Joshua M Bock, Soumya Vungarala, Sreeja Sompalli, Naima Covassin, Jan Bukartyk, Shahid Karim, Erik St Louis, R Scott Wright, Prachi Singh, Virend K Somers
{"title":"High-Intensity Atorvastatin and 24-Hour Blood Pressure in Obstructive Sleep Apnea: A Randomized, -Double-Blind, Placebo-Controlled Pilot Study.","authors":"Joshua M Bock, Soumya Vungarala, Sreeja Sompalli, Naima Covassin, Jan Bukartyk, Shahid Karim, Erik St Louis, R Scott Wright, Prachi Singh, Virend K Somers","doi":"10.1093/ajh/hpaf202","DOIUrl":"10.1093/ajh/hpaf202","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is a risk factor for hypertension and some evidence suggests this risk may not be mitigated with positive airway pressure. Low-intensity statin therapy can modestly reduce blood pressure (BP). In this exploratory analysis, we examined if six months of high-intensity statin therapy could lower resting or ambulatory BP in patients with OSA.</p><p><strong>Methods: </strong>39 patients with OSA (13F, age = 49 ± 9yrs, body mass index = 32.9 ± 4.2kg/m2, apnea-hypopnea index = 22.2 ± 12.4 events/hour) were randomized to high-intensity atorvastatin or placebo. BP was assessed using seated, \"office\" measurements and in 20-minute intervals over 24 consecutive hours at three timepoints (baseline, three- and six-months post-randomization). Participants maintained a diary denoting sleep and wake times for analysis. Changes (Δ) in BP from baseline were assessed and adjusted for adherence to participants' intervention (atorvastatin or placebo) as well as to their treatment for OSA (yes or no).</p><p><strong>Results: </strong>There were no between-group differences in baseline BP variables (P = .09-.96). At three months, the changes in resting (P = .74-.87), 24 hour mean (P = .54-.96), daytime (P = .70-.96), nor nighttime (P = .74-.96) BP did not differ between groups. Similarly, the changes in resting (P = .23-.92), 24 hour mean (P = .51-.82), daytime (P = .17-.78), and nighttime (P = .51-1.00) BP did not differ between groups following six months of their respective intervention.</p><p><strong>Conclusions: </strong>Our data suggest that high-intensity atorvastatin does not lower resting or ambulatory BP in patients with OSA relative to a placebo. Thus, it does not appear that atorvastatin is a viable adjunct intervention for BP reduction in patients with OSA.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT03308578.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"390-399"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273542","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":"Erythropoietin-induced Hypertension in Chronic Kidney Disease-A Mechanistic Randomized Controlled Trial.","authors":"Rajiv Agarwal","doi":"10.1093/ajh/hpaf200","DOIUrl":"10.1093/ajh/hpaf200","url":null,"abstract":"<p><strong>Background: </strong>The mechanism of hypertension associated with erythropoiesis-stimulating agents in chronic kidney disease (CKD) is complex and remains poorly understood.</p><p><strong>Methods: </strong>Here, anemic hypertensive patients with CKD and well-controlled or mildly elevated BP as confirmed by 24-hour ABP monitoring were randomly assigned to either a waitlisted group or darbepoetin in a 1:1 ratio stratified by stages of albuminuria. The primary end point was the change in 24-hour diastolic ABP from baseline to 12 weeks.</p><p><strong>Results: </strong>We screened 1699 patients and randomized 27 patients of the planned 160. Mean age (SD) was 75 (8) years, mean hemoglobin 9.4 (0.6) g/dL, mean clinic BP 124.4 (19.5)/57.2 (11.4) mm Hg and was similar between groups. At 12 weeks there was 1.7 g/dL (95% CI, 0.9-2.5 g/dL) difference in hemoglobin between waitlisted and immediate start group. Within group change in diastolic 24-hour ABP in the waitlisted group was -1.91 mm Hg and the immediate start group was +1.07 mm Hg. The difference in the changes was 2.98 mm Hg (95% CI, -1.36 to 7.31), P = .18. Comparing SBP, endothelial function, and UACR in the waitlisted and immediate start groups showed no significant differences between groups. However, within the waitlisted group UACR increased 35% from baseline (95% CI, 11%-82%) with darbepoetin exposure. Cardiovascular and atherothrombotic serious adverse events were more frequent during darbepoetin exposure.</p><p><strong>Conclusions: </strong>Among anemic CKD patients with reasonably controlled hypertension, exposure to darbepoetin did not change 24-hour ABP or endothelial function. However, increase in albuminuria and serious adverse events during exposure to darbepoetin is a cause for concern and requires larger studies to affirm or refute these observations.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"441-451"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237643","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}
