American Journal of Hypertension最新文献

Mineralocorticoid Receptor in Endothelial Cells Contributes to VEGF Receptor Inhibitor-Induced Vascular and Kidney Damage. 内皮细胞中的矿质皮质激素受体有助于血管内皮生长因子受体抑制剂诱发的血管和肾脏损伤

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-11-08 DOI: 10.1093/ajh/hpae140

Nicholas D Camarda, Qing Lu, Angelina F Tesfu, Rui R Liu, Jaime Ibarrola, Iris Z Jaffe

{"title":"Mineralocorticoid Receptor in Endothelial Cells Contributes to VEGF Receptor Inhibitor-Induced Vascular and Kidney Damage.","authors":"Nicholas D Camarda, Qing Lu, Angelina F Tesfu, Rui R Liu, Jaime Ibarrola, Iris Z Jaffe","doi":"10.1093/ajh/hpae140","DOIUrl":"https://doi.org/10.1093/ajh/hpae140","url":null,"abstract":"Background: Vascular endothelial growth factor receptor inhibitors (VEGFRis) improve cancer patient survival by inhibiting tumor angiogenesis. However, VEGFRis induce treatment-limiting hypertension which has been associated with impaired vascular endothelial cell (EC) function and kidney damage. The mineralocorticoid receptor (MR) regulates blood pressure via effects on the vasculature and the kidney. Thus, we interrogated the role of the MR in EC dysfunction, renal impairment, and hypertension in a mouse model of VEGFRi-induced hypertension using sorafenib.Methods: EC dysfunction in mesenteric arterioles was assessed by immunoblotting for phosphorylation of endothelial nitric oxide synthase (eNOS) at serine 1177. Renal damage was measured by assessing glomerular endotheliosis histologically. Blood pressure (BP) was measured using implanted radiotelemetry.Results: Six days of sorafenib treatment significantly impaired mesenteric resistance vessel EC function, induced renal damage, and increased BP. Pharmacologic MR blockade with spironolactone prevented the sorafenib-induced decline in eNOS phosphorylation and the renal glomerular endotheliosis, without affecting systolic or diastolic BP. Mice with the MR knocked out specifically in ECs (EC-MR-KO) were protected from sorafenib-induced EC dysfunction and glomerular endotheliosis, whereas smooth muscle cell-specific MR (SMC-MR) knockout mice were not. Neither EC-MR knockout nor SMC-MR knockout affected the degree to which sorafenib increased systolic or diastolic BP.Conclusions: These results reveal that the MR, specifically in EC but not in SMCs, is necessary for VEGFRi-induced renal and vascular injury. While ineffective at lowering SBP, these data suggest potential therapeutic benefits of MR antagonists, like spironolactone, to protect the vasculature and the kidneys from VEGFRi-induced injury.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trends in blood pressure control in US adults with hypertension, 2013-2014 to 2021-2023. 2013-2014 年至 2021-2023 年美国成人高血压患者的血压控制趋势。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-11-06 DOI: 10.1093/ajh/hpae141

Shakia T Hardy, Byron C Jaeger, Kathryn Foti, Lama Ghazi, Gregory Wozniak, Paul Muntner

