American Journal of Hypertension最新文献_第10页

Self-measurement of Blood Pressure in a Rural Health System: Highlighting the Opportunity for All Health Systems. 农村医疗系统的自我血压测量：为所有医疗系统提供机会。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-14 DOI: 10.1093/ajh/hpae097

Jeffrey Brettler

引用次数: 0

Patient Experience in a Remote Patient Monitoring Program for Hypertension: A Qualitative Study. 高血压远程患者监测计划中的患者体验：定性研究。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-14 DOI: 10.1093/ajh/hpae086

Fion Chu, Allison Stark, Andrew Telzak, Sharon Rikin

{"title":"Patient Experience in a Remote Patient Monitoring Program for Hypertension: A Qualitative Study.","authors":"Fion Chu, Allison Stark, Andrew Telzak, Sharon Rikin","doi":"10.1093/ajh/hpae086","DOIUrl":"10.1093/ajh/hpae086","url":null,"abstract":"Background: Remote patient monitoring (RPM), which includes out-of-office blood pressure (BP) measurement, coupled with interventions including telehealth and team-based care, is recommended for hypertension (HTN) management. We aimed to assess participant experience with RPM for HTN (RPM-HTN) to understand barriers and facilitators to implementing RPM-HTN in a primary care population where health disparities and social inequities are prevalent.Methods: This is a qualitative implementation study of participants' experiences with an RPM-HTN program for primary care patients with uncontrolled HTN at an academic health system. We recruited participants with high and low levels of engagement (≥16 or <16 days of transmitted BP readings per month). Semi-structured interviews were conducted, and descriptive statistics and rapid qualitative analysis were used to identify factors affecting the implementation of RPM-HTN, specifically adoption, acceptability, appropriateness, and feasibility.Results: Multiple themes emerged from interviews with 14 participants. A doctor's recommendation and wanting help with BP management were facilitators for engagement, while work conflicts and forgetfulness were barriers to engagement. Participants enjoyed the format and content of nurse and clinical pharmacist phone calls and forming a relationship with the team; expressed improved understanding of HTN and BP management; and appreciated the convenience of remote monitoring.Conclusions: Participants found RPM-HTN acceptable and appropriate, highlighting the team-based and out-of-office approach to care. This study provides actionable targets to overcome feasibility barriers to implementation. In order to increase engagement, RPM policies and procedures should take into account barriers including the quantity of required BP measurements and mechanisms of telehealth communication.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"861-867"},"PeriodicalIF":3.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465571","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

Prognostic Value of Mild Asymptomatic Intracranial Atherosclerotic Stenosis in Patients With Hypertension. 高血压患者轻度无症状颅内动脉粥样硬化狭窄的预后价值。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-14 DOI: 10.1093/ajh/hpae095

Jin Zhang, Xiaofeng Tang, Yuesheng Qian, Jing Ma, Qin Wang, Huawei Ling, Kemin Chen, Yan Li, Pingjin Gao, Yan Wang, Dingliang Zhu

{"title":"Prognostic Value of Mild Asymptomatic Intracranial Atherosclerotic Stenosis in Patients With Hypertension.","authors":"Jin Zhang, Xiaofeng Tang, Yuesheng Qian, Jing Ma, Qin Wang, Huawei Ling, Kemin Chen, Yan Li, Pingjin Gao, Yan Wang, Dingliang Zhu","doi":"10.1093/ajh/hpae095","DOIUrl":"10.1093/ajh/hpae095","url":null,"abstract":"Background: Mild asymptomatic intracranial atherosclerotic stenosis (aICAS) is common in Chinese patients with hypertension. However, there are no data on its prognostic value in this population. The aim of the present study was to clarify the prevalence and associated cardiovascular risk factors of mild aICAS and determine its prognostic value for overall and cardiovascular mortality in patients with hypertension.Methods: In total, 1,813 participants were evaluated for aICAS using computed tomographic angiography. The predictive effect of mild to severe aICAS on all-cause and cardiovascular mortality was evaluated using Kaplan-Meier survival curves and Cox regression analyses.Results: The prevalence rate of mild aICAS was 35.7%. Poorly controlled hypertension, in combination with diabetes and dyslipidemia, was associated with aICAS. Patients with aICAS had an independently significant increase in the risk of all-cause and cardiovascular death, with adjusted hazard ratios (HRs) for mild to severe stenosis ranging from 1.56 to 3.30 for all-cause death and from 2.48 to 6.38 for cardiovascular death. Among the patients with mild aICAS, only those with more than two stenoses had increased mortality after adjustment, with an HR of 2.44 (95% CI: 1.42-4.18) for total death and 4.49 (95% CI: 1.82-11.05) for cardiovascular death.Conclusions: A significant association between mild aICAS and mortality in stroke-free patients with hypertension was revealed. The results indicate that mild aICAS might be an imaging marker for cerebrovascular lesions in patients with hypertension and poor control of blood pressure and lipids in this population requires further research.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"893-900"},"PeriodicalIF":3.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141722866","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