Gregory L Hundemer, Alexander A Leung, Gregory A Kline
{"title":"Rethinking Primary Aldosteronism: The 2025 John H. Laragh Research Award.","authors":"Gregory L Hundemer, Alexander A Leung, Gregory A Kline","doi":"10.1093/ajh/hpaf156","DOIUrl":"10.1093/ajh/hpaf156","url":null,"abstract":"<p><p>Dr John Laragh, a pioneer in the field of hypertension, held a fundamental belief in the need to challenge existing dogmas in medicine to enhance our scientific understanding of disease and advance patient care. Perhaps in no area of hypertension does this ring truer with than primary aldosteronism (PA). Following its initial description in the mid-1950s with an initial surge in diagnoses soon thereafter, PA was ultimately relegated to be considered a \"zebra\" of hypertension felt to be responsible for only a small percentage of cases. In turn, diagnostic and treatment pathways went largely unchanged for decades. However, recent years have witnessed a renaissance in PA sparked by a number of scientific breakthroughs that have re-fashioned many long-held paradigms. Such breakthroughs include the recognition that classically defined PA is highly prevalent and that an even broader spectrum of milder forms of dysregulated aldosterone production (subclinical PA) goes completely unrecognized in modern-day clinical practice. Further, a number of pitfalls have recently been exposed across all steps of traditional PA diagnostic pathways, explaining many prior missed cases and missed opportunities. Acknowledging these pitfalls may allow for streamlined, practical, and evidence-based algorithms in the future to enhance disease detection. Finally, treatment approaches are now evolving with new strategies to better guide existing medical therapies along with emerging novel therapeutic options which may transform PA management in the future. This review discusses these recent advances in our understanding of PA and sheds light on what the future of PA management may entail.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"331-341"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939137","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}
Mingjuan Zeng, Eleanor Clapham, Dean Picone, Sonali R Gnanenthiran, Ruth Griffiths, Niamh Chapman, Aletta E Schutte
{"title":"Community Practices and Perceptions Regarding Blood Pressure Measurement Techniques.","authors":"Mingjuan Zeng, Eleanor Clapham, Dean Picone, Sonali R Gnanenthiran, Ruth Griffiths, Niamh Chapman, Aletta E Schutte","doi":"10.1093/ajh/hpaf195","DOIUrl":"10.1093/ajh/hpaf195","url":null,"abstract":"<p><strong>Background: </strong>Despite various blood pressure (BP) measurement methods being available, many people report never or infrequently having their BP measured. There is a gap between clinical guidelines and the implementation of BP monitoring. To bridge that gap, we interviewed community members to understand their practices and perceptions regarding various measurement methods.</p><p><strong>Methods: </strong>Australian adults who participated in a home BP measurement study were purposively sampled for semistructured interviews (2023-2024).</p><p><strong>Results: </strong>Participants (n = 29) were middle-aged (mean 61 ± 12.8 years, 55% female), and most (79%) had diagnosed hypertension. All participants had real-world experience with both clinic and home BP measurements; 15 with 24-hour ambulatory monitoring (24h ABPM); 10 with kiosks; and 3 used cuffless BP devices. Participants described clinic BP as routine and highly valued direct feedback from doctors. Participants valued home BP due to convenience and the number of measurements they could take. Most participants reported no issues with 24h ABPM, although 3 experienced severe discomfort or dislike. Concerns about measurement accuracy and privacy were raised by 4 participants regarding kiosk BP, as devices were sometimes nonstandardized and located in open areas. Most participants expressed interest in cuffless BP devices but had limited experience using them.</p><p><strong>Conclusions: </strong>We have identified barriers associated with clinic, 24-hour ABPM, home BP monitoring, and kiosk BP that need to be addressed to enhance consumer satisfaction and increase monitoring rates, highlighting the need for a coordinated approach involving key health organizations and healthcare professionals.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"382-389"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129787","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}