{"title":"Trends in blood pressure control in US adults with hypertension, 2013-2014 to 2021-2023.","authors":"Shakia T Hardy, Byron C Jaeger, Kathryn Foti, Lama Ghazi, Gregory Wozniak, Paul Muntner","doi":"10.1093/ajh/hpae141","DOIUrl":"10.1093/ajh/hpae141","url":null,"abstract":"Background: Prior studies have reported a decrease in the proportion of US adults with hypertension that had controlled blood pressure (BP).Methods: We analyzed data from the National Health and Nutrition Examination Survey (n=25,128, ≥18 years of age) to determine changes in BP control from 2013-2014 to 2021-2023. Hypertension was defined as systolic BP ≥140 mmHg, diastolic BP ≥90 mmHg or antihypertensive medication use. BP control was defined as systolic BP <140 mmHg and diastolic BP <90 mmHg.Results: The age-adjusted prevalence of hypertension (95%CI) was 32.8% (31.2%-34.4%) in 2013-2014 and 32.0% (30.1%-33.9%) in 2021-2023. Among US adults with hypertension, the age-adjusted proportion (95%CI) with controlled BP was 54.1% (49.1%-59.2%), 48.6% (44.5%-52.7%), and 48.3% (45.8%-50.8%) in 2013-2014, 2015-2016 and 2017-2020, respectively (p-trend=0.058), and 51.1% (47.9%-54.3%) in 2021-2023 (p-value=0.184 comparing 2021-2023 versus 2017-2020). The proportion (95%CI) of US adults taking antihypertensive medication with controlled BP was 72.0% (68.5%-75.5%), 66.7% (62.9%-70.5%), and 67.8% (65.3%-70.3%) in 2013-2014, 2015-2016, and 2017-2020, respectively (p-trend=0.085), and 68.3% (64.8%-71.9%) in 2021-2023 (p-value=0.654 comparing 2021-2023 versus 2017-2020). Among non-Hispanic Black adults, BP control increased from 37.4% (95%CI 33.6%-41.1%) to 49.6% (95%CI 42.3%-56.9%) between 2017-2020 and 2021-2023 for those with hypertension (p-value=0.005), and from 52.6% (95%CI 47.4%-57.8%) to 62.6% (95%CI 55.6%-69.7%) for those taking antihypertensive medication (p-value=0.033). There was no difference in BP control across race/ethnicity groups in 2021-2023.Conclusions: The decline in BP control from 2013-2014 to 2017-2020 did not continue through 2021-2023. An increase in BP control occurred from 2017-2020 and 2021-2023 among non-Hispanic Black adults.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bladder Symptoms Prvoked by Short, Rapid Acting Loop Diuretics: A Frequent But Often Overlooked Problem. 短效、速效襻利尿剂引发的膀胱症状：经常出现但常被忽视的问题。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-11-01 DOI: 10.1093/ajh/hpae139

Christopher S Wilcox, Negiin Pourafshar, Karina Han, Suzanne Shah, Rachael D Sussman, Jeffrey Testani, Milton Packer, Patrick Rossignol, Faiez Zannad, Bertram Pitt, Salim Shah

{"title":"Bladder Symptoms Prvoked by Short, Rapid Acting Loop Diuretics: A Frequent But Often Overlooked Problem.","authors":"Christopher S Wilcox, Negiin Pourafshar, Karina Han, Suzanne Shah, Rachael D Sussman, Jeffrey Testani, Milton Packer, Patrick Rossignol, Faiez Zannad, Bertram Pitt, Salim Shah","doi":"10.1093/ajh/hpae139","DOIUrl":"https://doi.org/10.1093/ajh/hpae139","url":null,"abstract":"Background: Bladder dysfunction entails overactive bladder (OAB) defined as symptoms of urinary urgency, frequency, and/or nocturia with or without incontinence if there is no obvious pathology or infection or lower urinary tract symptoms (LUTS) that includes recognized causes of bladder dysfunction.Methods: Literature search.Results: Symptoms of OAB are reported in about 15% of the adult US population. This is increased 2- to 3- fold in patients with congestive heart failure (CHF), hypertension, cardiovascular disease (CVD), chronic kidney disease (CKD) or the elderly where it often accompanies prescription for short, rapid acting loop diuretics. However, less than 2% of patients seeking care for OAB receive treatment. The fear of urinary incontinence from short, rapid acting loop diuretics may contribute to medication nonadherence and less well controlled, apparently resistant hypertension. The bladder contracts to rapid stretch. Thus, less rapid acting diuretics such as thiazides or extended-release formulations of loop diuretics may be preferable for those with bladder dysfunction. Alternatively, the use of a mineralocorticosteroid receptor antagonist, angiotensin receptor antagonist/neprilysin inhibitor or sodium glucose linked transport type 2 inhibitor may allow a reduction in dose of a short, rapid acting loop diuretic for those with bladder dysfunction.Conclusion: A worsening of symptoms from bladder dysfunction by short, rapid acting loop diuretics occurs frequently in patients with CVD, CHF, hypertension and CKD where it can contribute to impaired quality of life and poor adherence and thereby to worsening outcomes.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pulse Pressure and Cardiovascular and Kidney Outcomes by Age in the Chronic Renal Insufficiency Cohort (CRIC). 慢性肾功能不全队列 (CRIC) 中按年龄划分的脉压与心血管和肾脏结果。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-22 DOI: 10.1093/ajh/hpae136

