American Journal of Hypertension最新文献

{"title":"Primary Aldosteronism in a Hispanic Cohort: Responses to Mineralocorticoid Receptor Antagonism and Remission in a Case.","authors":"Alejandra Tapia-Castillo, Andrea Vecchiola, Paola Quiñones, René Baudrand, Thomas Uslar, José Delgado, Cristian A Carvajal, Carlos E Fardella","doi":"10.1093/ajh/hpaf020","DOIUrl":"10.1093/ajh/hpaf020","url":null,"abstract":"<p><strong>Background: </strong>Primary aldosteronism (PA) is the main cause of secondary arterial hypertension. In this study, we present the medical treatment of Hispanic patients with PA followed for up to 5 years, highlighting the complete cure with pharmacological treatment in one of our patients.</p><p><strong>Methods: </strong>We studied 32 PA patients, followed every 6 months after starting MRA. A clinical response was the normalization of blood pressure (BP) in the absence of other antihypertensive drugs. The biochemical response was considered with normalization of potassium and renin. Responses to treatment were compared using the defined daily dose (DDD). The effect of MRA was evaluated in vitro. The HAC15 cells were cultured and stimulated with aldosterone and spironolactone for 24-72 h, and the apoptotic cell death was measured.</p><p><strong>Results: </strong>At 12 months posttreatment with MRA, 68% of the patients had a total clinical response, and 67% had a total biochemical response. Response to MRA treatment reduced DDD by an average of 74%. Additionally, we observed one PA patient treated with spironolactone after 3 years, he presented a pharmacological cure with normalization of aldosterone and renin without treatment with spironolactone. The in vitro study shows that spironolactone increased early apoptosis by 60% and late apoptosis by 50%.</p><p><strong>Conclusions: </strong>These results suggest the importance of timely diagnosis of PA and specific treatment with MRA, especially in patients with a poor response to treatment. Moreover, remission of PA may occur in some patients after spironolactone treatment due to its suggestive role as an apoptotic agent.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"354-360"},"PeriodicalIF":3.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439828","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":"Orthostatic Hypertension in Childhood: Filling the Gap of Information on the Phenotype.","authors":"Stella Stabouli, Guido Grassi","doi":"10.1093/ajh/hpaf032","DOIUrl":"10.1093/ajh/hpaf032","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"352-353"},"PeriodicalIF":3.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603410","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 comparative study of the clinical efficacy of superselective adrenal artery embolization for patients with primary aldosteronism.","authors":"L Wang, R Xiang, J Chang, M Mao, R Feng, L Tao, P Tang, Y P Zhao, Z Zuo, D S Gao, P Pu, W Huang, X Li, J Chen, H Zhao, Q Y Shi, F J Lv, Y T He, N A Khan, Z X Xu","doi":"10.1093/ajh/hpaf083","DOIUrl":"https://doi.org/10.1093/ajh/hpaf083","url":null,"abstract":"<p><strong>Background: </strong>Superselective adrenal artery embolization (SAAE) is a potential treatment option for patients with primary aldosteronism (PA).</p><p><strong>Methods: </strong>This retrospective study aimed to compare the clinical efficacy and impact on cardiorenal organs of SAAE with mineralocorticoid receptor antagonists (MRA) and adrenalectomy (ADX) in patients with PA. After a median follow-up of 19 (12.5-26.5) months, 148 patients with PA were included in the study. The study cohorts consisted of 58, 53, and 37 patients treated with SAAE, MRA, and ADX, respectively.</p><p><strong>Results: </strong>During follow-up, SAAE achieved a significantly greater level of complete clinical success in the treatment of PA compared to MRA (p < 0.05). Within the SAAE group (n=58), 19 (32.8%) and 26 (44.8%) patients achieved complete and partial clinical success, respectively. However, there were no significant differences in the prognostic parameters of the cardiorenal organs between the two groups. In the comparison of patients with UPA treated with SAAE (n=35) and ADX (n=37), there was no significant difference in clinical efficacy between the two groups.