Sarah D R Krumholz, Suzanne E Judd, Timothy B Plante
{"title":"Response to Comment on \"Soluble Receptor for Advanced Glycation End Products and Incident Hypertension in REGARDS\".","authors":"Sarah D R Krumholz, Suzanne E Judd, Timothy B Plante","doi":"10.1093/ajh/hpaf229","DOIUrl":"10.1093/ajh/hpaf229","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"468-469"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547657","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}
Thomas Joseph Alexander, Abigail Marie Gauen, Lucia Catherine Petito, Ciaran Navin Kohli-Lynch, Thomas W Carton, Steven M Smith, Greg Merritt, Faraz S Ahmad, Norrina Bai Allen
{"title":"Hypertension in Young Adults: Social Determinants of Prevalence, Awareness, Treatment, and Control.","authors":"Thomas Joseph Alexander, Abigail Marie Gauen, Lucia Catherine Petito, Ciaran Navin Kohli-Lynch, Thomas W Carton, Steven M Smith, Greg Merritt, Faraz S Ahmad, Norrina Bai Allen","doi":"10.1093/ajh/hpaf203","DOIUrl":"10.1093/ajh/hpaf203","url":null,"abstract":"<p><strong>Background: </strong>Hypertension prevalence remains high among US young adults, and the role of social needs in their hypertension management remains poorly understood.</p><p><strong>Methods: </strong>Data from 2017 to 2020 National Health and Nutrition Examination Surveys (N = 8,024, representing 244 million adults) were used to study hypertension, defined per 2017 ACC/AHA guidelines or self-report of blood pressure-lowering medications. Prevalences of hypertension, awareness of condition, treatment if aware, and control if treated were estimated among young (18-39 years), middle-aged (40-64 years), and older adults (≥65 years). Weighted log binomial regression estimated associations between social needs (0, 1, or ≥2) and hypertension outcomes, adjusted for age, sex, and race/ethnicity. Social needs included less than high school education, family income <100% of the federal poverty level, no health insurance, food insecurity based on the U.S. Food Security Survey, and current unemployment.</p><p><strong>Results: </strong>Among 2,680 young adults (weighted N = 92 million; 51% female, 58% NHW), hypertension prevalence was 22.6% (95% CI, 19.5-25.7). Among those with hypertension, 19.3% of young, 20.2% of middle-aged, and 10.0% of older adults had ≥2 social needs. Among treated adults, those with ≥2 vs no social needs were less likely to have controlled hypertension (adjusted risk ratio [aRR]: 0.74; 95% CI, 0.59-0.92). This aRR was 0.75 (95% CI, 0.43-1.32) in young adults, 0.74 (95% CI, 0.57-0.96) in middle-aged adults, and 0.73 (95% CI, 0.51-1.04) in older adults (p for interaction = 0.12).</p><p><strong>Conclusions: </strong>Unmet social needs, more prevalent among young adults, were associated with lower rates of hypertension control, highlighting directions for interventions.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"425-431"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145511699","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}
Trevor Sproule, Lana Sargent, Elvin Price, Marissa Mackiewicz, Leroy Thacker, Dave Dixon
{"title":"Association Between ABPM Phenotypes and Cognitive Impairment in a Community-Dwelling, Older Adult Population Taking Antihypertensive Medication: A Pilot Study.","authors":"Trevor Sproule, Lana Sargent, Elvin Price, Marissa Mackiewicz, Leroy Thacker, Dave Dixon","doi":"10.1093/ajh/hpaf188","DOIUrl":"10.1093/ajh/hpaf188","url":null,"abstract":"<p><strong>Background: </strong>Hypertension (HTN) is associated with an increased risk of cognitive impairment (CI). This study aimed to explore the relationship between Ambulatory BP Monitoring (ABPM) phenotypes and CI in a predominantly Black, older adult population.