American Journal of Hypertension最新文献

{"title":"Are Your Kidneys Ok? Detect Early to Protect Kidney Health.","authors":"Joseph A Vassalotti, Anna Francis, Augusto Cesar Soares Dos Santos, Ricardo Correa-Rotter, Dina Abdellatif, Li-Li Hsiao, Stefanos Roumeliotis, Agnes Haris, Latha A Kumaraswami, Siu-Fai Lui, Alessandro Balducci, Vassilios Liakopoulos","doi":"10.1093/ajh/hpaf062","DOIUrl":"10.1093/ajh/hpaf062","url":null,"abstract":"<p><p>Early identification of kidney disease can protect kidney health, prevent kidney disease progression and related complications, reduce cardiovascular disease risk, and decrease mortality. We must ask \"Are your kidneys ok?\" using serum creatinine to estimate kidney function and urine albumin to assess for kidney and endothelial damage. Evaluation for causes and risk factors for chronic kidney disease (CKD) includes testing for diabetes and measurement of blood pressure and body mass index. This World Kidney Day we assert that case-finding in high-risk populations, or even population-level screening, can decrease the burden of kidney disease globally. Early-stage CKD is asymptomatic, and simple to test for, and recent paradigm shifting CKD treatments such as sodium-glucose co-transporter-2 inhibitors dramatically improve outcomes and favor the cost-benefit analysis for screening or case-finding programs. Despite this, numerous barriers exist, including resource allocation, healthcare funding, healthcare infrastructure, and healthcare-professional and population awareness of kidney disease. Coordinated efforts by major kidney non-governmental organizations to prioritize the kidney health agenda for governments and aligning early detection efforts with other current programs will maximize efficiencies.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":"38 8","pages":"612-619"},"PeriodicalIF":3.1,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635884","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}

{"title":"Accuracy of a Novel High-Throughput \"Car Blood Pressure\" Measurement Protocol.","authors":"Neiberg de Alcantara Lima, Shaun Cardozo, Andrew Johnson, Brian Reed, Steven Korzeniewski, Phillip D Levy, Robert D Brook","doi":"10.1093/ajh/hpaf016","DOIUrl":"10.1093/ajh/hpaf016","url":null,"abstract":"<p><strong>Background: </strong>More than one in three adults with hypertension in the United States are unaware of their condition, highlighting the importance of large-scale screening campaigns. Currently, the identification of hypertension is largely limited to medical settings. To help overcome this barrier, we developed a novel high-throughput screening protocol that measures blood pressure (BP) while patients remain seated in an automobile (\"car-BP\"). The aim of this study was to provide an initial assessment of the accuracy of car-BP.</p><p><strong>Methods: </strong>Three BP readings were determined in a clinic exam room before and after three BP readings were taken while patients were seated in a parked car outside (n = 100 participants). The same validated device model (Omron HEM-907XL) and BP measurement methods adhering to guidelines were used in both scenarios. The average of all 6 clinic readings was compared to the average of the 3 car-BP readings in each individual.</p><p><strong>Results: </strong>Mean clinic and car-BP readings were 120.9 ± 16.2/78.0 ± 9.9 and 118.9 ± 15.2/76.0 ± 10.0 mm Hg, respectively. The paired mean and absolute mean differences in systolic BP levels between methods were -1.92 mm Hg (95% confidence interval (CI) -3.2 to -0.7 mm Hg) and 4.8 mm Hg (95%CI 3.8 to 5.6 mm Hg), respectively. A total of 85% of participants had both systolic and diastolic BP levels ≤ 10 mm Hg different between measurement scenarios (meeting the a priori determined study primary outcome).</p><p><strong>Conclusions: </strong>Car-BP represents an innovative and accessible approach for potential large-scale hypertension screening campaigns.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"534-536"},"PeriodicalIF":3.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062957","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}