</p><p><strong>Conclusions: </strong>The findings of this study suggest that for patients with PA who are not suitable for ADX, SAAE is a viable treatment option that significantly improves clinical outcomes compared to MRA treatment.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075350","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":"Parasympathetic Modulation is Correlated With Baroreflex Sensitivity and Orthostatic Pressor Response in Childhood.","authors":"Chaima El Khadiri, Plamen Bokov, Benjamin Dudoignon, Chérine Benzouid, Bérengère Koehl, Julien Hogan, Christophe Delclaux","doi":"10.1093/ajh/hpaf025","DOIUrl":"10.1093/ajh/hpaf025","url":null,"abstract":"<p><strong>Background: </strong>The objective of our case-control study was to evaluate the determinants of childhood cardio-vagal baroreflex failure and exaggerated orthostatic pressor response, which are risk factors for subsequent hypertension.</p><p><strong>Methods: </strong>Four groups of children were matched for sex and age: 12 with congenital central hypoventilation syndrome (autonomic nervous system dysfunction), 12 with chronic kidney disease (frequently abnormal blood pressure [BP]), 12 with sickle cell disease (frequently abnormal orthostatic BP), and 24 control children (preterm birth with normal BP). The children underwent tonometry evaluation (aortic systolic BP) and continuous BP and ECG measurements in supine and standing positions, allowing ambulatory BP monitoring and the computation of heart rate variability indices, baroreflex sensitivity (BRS), and orthostatic systolic BP response.</p><p><strong>Results: </strong>Supine and standing BRS correlated significantly with aortic systolic BP (ρ = -0.34, ρ = -0.52, respectively), daytime systolic BP (ρ = -0.33, ρ = -0.54, respectively), low frequencies power in similar body positions (supine: ρ = 0.68, standing: ρ = 0.65), and high frequencies (HF) power (ρ = 0.78, ρ = 0.76, respectively). Orthostatic BP response correlated significantly with standing BRS (ρ = -0.38) and standing HFnu (ρ = -0.46). In multivariate analyses, only supine and standing HF power remained independently associated with the respective BRS, while standing HFnu and standing BRS were independently associated with the orthostatic pressor response.</p><p><strong>Conclusions: </strong>Defective parasympathetic modulation's detrimental effect on baroreflex sensitivity and the orthostatic pressor response in childhood is evident, regardless of the underlying pathology.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"389-397"},"PeriodicalIF":3.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456770","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":"Decoding Monogenic Hypertension: A Review of Rare Hypertension Disorders.","authors":"Flora R Gallegos, Meaghan P Delahunty, Jieji Hu, Shivani B Yerigeri, Vishnu Dev, Girish Bhatt, Rupesh Raina","doi":"10.1093/ajh/hpaf005","DOIUrl":"10.1093/ajh/hpaf005","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a growing concern worldwide, with increasing prevalence rates in both children and adults. Most cases of hypertension are multifactorial, with various genetic, environmental, socioeconomic, and lifestyle influences. However, monogenic hypertension, a blanket term for a group of rare hypertensive disorders, is caused by single-gene mutations that are typically inherited in an autosomal dominant fashion, and ultimately disrupt normal blood pressure regulation in the kidney or adrenal gland. Being able to recognize and understand the pathophysiology of these rare disorders is critical for properly diagnosing hypertension, particularly in children and young adults, as treating each form of monogenic hypertension requires specific and targeted treatment approaches.</p><p><strong>Methods: </strong>A scoping literature review was conducted on the available knowledge regarding each of the disorders currently categorized as forms of monogenic hypertension.</p><p><strong>Results: </strong>This narrative review serves to highlight the epidemiology, pathophysiology, clinical presentation, recent case reports, and most current methods of evaluation and treatment for familial hyperaldosteronism types 1-4, Gordon syndrome. Liddle syndrome, syndrome of apparent mineralocorticoid excess, congenital adrenal hyperplasia, Geller syndrome, hereditary syndromes related to pheochromocytomas and paragangliomas, and brachydactyly type E.