State-of-the-Art-Review: Mechanisms of Action of SGLT2 Inhibitors and Clinical Implications. 最新进展回顾 SGLT2 抑制剂的作用机制和临床意义。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-14 DOI: 10.1093/ajh/hpae092

Volker Vallon

{"title":"State-of-the-Art-Review: Mechanisms of Action of SGLT2 Inhibitors and Clinical Implications.","authors":"Volker Vallon","doi":"10.1093/ajh/hpae092","DOIUrl":"10.1093/ajh/hpae092","url":null,"abstract":"Background: Inhibitors of the Na+-coupled glucose transporter SGLT2 (SGLT2i) primarily shift the reabsorption of large amounts of glucose from the kidney's early proximal tubule to downstream tubular segments expressing SGLT1, and the non-reabsorbed glucose is spilled into the urine together with some osmotic diuresis. How can this protect the kidneys and heart from failing as observed in individuals with and without type 2 diabetes?Goal: Mediation analyses identified clinical phenotypes of SGLT2i associated with improved kidney and heart outcome, including a reduction of plasma volume or increase in hematocrit, and lowering of serum urate levels and albuminuria. This review outlines how primary effects of SGLT2i on the early proximal tubule can explain these phenotypes.Results: The physiology of tubule-glomerular communication provides the basis for acute lowering of GFR and glomerular capillary pressure, which contributes to lowering of albuminuria but also to long term preservation of GFR, at least in part by reducing kidney cortex oxygen demand. Functional co-regulation of SGLT2 with other sodium and metabolite transporters in the early proximal tubule explains why SGLT2i initially excrete more sodium than expected and are uricosuric, thereby reducing plasma volume and serum urate. Inhibition of SGLT2 reduces early proximal tubule gluco-toxicity and by shifting transport downstream may simulate \"systemic hypoxia\", and the resulting increase in erythropoiesis, together with the osmotic diuresis, enhances hematocrit and improves blood oxygen delivery. Cardio-renal protection by SGLT2i is also provided by a fasting-like and insulin-sparing metabolic phenotype and, potentially, by off-target effects on the heart and microbiotic formation of uremic toxins.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"841-852"},"PeriodicalIF":3.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11471837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625657","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

SIRT3/AMPK Signaling Pathway Regulates Lipid Metabolism and Improves Vulnerability to Atrial Fibrillation in Dahl Salt-Sensitive Rats. SIRT3/AMPK 信号通路调节脂质代谢并改善对达尔盐敏感大鼠心房颤动的易感性。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-14 DOI: 10.1093/ajh/hpae091

Xiu-Heng Wang, Zhi-Hong Ning, Zhong Xie, Yun Ou, Jia-Yang Yang, Yun-Xi Liu, Hong Huang, Hui-Fang Tang, Zhi-Sheng Jiang, Heng-Jing Hu