{"title":"Disparities in Initial Antihypertensive Intensity by Sex, Race and Ethnicity in Newly Treated Patients With Hypertension.","authors":"Shailina Keshwani, Kayla M Smith, Almut G Winterstein, Matthew J Gurka, Marta G Walsh, Anne Libby, William Hogan, Carl J Pepine, Rhonda M Cooper-DeHoff, Steven M Smith","doi":"10.1093/ajh/hpaf060","DOIUrl":"10.1093/ajh/hpaf060","url":null,"abstract":"<p><strong>Background: </strong>Sex, race, and ethnicity disparities in hypertension (HTN) treatment intensity have been previously described. It remains unclear if these disparities occur at treatment onset and whether they can be explained by differences in clinical factors.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional study of adults with newly treated HTN using linked EHR + claims data from OneFlorida + Consortium. We included Florida Medicaid & Medicare-recipients diagnosed with HTN and prescribed ≥ 1 first-line antihypertensive during 2013-2020. We used generalized linear models to estimate differences in total therapeutic intensity score (TTIS)-a patient's total daily dose (TDD) divided by recommended maximum TDD for a drug, summed across entire regimen-by sex, race, and ethnicity. We then modeled the same, controlling for demographics, blood pressure, and relevant comorbidities.</p><p><strong>Results: </strong>In total 4,094 patients (mean age 58 ± 16; female 57.6%; White 56.7%) were included. We observed variations in the initiation of antihypertensive classes by sex, race and ethnicity. In univariate analyses, men averaged 7.6% (95% CI: 3.9%-11.3%) greater TTIS versus women and Black individuals averaged 10.5% (95% CI: 6.6%-14.3%) greater TTIS versus White individuals, whereas no disparities were observed by ethnicity. After adjusting for clinical factors, these disparities persisted: men had 7.6% (95% CI: 3.9%-11.4%) greater TTIS versus women, and Black individuals had 17.9% (95% CI: 13.8%-21.9%) greater TTIS versus White individuals.</p><p><strong>Conclusions: </strong>We observed disparities in treatment intensity by sex and race that were not explained by differences in clinical factors. There was sex-based variation in practice patterns, and Black individuals received more intensive initial antihypertensive therapy than White individuals.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"560-569"},"PeriodicalIF":3.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965992","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}

{"title":"Association between Dietary Patterns and Incident Hypertension in Regards (Reasons for Geographic and Regional Differences in Stroke) Participants.","authors":"Kara F Morton, John Emerson Scheinuk, John Emerson Scheinuk, Sarah Bowman, Hely D Nanavati, Stephen A Clarkson, Vera Bittner, Kim A Williams, Timothy B Plante, James M Shikany, Suzanne E Judd","doi":"10.1093/ajh/hpaf063","DOIUrl":"10.1093/ajh/hpaf063","url":null,"abstract":"<p><strong>Background: </strong>Diet contributes to the development of hypertension. We examined associations between five dietary patterns and incident hypertension in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort.</p><p><strong>Methods: </strong>Participants without prevalent hypertension (blood pressure < 130/80 mmHg or antihypertensive medication use) were evaluated at baseline and follow-up. Dietary patterns were developed using food frequency questionnaires. Diet adherence was divided into quartiles, and Modified Poisson regression estimated risk ratios of incident hypertension by quartile. We adjusted for covariates sequentially. Sex and race interactions were tested with a priori stratified analyses. An identical sensitivity analysis was completed using the Joint National Comission-7 definition of hypertension, the prevailing hypertension definition at the time of enrollment (>140/90 mmHg or antihypertensive medication use).</p><p><strong>Results: </strong>Of 30,239 REGARDS participants, 3,423 met inclusion criteria and 1,439 (42.0%) developed hypertension. Participants highly adherent to the Alcohol/Salad pattern had an increased risk of incident hypertension [RR = 1.12, 95% CI (1.00, 1.27)]. This persisted in White females after controlling for alcohol [RR = 1.27, 95% CI (1.04, 1.54)]. The remaining dietary patterns had no associations in fully adjusted models. Sex/race interactions were not significant. The sensitivity analysis included 6,582 participants, of whom 2,295 (34.9%) developed hypertension. No associations were found between diet and incident hypertension in fully adjusted models.</p><p><strong>Conclusions: </strong>The Alcohol/Salad dietary pattern portends the highest risk of incident hypertension. No further associations existed between other dietary patterns and incident hypertension after adjusting for covariates. Our findings suggest that diet is contributory, but not an exclusive cause, of incident hypertension.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"570-579"},"PeriodicalIF":3.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963021","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}