Clara J Fischman, Raymond R Townsend, Debbie L Cohen, Mahboob Rahman, Matthew R Weir, Stephen P Juraschek, Andrew M South, Lawrence J Appel, Paul Drawz, Jordana B Cohen

{"title":"Pulse Pressure and Cardiovascular and Kidney Outcomes by Age in the Chronic Renal Insufficiency Cohort (CRIC).","authors":"Clara J Fischman, Raymond R Townsend, Debbie L Cohen, Mahboob Rahman, Matthew R Weir, Stephen P Juraschek, Andrew M South, Lawrence J Appel, Paul Drawz, Jordana B Cohen","doi":"10.1093/ajh/hpae136","DOIUrl":"https://doi.org/10.1093/ajh/hpae136","url":null,"abstract":"Background: Wide pulse pressure (PP) is associated with cardiovascular events and the progression of chronic kidney disease (CKD) to kidney failure. PP naturally widens with age, but it is unclear whether the risks associated with greater PP are the same across all ages.Methods: We used Cox proportional hazards models to investigate the association of PP with (i) atherosclerotic cardiovascular disease (ASCVD) events or death and (ii) a 50% reduction in estimated glomerular filtration rate or kidney failure in the chronic renal insufficiency cohort (CRIC). We evaluated the association of time-updated PP with these outcomes, accounting for time-updated confounders using inverse probability weighting.Results: Among 5,621 participants with CKD, every 10-mmHg greater PP was associated with a 6% higher risk of an ASCVD event or death (hazard ratio [HR] = 1.06, 95% CI 1.04, 1.08) and 17% higher risk of the composite kidney outcome (HR = 1.17, 95% CI 1.16, 1.18). Greater PP was associated with a higher risk of ASCVD events or death among participants in the lowest age tertile (21-61 years), but a higher risk of the composite kidney outcome in the oldest age tertile (71-79 years). While wide PP in participants that experienced the primary outcomes was predominantly driven by elevated SBP, PP remained significantly associated with the composite kidney outcome across all ages and with ASCVD events or death in the first age tertile when SBP was added to the Cox regression model.Conclusions: Our findings suggest that the mechanism by which PP is associated with adverse outcomes may differ by age.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142492901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Elevated plasma level of arginine and its metabolites at labor among women with preeclampsia: A prospective cohort study. 子痫前期妇女分娩时血浆中精氨酸及其代谢物水平升高：一项前瞻性队列研究。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-21 DOI: 10.1093/ajh/hpae131

Tansim Akhter, Mikael Hedeland, Jonas Bergquist, Anders Larsson, Ove Axelsson, Susanne Hesselman, Alkistis Skalkidou

{"title":"Elevated plasma level of arginine and its metabolites at labor among women with preeclampsia: A prospective cohort study.","authors":"Tansim Akhter, Mikael Hedeland, Jonas Bergquist, Anders Larsson, Ove Axelsson, Susanne Hesselman, Alkistis Skalkidou","doi":"10.1093/ajh/hpae131","DOIUrl":"https://doi.org/10.1093/ajh/hpae131","url":null,"abstract":"Background: Preeclampsia complicates 3-5% of all pregnancies and is associated with higher levels of asymmetric (ADMA) and symmetric (SDMA) dimethylarginines. Dimethylarginines are inhibitors of nitric oxide, which is a uterine smooth muscles relaxant. Women with hypertensive disorders experience a shorter labor duration compared to normotensive women. However, very little is known about the possible biochemical mechanisms behind differences in labor duration. In this study we aimed to investigate if women with preeclampsia had higher levels of arginines (ADMA, SDMA and L-arginine) at labor than controls, and also investigate the association between arginines and labor duration.Methods: The study was based on data from the Swedish, Uppsala County population-based, prospective cohort BASIC, between 2009 and 2018. Arginines were analyzed by Ultra-High Performance Liquid Chromatography using plasma samples taken at labor from women with preeclampsia (n=47) and normotensive pregnancy (n=90). We also analyzed inflammation markers CRP, TNF-R1, TNF-R2 and GDF-15.Results: Women with preeclampsia had higher levels of ADMA (p<0.001), SDMA (p<0.001), L-arginine (p<0.001), TNF-R1 (p<0.001), TNF-R2 (p=0.03) and GDF-15 (p<0.01) compared to controls. Further, ADMA and SDMA, not inflammation markers, were negatively correlated to labor duration in preeclampsia. No correlations were observed when comparing arginines and inflammation markers.Conclusions: Among women with preeclampsia, our novel findings of higher level of arigines, negative correlation of arginines to duration of labor and absence of correlation of arginines to inflammation markers might support the theory that it is not inflammation but arginines which could be associated with shorter duration of labor in preeclampsia.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Targeted Treatment Reverses Increased Left Cardiac Work in Unilateral vs. Bilateral Primary Aldosteronism. 靶向治疗可逆转单侧原发性醛固酮增多症与双侧原发性醛固酮增多症的左心功增加。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-14 DOI: 10.1093/ajh/hpae087