{"title":"SIRT3/AMPK Signaling Pathway Regulates Lipid Metabolism and Improves Vulnerability to Atrial Fibrillation in Dahl Salt-Sensitive Rats.","authors":"Xiu-Heng Wang, Zhi-Hong Ning, Zhong Xie, Yun Ou, Jia-Yang Yang, Yun-Xi Liu, Hong Huang, Hui-Fang Tang, Zhi-Sheng Jiang, Heng-Jing Hu","doi":"10.1093/ajh/hpae091","DOIUrl":"10.1093/ajh/hpae091","url":null,"abstract":"Background: Hypertension may result in atrial fibrillation (AF) and lipid metabolism disorders. The Sirtuins3 (SIRT3)/AMP-activated protein kinase (AMPK) signaling pathway has the capacity to regulate lipid metabolism disorders and the onset of AF. We hypothesize that the SIRT3/AMPK signaling pathway suppresses lipid metabolism disorders, thereby mitigating salt-sensitive hypertension (SSHT)-induced susceptibility to AF.Methods: The study involved 7-week-old male Dahl salt-sensitive that were fed either a high-salt diet (8% NaCl; DSH group) or a normal diet (0.3% NaCl; DSN group). Then DSH group was administered either oral metformin (MET, an AMPK agonist) or intraperitoneal injection of Honokiol (HK, a SIRT3 agonist). This experimental model allowed for the measurement of Systolic blood pressure (SBP), the expression levels of lipid metabolism-related biomarkers, pathological examination of atrial fibrosis, and lipid accumulation, as well as AF inducibility and AF duration.Results: DSH decrease SIRT3, phosphorylation-AMPK, and very long-chain acyl-CoA dehydrogenase, (VLCAD) expression, increased FASN and FABP4 expression and concentrations of free fatty acid and triglyceride, atrial fibrosis and lipid accumulation in atrial tissue, enhanced level of SBP, promoted AF induction rate and prolonged AF duration, which are blocked by MET and HK. Our results also showed that the degree of atrial fibrosis was negatively correlated with VLCAD expression, but positively correlated with the expression of FASN and FABP4.Conclusions: We have confirmed that a high-salt diet can result in hypertension, and associated atrial tissue lipid metabolism dysfunction. This condition is linked to the inhibition of the SIRT3/AMPK signaling pathway, which plays a significant role in the progression of susceptibility to AF in SSHT rats.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"901-908"},"PeriodicalIF":3.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632363","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

Towards Optimal Use of Home BP Monitoring Technology: Incorporating Patient Perspectives. 实现家庭血压监测技术的最佳使用：纳入患者观点。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-14 DOI: 10.1093/ajh/hpae107

Raj Padwal, Jennifer Cluett

引用次数: 0

A Novel Imaging Marker for Asymptomatic Cerebrovascular Lesions in Hypertension. 高血压无症状脑血管病变的新型成像标记。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-14 DOI: 10.1093/ajh/hpae100

Gaetano Santulli, Marco Savino, Klara Komici, Pasquale Mone, Luigi Savino, Stanislovas S Jankauskas

引用次数: 0

Estimated Pulse Wave Velocity Is Associated With a Higher Risk of Dementia in the Health and Retirement Study. 健康与退休研究》中估计的脉搏波速度与痴呆症的高风险有关。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-14 DOI: 10.1093/ajh/hpae096