{"title":"Delayed Treatment, Lasting Consequences: The Need for Early Hypertension Diagnosis and Management in Young Adults.","authors":"Kathryn Foti, Shakia T Hardy","doi":"10.1093/ajh/hpaf073","DOIUrl":"10.1093/ajh/hpaf073","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"529-531"},"PeriodicalIF":3.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955777","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}

{"title":"A Randomized Clinical Trial of ICT-based Interventions for Sodium and Potassium Regulation in Healthy Adults.","authors":"Yuichiro Yano, Kaori Kitaoka, Takayoshi Ohkubo, Tomonori Okamura, Hiroshi Kanegae, Katsushi Yoshita, Rumi Tsukinoki, Yukiko Okami, Koichi Node, Hiromi Rakugi, Hiroshi Itoh, Katsuyuki Miura","doi":"10.1093/ajh/hpaf049","DOIUrl":"10.1093/ajh/hpaf049","url":null,"abstract":"<p><strong>Background: </strong>There is limited knowledge regarding effective strategies, including information and communication technology (ICT)-based interventions, to reduce sodium intake and increase potassium intake in healthy individuals.</p><p><strong>Methods: </strong>We conducted a 3-month randomized controlled trial involving healthy adult employees with spot urine sodium-to-potassium ratios (spot UNa/UK) ≥4.0 or estimated 24-hour salt intake ≥10g. Estimated 24-hour UNa and UK were calculated using the Tanaka formula. Participants were assigned to one of four groups: (i) online education, where participants monitored their spot UNa/UK and received feedback from dieticians (n = 84); (ii) messaging, with similar self-monitoring and dietician messages (n = 84); (iii) self-learning, provided with an educational leaflet (n = 87); and (iv) a control group (n = 87). The primary outcome was the change in spot UNa/UK ratios, and secondary outcomes included changes in estimated 24-hour UNa and UK. The trial protocol specified a hierarchical order for testing the interventions, anticipating the highest efficacy in the online education group.</p><p><strong>Results: </strong>After the intervention, the online education group showed a decrease in spot UNa/UK ratios (mean -0.9 (95% CI: -1.8 to 0.0), P = 0.052) compared to the control group. The increase in estimated 24-hour UK excretion was larger in online education compared to the control group (mean + 2.5 mmol/day (95% CI: -0.3 to 5.3), P = 0.085). The difference in estimated 24-hour UNa excretion between the online education and control groups was -4.3 mmol/day (95% CI: -15.5 to 6.9, P = 0.45).</p><p><strong>Conclusions: </strong>Combining self-monitoring of sodium and potassium intake with ICT-based interventions, including online nutritional education, was associated with a modest reduction in the estimated ratios of sodium and potassium intake in healthy individuals.</p><p><strong>Clinical trial registration: </strong>Japan Registry of Clinical Trials; 1032210217, https://jrct.niph.go.jp/en-latest-detail/jRCT1032210217.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"588-594"},"PeriodicalIF":3.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260158/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959994","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}