</p><p><strong>Methods: </strong>This cross-sectional study enrolled adults ≥60 years of age with HTN and taking ≥1 antihypertensive. Participants had 3 seated BP readings taken 1 minute apart, followed by 24-hour ABPM. Cognitive impairment was determined using the Mini-Mental State Examination (MMSE-2) with a cutoff score of ≤25. 24-hour ABPM control was defined as <125/75, and seated BP control was defined as <130/80 mm Hg. A sleep BP decline of <10% was used to identify non-dippers. ABPM phenotypes were compared to categorical data measured by the MMSE-2 and analyzed using the Chi-square test. Unadjusted and adjusted (age and gender) prevalence ratios were also calculated.</p><p><strong>Results: </strong>The 69 participants included in the analysis had a mean age of 69 years, 56.5% were female, and 73.9% identified as Black/African American. Cognitive impairment was identified in 29% (n = 20) of the participants according to their MMSE-2 score. Cognitive impairment prevalence was significantly higher among participants exhibiting a non-dipping BP pattern (75% vs 40.8%; P = .01), elevated sleep diastolic BP (P = .02), and 24-hour, awake, sleep, and seated heart rate (P < .05 for all).</p><p><strong>Conclusions: </strong>Sleep BP and heart rate were associated with a higher prevalence of CI and may offer clues as to the underlying pathophysiology of BP-associated CI. These findings warrant further study in a larger population followed longitudinally.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"367-371"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13383075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091076","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":"Clinical Potential of Arterial Stiffness Measured from the Aortic Valve to the Brachial Artery in a Seated Position.","authors":"Kazuhiro Shimizu, Tomoyuki Yamamoto, Akihiro Ogawa, Satoshi Kawakami, Takuro Ito, Shuji Sato, Hiroshi Mikamo, Toshio Kinoshita, Kohji Shirai","doi":"10.1093/ajh/hpaf198","DOIUrl":"10.1093/ajh/hpaf198","url":null,"abstract":"<p><strong>Background: </strong>The cardio-ankle vascular index (CAVI) is a widely used noninvasive marker of arterial stiffness that is independent of blood pressure at the time of measurement. However, its requirement for supine positioning limits practicality in certain settings. This study aimed to evaluate the feasibility and clinical utility of a novel seated-position stiffness index, termed the innovative CAVI (iCAVI), measured from the aortic valve to the brachial artery in assessing arterial stiffness.</p><p><strong>Methods: </strong>We enrolled 121 outpatients with cardiovascular risk factors. Participants were divided into groups with and without coronary artery disease (CAD). All CAD participants had previously undergone percutaneous coronary intervention at our department at least 3 months before enrollment and were in stable outpatient follow-up. Reproducibility, correlations with clinical parameters, and diagnostic performance for CAD were assessed.</p><p><strong>Results: </strong>The cohort included 63 CAD-positive and 58 CAD-negative patients. Both CAVI and iCAVI showed high intraobserver reproducibility (ρ = 0.937 and 0.895; P < .001). iCAVI correlated with CAVI (ρ = 0.481; P < .001). Diagnostic discrimination for CAD was modest and similar between indices: area under the curve 0.630 for iCAVI and 0.591 for CAVI. Optimal cutoffs were 2.95 (iCAVI) and 10.40 (CAVI). In sensitivity analyses, iCAVI showed no significant association with measurement-time SBP or DBP, in contrast to heart-brachial pulse wave velocity.</p><p><strong>Conclusions: </strong>In this single-center cohort, iCAVI showed modest discrimination for CAD, similar to conventional CAVI, while enabling seated measurement. The development of a dedicated device-akin to a home blood pressure monitor-could facilitate clinical implementation and support day-to-day health management.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"407-415"},"PeriodicalIF":3.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278887","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}
Ransford Asante, Zhiqi Yao, Omar Dzaye, Philip Berning, Yara Jelwan, Semenawit Burka, Roger S Blumenthal, Michael J Blaha
