"Risk Factors and Adverse Perinatal Outcomes in Severe Preeclampsia Complicated by HELLP Syndrome.","authors":"Chengfang Sun, Jiaying Chen, Hao Gu, Ying Gu, Minhui Jiang, Hongqin Wu, Xue Sang, Hualong Zhu, Yaling Feng","doi":"10.1111/jch.70289","DOIUrl":"10.1111/jch.70289","url":null,"abstract":"<p><p>This study investigated the risk factors and adverse perinatal outcomes of severe preeclampsia complicated with HELLP (Hemolysis, Elevated Liver Enzymes, and Low Platelet Count syndrome). A total of 170 patients with severe preeclampsia and 30 healthy pregnant women admitted to Wuxi Maternal and Child Health Hospital from January 2020 to October 2023 were enrolled. Of the 170 patients, 30 were complicated by HELLP syndrome and 140 were not; 30 healthy women served as controls. Clinical data, laboratory results, and pregnancy outcomes were compared. Risk factors were analyzed by logistic regression, and predictive efficacy was evaluated by ROC curves. Maternal and neonatal outcomes were assessed, and correlations with risk factors were analyzed. Patients with severe preeclampsia had higher age, BMI, and blood pressure but lower gestational weeks than controls (p < 0.05). In the HELLP group, D-dimer, bilirubin, liver enzymes, and lactate dehydrogenase (LDH) were significantly elevated, while platelets, albumin, and globulin were reduced compared with the non-HELLP group (p < 0.05). Multivariate analysis identified D-dimer and LDH as independent risk factors. ROC analysis showed AUCs of 0.929 for D-dimer, 0.937 for LDH, and 0.956 for their combination, with cutoffs of 3.26 mg/L and 261.60 U/L, yielding 94.4% sensitivity and 92.6% specificity. Adverse outcomes, including stillbirth, preterm labor, neonatal asphyxia, and MICU transfer, were more frequent in HELLP patients (p < 0.05). Elevated D-dimer and LDH correlated with fetal growth restriction and neonatal asphyxia. In conclusion, D-dimer and LDH are independent predictors of HELLP syndrome and adverse perinatal outcomes.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 5","pages":"e70289"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147985070","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":"Antihypertensive Combinations Modify Cardiovascular Risk Factor Importance: A Machine Learning Analysis of the ACCOMPLISH Trial.","authors":"Niko Kaciroti, Phillip D Levy, Kenneth A Jamerson, Robert D Brook","doi":"10.1111/jch.70278","DOIUrl":"10.1111/jch.70278","url":null,"abstract":"<p><p>Results from the ACCOMPLISH (Avoiding Cardiovascular Events through COMbination Therapy in Patients LIving with Systolic Hypertension) trial suggest that combining benazepril with amlodipine, rather than hydrochlorothiazide, provides superior cardiovascular protection potentially in a BP-independent manner. We employed random survival forest, a powerful machine learning approach, to compare the relative importance of risk factors (i.e., variable importance factor (VIF)), focusing on in-trial BP control for predicting the primary composite cardiovascular outcome in the 2 treatment limbs. Among the 6 risk factors with significantly different VIFs between treatments, all were lower under benazepril/amlodipine combination. The VIF for achieved systolic BP at 6-months was 35% lower in the benazepril/amlodipine (0.082) versus the benazepril/hydrochlorothiazide (0.126) limb. The fact that in-trial BP control was less important for preventing cardiovascular events during benazepril/amlodipine treatment provides novel support for our contention that this combination regimen provides a degree of clinically-relevant cardio-protective actions in a BP-independent manner.</p>","PeriodicalId":520663,"journal":{"name":"Journal of clinical hypertension (Greenwich, Conn.)","volume":"28 5","pages":"e70278"},"PeriodicalIF":2.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13172597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147937185","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 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":"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}