</p><p><strong>Conclusions: </strong>Recent and future advances in genetic analysis techniques will further enhance the diagnosis and early management of these disorders, preventing the consequences of uncontrolled hypertension.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"333-351"},"PeriodicalIF":3.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969419","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":"Switching From ARBs to Sacubitril/Valsartan Safely Improves 24-Hour Ambulatory Blood Pressure in Patients With Advanced Chronic Kidney Disease.","authors":"Sho Kinguchi, Kohei Ishiga, Hiromichi Wakui, Kengo Azushima, Tomohiko Kanaoka, Yusuke Kobayashi, Tatsuya Haze, Nobuhito Hirawa, Kouichi Tamura","doi":"10.1093/ajh/hpaf028","DOIUrl":"10.1093/ajh/hpaf028","url":null,"abstract":"<p><strong>Background: </strong>We investigated the effects of sacubitril/valsartan, a first-in-class angiotensin receptor neprilysin inhibitor (ARNI), on 24-hour blood pressure (BP) and safety for 12 weeks in Japanese patients with non-dialysis advanced chronic kidney disease (CKD).</p><p><strong>Methods: </strong>We conducted a prospective, single-arm exploratory study. Patients with non-dialysis CKD stage G4-5 (estimated glomerular filtration (eGFR) <30 mL/min/1.73 m2) who did not achieve their BP goals with angiotensin receptor blocker (ARB) administration, were enrolled and switched to sacubitril/valsartan. Primary and key secondary endpoints were changes from baseline in the 24-hour systolic BP (SBP) measured via ambulatory BP monitoring (ABPM) over 12 weeks and the safety, especially incidence of serum creatinine (Cr) increase (≥ 30% increase from baseline) and hyperkalemia.</p><p><strong>Results: </strong>Thirty patients were enrolled, and 29 patients were switched to sacubitril/valsartan. Efficacy analysis was conducted on 26 patients. Baseline mean eGFR and office BP were 21.1 ± 5.0 mL/min/1.73m2 and 149.4 ± 23.7/80.7 ± 11.9 mmHg, respectively. Baseline 24-hour, daytime, and nighttime BP were 139.6 ± 17.7/77.0 ± 7.8 mmHg, 143.5 ± 18.5/79.6 ± 8.7 mmHg, and 131.0 ± 20.4/71.1 ± 8.8 mmHg, respectively. After 12 weeks, changes in 24-hour, daytime, and nighttime SBP from baseline were -7.1 ± 12.4 mmHg (P < 0.01), -7.7 ± 12.9 mmHg (P < 0.01), and -5.8 ± 15.8 mmHg (P = 0.07), respectively. No incidences of potassium values > 6.0 mmol/L or serum Cr ≥ 30% increase from baseline were reported after sacubitril/valsartan initiation.</p><p><strong>Conclusions: </strong>Switching from ARB to sacubitril/valsartan can safely enhance 24-hour antihypertensive treatment in patients with non-dialysis CKD G4-5 who do not achieve BP goals with ARBs. CLINICAL TRIALS REGISTRATION: Trial Number jRCT1031220149.</p><p><strong>Clinical trials registration: </strong>Trial Number jRCT1031220149.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"380-388"},"PeriodicalIF":3.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596116","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":"Impact of Daytime and Nighttime Blood Pressure and Nocturnal Blood Pressure Fall on Heart Failure Risk in Treated Hypertension.","authors":"Francesca Coccina, Gil F Salles, Ramón C Hermida, José R Banegas, José M Bastos, Claudia R L Cardoso, Guilherme C Salles, Artemio Mojon, José R Fernandez, Mercedes Sanchez-Martinez, Carlos Costa, Simão Carvalho, Joao Faia, Sante D Pierdomenico","doi":"10.1093/ajh/hpaf008","DOIUrl":"10.1093/ajh/hpaf008","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the impact of daytime, nighttime, and nocturnal blood pressures (BPs) fall on heart failure (HF).</p><p><strong>Methods: </strong>We analyzed data from five cohorts including 15,526 treated hypertensive patients, experiencing 625 HF events, by study-level meta-analysis. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) for 1SD increase in BP parameters or per group were calculated.