Eeva Kokko, Marianna Viukari, Jenni K Koskela, Manoj Kumar Choudhary, Niina Matikainen, Jukka Mustonen, Pasi I Nevalainen, Ilkka Pörsti

{"title":"Targeted Treatment Reverses Increased Left Cardiac Work in Unilateral vs. Bilateral Primary Aldosteronism.","authors":"Eeva Kokko, Marianna Viukari, Jenni K Koskela, Manoj Kumar Choudhary, Niina Matikainen, Jukka Mustonen, Pasi I Nevalainen, Ilkka Pörsti","doi":"10.1093/ajh/hpae087","DOIUrl":"10.1093/ajh/hpae087","url":null,"abstract":"Background: The incidence of cardiovascular complications may be higher in unilateral than bilateral primary aldosteronism (PA). We compared noninvasive hemodynamics after targeted therapy of bilateral vs. unilateral PA.Methods: Adrenal vein sampling was performed, and hemodynamics recorded using radial artery pulse wave analysis and whole-body impedance cardiography (n = 114). In 40 patients (adrenalectomy n = 20, spironolactone-based treatment n = 20), hemodynamic recordings were performed after 33 months of PA treatment.Results: In initial cross-sectional analysis, 51 patients had bilateral and 63 unilateral PA. The mean ages were 50.6 and 54.3 years (P = 0.081), and body mass indexes 30.3 and 30.6 kg/m2 (P = 0.724), respectively. Aortic blood pressure (BP) and cardiac output did not differ between the groups, but left cardiac work was ~10% higher in unilateral PA (P = 0.022). In the follow-up study, initial and final BPs in the aorta were not significantly different, while initial cardiac output (+13%, P = 0.015) and left cardiac work (+17%, P = 0.009) were higher in unilateral than bilateral PA. After median treatment of 33 months, the differences in cardiac load were abolished, and extracellular water volume was reduced by 1.3 and 1.4 l in bilateral vs. unilateral PA, respectively (P = 0.814).Conclusions: These results suggest that unilateral PA burdens the heart more than bilateral PA, providing a possible explanation for the higher incidence of cardiac complications in unilateral disease. A similar reduction in aldosterone-induced volume excess was obtained with targeted surgical and medical treatment of PA.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141562426","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}

引用次数: 0

Use of Impedance Cardiography to Guide Blood Pressure Lowering Medication Selection: Systematic Review of Randomized Controlled Trials. 使用阻抗心动图指导降压药物选择：随机对照试验的系统回顾。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-14 DOI: 10.1093/ajh/hpae090

Anthony J Viera, Lauren Hart, Pedro Gomez Altamirano, Brandi Tuttle, Ashley Price, Andrew Sherwood