{"title":"Association of Scalloped Tongue with Blood Pressure Among Community-Dwelling Japanese: The Toon Health Study.","authors":"Hiromi Shashiki, Kiyohide Tomooka, Ai Ikeda, Yasunori Takata, Ryoichi Kawamura, Isao Saito, Kotatsu Maruyama, Denichirou Yamaoka, Hiroshi Kakuto, Hadrien Charvat, Takeshi Tanigawa","doi":"10.1093/ajh/hpaf057","DOIUrl":"10.1093/ajh/hpaf057","url":null,"abstract":"<p><strong>Background: </strong>In traditional East Asian medicine, scalloped tongue, characterized by dental indentations, indicates fluid retention and may be associated with hypertension. Few epidemiological studies have examined the association between scalloped tongue and blood pressure. Therefore, we aimed to examine this association in the Japanese general population.</p><p><strong>Methods: </strong>This study included 1,681 individuals, aged 30-84 years, who had participated in the Toon Health Study. The scalloped tongue was assessed using tongue images and we classified them into two groups: scalloped and non-scalloped. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured and hypertension was defined as SBP ≥ 140 mmHg, DBP ≥ 90 mmHg, or the use of antihypertensive medication. Multivariable-adjusted Poisson regression analyses were used to examine the association between scalloped tongue and blood pressure after adjusting for potential confounders including age, sex and body mass index.</p><p><strong>Results: </strong>Of the participants, 326 (19.6%) had scalloped tongue and 624 (51.6%) had hypertension. The multivariable-adjusted means of SBP were 126.6 mmHg and 129.7 mmHg in the non-scalloped and scalloped tongue groups (P < 0.01), respectively. The respective means of DBP were 76.5 mmHg and 78.0 mmHg (P = 0.02). The multivariable-adjusted prevalence ratios (95% confidence intervals) for hypertension and the highest quartile of SBP and DBP for scalloped tongue were 1.21 (1.04-1.41), 1.50 (1.23-1.84), and 1.25 (1.03-1.53), respectively, compared to the non-scalloped tongue group.</p><p><strong>Conclusions: </strong>The present study found that participants with scalloped tongue had higher SBP and DBP, even after adjusting for potential confounding factors.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"544-550"},"PeriodicalIF":3.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959446","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}

{"title":"Car-BP: Taking Hypertension Screening Beyond Clinics.","authors":"Jesus D Melgarejo, Gladys E Maestre, Eron Manusov","doi":"10.1093/ajh/hpaf039","DOIUrl":"10.1093/ajh/hpaf039","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"527-528"},"PeriodicalIF":3.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762586","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}

{"title":"Efficacy of Esaxerenone Plus a Renin-Angiotensin System Inhibitor or Calcium Channel Blocker for Nocturnal Hypertension: A Post Hoc Analysis.","authors":"Kazuomi Kario, Sadayoshi Ito, Hiroshi Itoh, Hiromi Rakugi, Yasuyuki Okuda, Satoru Yamakawa","doi":"10.1093/ajh/hpaf048","DOIUrl":"10.1093/ajh/hpaf048","url":null,"abstract":"<p><strong>Background: </strong>Nocturnal blood pressure (BP) is superior to daytime BP in predicting cardiovascular mortality. It is of clinical relevance to evaluate the effect of esaxerenone combination therapy on nighttime BP in patients with uncontrolled hypertension.</p><p><strong>Methods: </strong>A post hoc analysis of a multicenter, open-label, phase 3 study evaluated the nighttime BP-lowering effects of esaxerenone as monotherapy or in combination with a calcium channel blocker (CCB) or renin-angiotensin system inhibitor (RASi) in Japanese patients with uncontrolled hypertension. In addition, the effect on N-terminal pro B-type natriuretic peptide (NT-proBNP), a known biomarker of cardiovascular disease prognosis, was evaluated.</p><p><strong>Results: </strong>In total, 270 patients were included in this analysis (172, 49, and 49 patients in the monotherapy, CCB, and RASi groups, respectively). The 24-hour ambulatory systolic BP reduction from baseline was - 10.0, - 6.0, and - 17.0 mm Hg in the monotherapy, CCB, and RASi groups, respectively. Nighttime systolic BP decreased significantly from baseline to week 28 in all groups (P < 0.001 each); the RASi group showed the greatest change (- 20.6 mm Hg). NT-proBNP decreased significantly in all three treatment groups.</p><p><strong>Conclusions: </strong>Esaxerenone when used in combination with a CCB or RASi, but especially when used in combination with a RASi, may be a useful treatment option for patients with uncontrolled hypertension to control nocturnal BP.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"605-611"},"PeriodicalIF":3.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12260155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771095","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}

{"title":"Kidneys Under Pressure in CKD Patients With and Without Nocturnal Hypertension.","authors":"Peter W de Leeuw, Liffert Vogt","doi":"10.1093/ajh/hpaf079","DOIUrl":"10.1093/ajh/hpaf079","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"532-533"},"PeriodicalIF":3.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966031","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}