</p><p><strong>Results: </strong>When individually analyzed after adjustment for covariates, clinic systolic BP (SBP) (HR 1.20, 95% CI 1.01-1.43), daytime SBP (HR 1.34, 95% CI 1.06-1.70), nighttime SBP (HR 1.43, 95% CI 1.20-1.71), nighttime diastolic BP (DBP) (HR 1.26, 95% CI 1.05-1.52), % of nocturnal SBP fall (HR 0.81, 95% CI 0.75-0.88), and nondipping (HR 1.64, 95% CI 1.54-1.98) were associated with HF. If daytime or nighttime BP was further adjusted for clinic BP results remained similar. When clinic, daytime, and nighttime BPs were mutually adjusted, nighttime SBP (HR 1.43, 95% CI 1.27-1.61) and nighttime DBP (HR 1.37, 95% CI 1.14-1.64) remained associated with the outcome. Heterogeneity across cohorts was explained by BP, sex, and follow-up duration. In sensitivity analyses, for daytime and nighttime BPs, no study had a relevant influential effect on overall estimates. Looking for publication bias and adjusting for missing studies by Duval and Tweedie's method, clinic SBP lost significance but daytime SBP, and nighttime SBP and DBP remained significantly associated with HF.</p><p><strong>Conclusions: </strong>Daytime and nighttime BPs are stronger than clinic BP in predicting HF, nighttime BP is stronger than daytime BP, and a reduced nocturnal BP fall is associated with outcome.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"361-369"},"PeriodicalIF":3.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969443","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":"Elevated Blood Pressure and Cardiac Mechanics in Children and Adolescents: A Systematic Review and Meta-Analysis.","authors":"Andrea Faggiano, Elisa Gherbesi, Carla Sala, Stefano Carugo, Guido Grassi, Cesare Cuspidi, Marijana Tadic","doi":"10.1093/ajh/hpaf026","DOIUrl":"10.1093/ajh/hpaf026","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence on left ventricular (LV) mechanics, assessed by speckle tracking echocardiography (STE), in children and adolescents with elevated blood pressure (BP)/hypertension is scanty.</p><p><strong>Aim: </strong>The aim of the present meta-analysis was to provide an updated information on LV systolic function phenotyped by global longitudinal strain (GLS) and LV ejection fraction (LVEF) in the setting of pediatric hypertension.</p><p><strong>Methods: </strong>Systematic searches were conducted across bibliographic databases (Pub-Med, OVID, EMBASE, and Cochrane Library) to identify eligible studies from inception up to 30 November 2024. Studies reporting data on LV mechanics in pediatric hypertension and controls were included. The statistical difference of the echocardiographic variables of interest between groups such as LVEF and GLS was calculated by standardized mean difference (SMD) with 95% confidence interval (CI) using random-effects models.</p><p><strong>Results: </strong>Eight studies including 719 individuals with elevated BP/hypertension and 1,653 age-matched healthy controls were considered for the analysis. Pooled average LVEF values were 72.4 ± 1.6% in the healthy control group and 72.5 ± 1.8% in the elevated BP/hypertensive group (SMD: 0.08 ± 0.15, CI: -0.21/0.36, P = 0.60); the corresponding values of GLS were -19.6 ± 1.1% and 18.5 ± 0.9% (SMD: -0.96 ± 0.25, CI: -1.46/-0.47, P < 0.0001). A parallel impairment of global circumferential strain emerged from pooled data of three studies (SMD: -0.96 ± 0.25, CI: -1.46/-0.47, P < 0.0001).</p><p><strong>Conclusions: </strong>Our data suggest that LVEF is unable to detect early alterations in systolic function in pediatric hypertension, and the implementation of STE may be highly useful in unmasking systolic dysfunction in this setting.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"370-379"},"PeriodicalIF":3.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456740","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":"Blood Pressure Outcomes Following a Home Blood Pressure Monitoring Program in a Large Integrated US Health System.","authors":"Teresa N Harrison, Rachelle A Juan, Jaejin An, Hui Zhou, Janet Mora Marquez, Angeline L Ong-Su, Jeffrey W Brettler, Kristi Reynolds","doi":"10.1093/ajh/hpaf082","DOIUrl":"https://doi.org/10.1093/ajh/hpaf082","url":null,"abstract":"<p><strong>Background: </strong>Home blood pressure telemonitoring (HBPT) can empower patients to participate in their healthcare and reduce office BP. Evidence whether BP control can be sustained following HBPT is scarce. We examined the effects of a HBPT program on BP outcomes.