Kevin S Heffernan, Janet M Wilmoth, Andrew S London

{"title":"Estimated Pulse Wave Velocity Is Associated With a Higher Risk of Dementia in the Health and Retirement Study.","authors":"Kevin S Heffernan, Janet M Wilmoth, Andrew S London","doi":"10.1093/ajh/hpae096","DOIUrl":"10.1093/ajh/hpae096","url":null,"abstract":"Background: In this paper, we use the Health and Retirement Study (HRS) to examine the relationship between an estimated measure of pulse wave velocity (ePWV) and cognitive impairment with no dementia and dementia, respectively.Methods: We modeled the relationship between ePWV and cognitive status in 2006/2008 using data from 8,492 men and women (mean age 68.6 years) controlling for age, blood pressure, sociodemographic, and socioeconomic characteristics (sex, race and ethnicity, education, income, wealth), health behaviors (smoking and physical activity), body mass index (BMI), health status and related medication use (history of cardiovascular disease, diabetes, and stroke), and cerebrovascular disease (CVD)-related biomarkers (C-reactive protein, cystatin-C, hemoglobin A1c, total cholesterol, high-density lipoprotein [HDL] cholesterol). We assess cognitive function with the 27-item Langa-Weir Telephone Interview for Cognitive Status (TICS) scale. ePWV is derived from an equation based on participant age and resting blood pressure.Results: In a model that controlled for the constituent components of ePWV (age, age squared, systolic and diastolic blood pressure), ePWV is associated with increased odds of having cognitive impairment with no dementia (OR = 2.761) and dementia (OR = 6.344) relative to a group with no cognitive impairment or dementia. After controlling for the constituent components of ePWV, sociodemographic and socioeconomic characteristics, health behaviors, BMI, health status and medication use, and CVD-related biomarkers, ePWV remains significantly associated with dementia (OR = 3.969) but not cognitive impairment with no dementia (OR = 1.782).Conclusions: These findings suggest that ePWV may be a novel research tool and biomarker of vascular aging that can be used in large, population-representative studies to examine cognitive aging and dementia risk.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"909-915"},"PeriodicalIF":3.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141730971","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

Arterial Properties and Ventricular-Arterial Interactions in Severe Aortic Stenosis: Impact on Prognosis. 重度主动脉瓣狭窄的动脉特性和心室-动脉相互作用：对预后的影响。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-03 DOI: 10.1093/ajh/hpae127

Edward R Horton, Bryce V Johnson, Mahesh Vidula, Jonathan J Lee, Soumya Kondaveeti, Caroline A Magro, Srivinas Denduluri, Patrick Segers, Howard C Herrmann, Julio A Chirinos

{"title":"Arterial Properties and Ventricular-Arterial Interactions in Severe Aortic Stenosis: Impact on Prognosis.","authors":"Edward R Horton, Bryce V Johnson, Mahesh Vidula, Jonathan J Lee, Soumya Kondaveeti, Caroline A Magro, Srivinas Denduluri, Patrick Segers, Howard C Herrmann, Julio A Chirinos","doi":"10.1093/ajh/hpae127","DOIUrl":"10.1093/ajh/hpae127","url":null,"abstract":"Background: Systemic arterial properties contribute to clinical heterogeneity and outcomes in degenerative calcific aortic stenosis (AS). Lumped parameters of afterload have previously been associated with adverse left ventricular remodeling, mortality, and poor exercise tolerance in this population, but most studies did not assess pulsatile aortic pressure-flow relations, the gold standard method for assessing arterial load. Moreover, arterial compliance is highly dependent on non-pulsatile (mean) arterial pressure, which influences prognosis in this population.Methods: We retrospectively studied 135 patients with severe AS with same-day catheterization and echocardiogram. Invasive aortic pressures and echocardiographic flow waveforms were used to assess pressure-flow and pressure-volume relations using Windkessel modeling and wave separation analyses. We used Cox regression to assess the relationship between pulsatile load and time to death and heart failure hospital admission (DHFA).Results: Total arterial compliance accounting for pressure-dependence (PD-TAC) was independently predictive of all-cause mortality (HR=0.80, 95%CI=0.66-0.97; p=0.023) and DHFA (HR=0.70; 95%CI=0.50-0.97; p=0.031) even after adjustment for age, race, gender, BMI, and comorbidities, while other arterial parameters were not.Conclusions: In patients with severe AS, pressure-dependent arterial compliance predicts adverse outcomes, while traditional pulsatile arterial load measures do not. Our findings suggest that methods accounting for pressure load on the arterial wall are advantageous in this population in which lower mean pressure can result from severe stenosis and ventricular dysfunction.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142363976","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

Correction to: Prognostic Value of Mild Asymptomatic Intracranial Atherosclerotic Stenosis in Patients With Hypertension. 更正：高血压患者轻度无症状颅内动脉粥样硬化性狭窄的预后价值。

IF 3.2 3区医学

American Journal of Hypertension Pub Date : 2024-10-01 DOI: 10.1093/ajh/hpae125

引用次数: 0