{"title":"Prescription Trends of Hydrochlorothiazide vs. Chlorthalidone in the United States (2019-2024).","authors":"Ransford Asante, Zhiqi Yao, Omar Dzaye, Philip Berning, Yara Jelwan, Semenawit Burka, Roger S Blumenthal, Michael J Blaha","doi":"10.1093/ajh/hpaf190","DOIUrl":"10.1093/ajh/hpaf190","url":null,"abstract":"<p><strong>Background: </strong>Hydrochlorothiazide and chlorthalidone have been cornerstones of hypertension management for decades. Given the historical debate about their comparative effectiveness and cardiovascular outcomes, as well as recent clinical trial evidence, we studied prescription trends to assess the association of prescribing patterns with evolving knowledge.</p><p><strong>Methods: </strong>We analyzed prescriptions of hydrochlorothiazide and chlorthalidone from January 2019 to December 2024 using IQVIA's National Prescription Audit. Interrupted time series analysis assessed inflections in prescribing practice around the December 2022 Diuretic Comparison Project (DCP) findings and the August 2020 hydrochlorothiazide US Food and Drug Administration (FDA) nonmelanoma skin cancer warning.</p><p><strong>Results: </strong>On average, 3,734,790 hydrochlorothiazide and 543,402 chlorthalidone prescriptions were dispensed, a 7:1 ratio. A drop of 503,367 hydrochlorothiazide prescriptions (14%; 95% CI: -673,109 to -333,624) was observed in the first month after the FDA's warning, and the prewarning 43,913 (95% CI: 31,701-56,125) monthly increase reversed to a monthly decline of 13,546 (95% CI: -16,137 to -10,954) prescriptions post-warning. After the DCP report, a slowdown of 2738 (95% CI: -4472 to -1004) monthly prescriptions for chlorthalidone was seen, reducing the rate of monthly increase from 3602 (95% CI: 1916-5289) to 864 (95% CI: 431-1298). Monthly hydrochlorothiazide prescriptions declined to -20,124 (95% CI: -26,285 to -13,962) post DCP report.</p><p><strong>Conclusion: </strong>The FDA warning and DCP report were associated with a decline in hydrochlorothiazide and chlorthalidone prescriptions, while the DCP report slowed chlorthalidone prescribing.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"459-465"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145123946","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":"R-Wave Peak Time and Subclinical Left Ventricular Dysfunction in Hypertensive Patients: Insights From Speckle-Tracking Echocardiography.","authors":"Ayca Arslan, Dogan Ilis, Inanc Artac, Muammer Karakayali, Timor Omar, Zihni Cagin, Zulfiye Kuzu, Ozcan Yagcibulut, Cengiz Burak, Yavuz Karabag, Ibrahim Rencuzogullari","doi":"10.1093/ajh/hpaf180","DOIUrl":"10.1093/ajh/hpaf180","url":null,"abstract":"<p><strong>Background: </strong>Hypertension (HT) is one of the most common causes of myocardial dysfunction. Although early detection of myocardial impairment remains challenging, left ventricular global longitudinal strain (LV-GLS) is a sensitive echocardiographic parameter that can identify subclinical myocardial damage. However, its application is limited in routine clinical settings. R-wave peak time (RWPT) is a simple and widely available electrocardiographic parameter that may reflect intramyocardial conduction delay and early structural remodeling. This study aimed to investigate the association between RWPT and LV-GLS in patients with HT.</p><p><strong>Methods: </strong>This prospective study included 403 patients with a confirmed diagnosis of HT. All participants underwent transthoracic echocardiography and 12-lead surface ECG. LV-GLS was assessed using speckle-tracking echocardiography. ECG images were digitized and analyzed using ImageJ software, and RWPT was defined as the interval from the onset of the QRS complex to the peak of the R-wave.</p><p><strong>Results: </strong>Patients were divided into two groups according to their LV-GLS value of -15.9%, which is defined as the cutoff value of myocardial impairment. Patients with a lower LV-GLS had significantly longer RWPT and QRS durations. In multivariate analysis, RWPT was found to be an independent predictor of impaired LV-GLS (OR: 1.085; 95% CI: 1.056-1.114; P < 0.001). ROC analysis demonstrated an AUC of 0.715 (95% CI: 0.665-0.765; P < 0.001) with a sensitivity of 64.9% and a specificity of 67.7% at a cutoff value of 45.5 ms.</p><p><strong>Conclusions: </strong>RWPT may serve as a practical, accessible, and sensitive electrocardiographic marker for detecting subclinical myocardial dysfunction in patients with HT.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"432-440"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129833","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}