</p><p><strong>Methods: </strong>We included patients with uncontrolled hypertension enrolled in a HBPT program at an integrated healthcare system between November 2019-June 2022. Clinicians enrolled patients and provided them with a BP device and a mobile application. We examined clinic BP before and after enrollment in HBPT, and sustained clinic BP control (last clinic BP <140/90 mmHg) within 12 months following graduation from the program (home BP <135/85 mmHg). Multivariable robust Poisson regression was used to identify factors associated with sustained clinic BP control.</p><p><strong>Results: </strong>Overall, 3574 patients were enrolled and 59% consented to participation. Among those who consented, 3% did not submit >1 home BP, 37% were actively enrolled, 30% disenrolled without meeting home BP control and 30% graduated by meeting home BP control. Among 527 patients who graduated and had ≥ 1 follow-up clinic BP, 396 (75%) sustained clinic BP control within 12 months while mean clinic SBP and DBP was reduced by 16.3 (95% CI: -18.3, -14.4) mmHg and 10.0 (95% CI: -11.1, -8.9) mmHg, respectively (p<.0001 for both) compared with the last clinic BP prior to HBPT enrollment.</p><p><strong>Conclusions: </strong>The HBPT program in this healthcare system demonstrates potential; however, effective strategies are needed to facilitate enrollment and consent of patients, and to scale the program.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965910","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":"Medical Costs, Health Care Utilization, and Productivity Losses Associated with Hypertension Moderated by COVID-19 Diagnosis Among US Commercial Enrollees.","authors":"Jun Soo Lee, Yidan Xue Zhang, Yu Wang, Joohyun Park, Ashutosh Kumar, Bruce Donald, Feijun Luo, Kakoli Roy","doi":"10.1093/ajh/hpaf081","DOIUrl":"https://doi.org/10.1093/ajh/hpaf081","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a major risk factor for cardiovascular and renal diseases, significantly contributing to morbidity and mortality. The COVID-19 pandemic has heightened concerns about the impact of hypertension on severe COVID-19 outcomes.</p><p><strong>Methods: </strong>We analyzed 2020-2021 data from the MarketScan Commercial and Health and Productivity Management databases, focusing on adults aged 18-64 years with continuous employer-sponsored private insurance, excluding pregnancy or capitated plans. We compared medical costs, healthcare utilization (emergency department [ED] visits, inpatient admissions, outpatient visits, and outpatient prescription drugs), and productivity losses (sick absences, short-term disability [STD], and long-term disability [LTD]) between individuals with and without hypertension, stratified by COVID-19 diagnosis. We used multivariable regression models, including an interaction term for hypertension and COVID-19 diagnosis, to estimate differences in outcomes, adjusting for demographics and comorbidities.</p><p><strong>Results: </strong>Among 1,296,596 adults, 21% had hypertension. Those with hypertension were older, less likely female, less likely urban residents, and had more comorbidities. Excess medical costs associated with hypertension were $8,572 per patient over the two-year period (95% CI $8,182-$8,962). Patients with versus without hypertension had 0.200 (95% CI, 0.195-0.205) more ED visits, 0.081 (95% CI, 0.077-0.085) more inpatient admissions, 5.984 (95% CI, 5.892-6.075) more outpatient visits, and 20.25 (95% CI, 20.09-20.41) more prescriptions per patient over the two-year period. They also had more sick absences (1.13 days; 95% CI 0.93-1.34) and STD occurrences (3.88 days; 95% CI 3.56-4.20) per patient. Among those with hypertension, individuals with versus without COVID-19 had $3,495 (95% CI, $2,135-$4,856) higher medical costs and 2.588 (95% CI, 1.112-4.065) more STD days per patient over the two-year period.</p><p><strong>Conclusions: </strong>Hypertension was associated with higher medical costs, healthcare utilization, and productivity losses, exacerbated by COVID-19.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961462","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}