{"title":"Use of Impedance Cardiography to Guide Blood Pressure Lowering Medication Selection: Systematic Review of Randomized Controlled Trials.","authors":"Anthony J Viera, Lauren Hart, Pedro Gomez Altamirano, Brandi Tuttle, Ashley Price, Andrew Sherwood","doi":"10.1093/ajh/hpae090","DOIUrl":"10.1093/ajh/hpae090","url":null,"abstract":"Background: Blood pressure (BP) control can be difficult to attain due to multiple factors, including choosing and titrating antihypertensive medications. Measurement of hemodynamic parameters using impedance cardiography (ICG) at the point of care may allow better alignment of medication with the mechanism(s) underlying an individual's hypertension. We conducted a systematic review of randomized controlled trials of ICG compared to usual care for attainment of BP control.Methods: We searched Medline inclusive of the year 1946 to January 31, 2024, using a combination of MeSH terms and keywords. English-language articles were eligible for inclusion if they described results of a randomized controlled trial designed to compare ICG-guided BP-medication selection to usual care (i.e., clinician judgment/guidelines-based alone) among a sample of hypertensive patients.Results: Of 1,952 titles screened, 6 trials met inclusion criteria. The first was published in 2002 from a specialty clinic in the United States, and the most recent in 2021 from a specialty clinic in China. One trial was conducted in a primary care setting. Sample sizes ranged from 102 to 164. Participants randomized to ICG-guided antihypertensive medication had reduced BP in the short-term to a greater extent than those randomized to usual care, with odds ratios for BP control (<140/90 mm Hg) at 3 months ranging from 1.87 to 2.92. This effect was seen in both specialty clinics and in a primary care setting.Conclusions: Incorporation of ICG in the clinical setting may facilitate medication selection that leads to a greater proportion of patients obtaining BP control in the short term.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141589396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Geographical Differences in Hydrochlorothiazide Associated Risk of Skin Cancer Balanced Against Disability Related to Hypertensive Heart Disease. 氢氯噻嗪相关皮肤癌风险的地域差异与高血压心脏病相关残疾的平衡。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-14 DOI: 10.1093/ajh/hpae101

Anders Almskou Rasmussen, Niels Henrik Buus, Simon G Comerma Steffensen

{"title":"Geographical Differences in Hydrochlorothiazide Associated Risk of Skin Cancer Balanced Against Disability Related to Hypertensive Heart Disease.","authors":"Anders Almskou Rasmussen, Niels Henrik Buus, Simon G Comerma Steffensen","doi":"10.1093/ajh/hpae101","DOIUrl":"10.1093/ajh/hpae101","url":null,"abstract":"Background: Hypertension affects 25%-30% of the world population. Hydrochlorothiazide (HCTZ) is among the most used and cheapest medications but was in 2018 labeled with a warning stating the increased risk of nonmelanoma skin cancer (NMSC). This study describes geographical differences in the association between HCTZ and NMSC from the perspective of hypertensive heart disease (HHD).Methods: We conducted a systematic literature search (PubMed, Embase, Clinicaltrial.gov, and Clinicaltrial.eu) using PICO/PECO acronyms, including case-control, cohort, and randomized controlled trials. We constructed a rate ratio of disability-adjusted life years (DALY) for HHD/NMSC in the global burden of disease (GBD) regions.Results: No increased risk of NMSC with the use of HCTZ was found in Taiwan, India, and Brazil. A small (hazard ratio (HR)/odds ratio (OR) ≤1.5) but significantly increased risk was seen in Canada, the United States, and Korea. An increased risk (1.5< HR/OR ≤2.5) in Iceland, Spain, and Japan and a highly increased risk (HR/OR >2.5) in the United Kingdom, Denmark, the Netherlands, and Australia. HHD is associated with a more than tenfold DALY rate compared with NMSC in 13 of 21 GBD regions, corresponding to 77.2% of the global population. In none of these 13 regions was there an increased risk of HCTZ-associated NMSC.Conclusions: Despite limited information from many countries, our data point to large geographical differences in the association between HCTZ and NMSC. In all GBD regions, except Australasia, HHD constitutes a more than fivefold DALY rate compared to NMSC. This disproportionate risk should be considered before avoiding HCTZ from the antihypertensive treatment.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141900646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Blood Pressure on Ambulatory Monitoring and Risk for Cardiovascular Disease and All-cause Mortality: Ecological Validity or Measurement Reliability? 动态监测血压与心血管疾病和全因死亡率风险：生态有效性还是测量可靠性？

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-14 DOI: 10.1093/ajh/hpae133

Rikki M Tanner, Byron C Jaeger, Corey K Bradley, S Justin Thomas, Yuan-I Min, Shakia T Hardy, M Ryan Irvin, Daichi Shimbo, Joseph E Schwartz, Paul Muntner

{"title":"Blood Pressure on Ambulatory Monitoring and Risk for Cardiovascular Disease and All-cause Mortality: Ecological Validity or Measurement Reliability?","authors":"Rikki M Tanner, Byron C Jaeger, Corey K Bradley, S Justin Thomas, Yuan-I Min, Shakia T Hardy, M Ryan Irvin, Daichi Shimbo, Joseph E Schwartz, Paul Muntner","doi":"10.1093/ajh/hpae133","DOIUrl":"https://doi.org/10.1093/ajh/hpae133","url":null,"abstract":"Background: The association with cardiovascular disease (CVD) is stronger for mean systolic blood pressure (SBP) estimated using ambulatory blood pressure monitoring (ABPM) versus office measurements. Determining whether this is due to ABPM providing more measurement reliability or greater ecological validity can inform its use.Methods: We estimated the association of mean SBP based on 2 office measurements and 2, 5, 10, and 20 measurements on ABPM with incident CVD in the Jackson Heart Study (n=773). Hazard ratios (HRs) for CVD were estimated per standard deviation higher mean SBP. CVD events were defined by incident fatal or non-fatal stroke, non-fatal myocardial infarction, or fatal coronary heart disease.Results: There were 80 CVD events over a median 15 years. The adjusted HRs for incident CVD were 1.03 (95%CI: 0.90-1.19) for mean office SBP and 1.30 (95%CI: 1.12-1.50), 1.34 (95%CI: 1.15-1.56), 1.36 (95%CI: 1.17-1.59), and 1.38 (95%CI: 1.17-1.63) for mean SBP using the first 2, 5, 10 and 20 ABPM readings. The difference in the HRs for incident CVD ranged from 0.26 (95%CI: 0.07-0.46) to 0.35 (95%CI: 0.15-0.54) when comparing mean office SBP versus 2, 5, 10, or 20 sequential ABPM readings. The association with incident CVD was also stronger for mean SBP based on 2, 5, 10, and 20 randomly-selected ABPM readings versus 2 office readings.Conclusion: Mean SBP based on two ABPM readings versus two office measurements had a stronger association with CVD events. The increase in the strength of the association with more ABPM readings was small.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patient Practices, Perceptions, and Barriers to Self-measurement of Blood Pressure in a Rural Health System. 农村医疗系统中患者自我测量血压的做法、看法和障碍。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-14 DOI: 10.1093/ajh/hpae085

Sunny Parmar, Yvonne Commodore-Mensah, Gurmukteshwar Singh, Kathryn Foti, Cheryl Himmelfarb, Alexander Richard Chang, Ion Dan Bucaloiu

{"title":"Patient Practices, Perceptions, and Barriers to Self-measurement of Blood Pressure in a Rural Health System.","authors":"Sunny Parmar, Yvonne Commodore-Mensah, Gurmukteshwar Singh, Kathryn Foti, Cheryl Himmelfarb, Alexander Richard Chang, Ion Dan Bucaloiu","doi":"10.1093/ajh/hpae085","DOIUrl":"10.1093/ajh/hpae085","url":null,"abstract":"Background: Self-measurement of blood pressure (SMBP) is endorsed by current guidelines for diagnosing and managing hypertension (HTN). We surveyed individuals in a rural healthcare system on practices and attitudes related to SMBP that could guide future practice.Methods: Survey questions were sent via an online patient portal to a random sample of 56,275 patients with either BP > 140/90 mm Hg or cardiovascular care in the system. Questions addressed home blood pressure (BP) monitor ownership, use, willingness to purchase, desire to share data with providers, perceptions of patient education, and patient-centeredness of care. Multivariable logistic regression was used to examine patient characteristics associated with SMBP behaviors.Results: The overall response rate was 12%, and 8.4% completed all questions. Most respondents, 60.9%, owned a BP monitor, while 51.5% reported checking their BP at home the month prior. Among device owners, 45.1% reported receiving instructions on SMBP technique, frequency, and reading interpretation. Only 29.2% reported sharing readings with providers in the last 6 months, whereas 57.9% said they would be willing to do so regularly. Older age, female sex, and higher income were associated with a higher likelihood of device ownership. Younger age, lower income, and Medicaid insurance were associated with a greater willingness to share SMBP results with providers regularly.Conclusions: While a significant proportion of respondents performed SMBP regularly, many reported insufficient education on SMBP, and few shared their home BP readings with providers. Patient-centered interventions and telemedicine-based care are opportunities that emerged in our survey that could enhance future HTN care.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141454640","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}

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