American Journal of Hypertension最新文献

{"title":"The imperative for improved antihypertensives.","authors":"Reinhold Kreutz","doi":"10.1093/ajh/hpag084","DOIUrl":"https://doi.org/10.1093/ajh/hpag084","url":null,"abstract":"<p><p>Hypertension remains a leading modifiable risk factor for cardiovascular morbidity and mortality worldwide, yet blood pressure (BP) control rates remain suboptimal despite the availability of multiple antihypertensive drug classes. This persistent gap reflects a combination of patient-related factors, including poor adherence, physician-related factors such as therapeutic inertia, health system limitations, and intrinsic shortcomings of current pharmacological therapies. Existing antihypertensive agents are effective at the population level but are limited by interindividual variability in response, incomplete targeting of underlying pathophysiological mechanisms, adverse effects, and insufficient 24-hour BP control. These limitations highlight a mismatch between the heterogeneous nature of hypertension and the largely empirical approach to treatment. Recent advances in systems biology, digital health, and artificial intelligence will offer opportunities for improved patient stratification and more individualized therapy in the future. In parallel, renewed drug development has led to novel approaches targeting both nontraditional pathways, such as endothelin receptor antagonism or more selective modulation within established systems, eg, particularly the inhibition of aldosterone. Future progress will require integration of improved implementation strategies for hypertension management with the development of more effective, better tolerated, and mechanism-based therapies to improve hypertension treatment and achieve optimal blood pressure control and outcomes.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":"39 Supplement_1","pages":"S5-S10"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134617","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":"Beyond the 4 pillars: aldosterone synthase inhibition as a fifth frontier in chronic kidney disease management.","authors":"Markus P Schlaich, Louise Woodhams, Lakshini Y Herat, Damon A Bell","doi":"10.1093/ajh/hpag090","DOIUrl":"https://doi.org/10.1093/ajh/hpag090","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is highly prevalent globally and affects approximately 1 in 10 adults, with a prevalence of 10% globally and ∼14.4% in North America. High blood pressure (BP) is one of the most common causes for the development of CKD. Conversely, hypertension occurs more frequently in patients with CKD and is found to be uncontrolled in 60%-80% of these patients. The rates of resistant hypertension are amongst the highest for any patient population, with estimates ranging between 40% and 50%. Deteriorating renal function is associated with increasing risk for co-morbid conditions including cardiac disease and stroke. Appropriate management of hypertension is important in patients with CKD but poses frequent challenges in clinical care with the need to balance the desired BP lowering and ideally reno-protective effects against increased risks for nephrotoxicity and medication side effects. Established therapeutic principles in the context of CKD include renin-angiotensin-aldosterone system (RAAS) blockade using either ACE inhibitors or angiotensin receptor blockers (ARBs), sodium-glucose transport 2 (SGLT-2) inhibitors, non-steroidal mineralocorticoid receptor antagonists (nsMRAs), and glucagon-like-peptide-1 (GLP-1) agonists. Aldosterone dysregulation is emerging as another key driver of persistently uncontrolled BP and deteriorating kidney function, not only through the associated sodium and fluid retention but also through BP-independent effects on endothelial function, inflammatory pathways, tissue fibrosis, and hypertrophic responses. The new drug class of aldosterone synthase inhibitors (ASIs), highly selective agents inhibiting CYP11B2 and thereby reducing circulating aldosterone levels, may offer a novel opportunity to effectively lower BP and reduce organ damage mediated by dysregulated aldosterone. Indeed, recently published data from phase 3 randomized controlled hypertension trials with various ASIs have demonstrated substantial office and ambulatory BP lowering efficacy with an acceptable safety profile. A reduction in albuminuria in early phase 2 trials in patients with hypertension and CKD may indicate reno-protective properties of ASIs. Dedicated outcome trials are ongoing to explore these prospects in detail.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":"39 Supplement_1","pages":"S49-S56"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134585","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":"Pathophysiology of aldosterone dysregulation in difficult-to-control hypertension.","authors":"Claudio Borghi, Federica Fogacci, Arrigo F G Cicero","doi":"10.1093/ajh/hpag082","DOIUrl":"https://doi.org/10.1093/ajh/hpag082","url":null,"abstract":"<p><p>Aldosterone, a key component of the renin-angiotensin-aldosterone system (RAAS), plays a central role in sodium balance, vascular tone, blood pressure control, and cardiovascular remodeling. Dysregulation of aldosterone mechanism, including excessive production, deficiency, and inappropriate receptor activation, represents a significant contributor to cardiovascular and renal disease which is often underrecognized. Aldosterone dysregulation may manifest as primary aldosteronism that is increasingly identified as a common cause of secondary hypertension, or by secondary hyperaldosteronism that reflects maladaptive responses in common clinical conditions such as heart failure and liver cirrhosis. Conversely, hypoaldosteronism, particularly in diabetic nephropathy, predisposes to hyperkalemia and metabolic acidosis. Furthermore, aldosterone dysregulation can be observed in many clinically important and common patient phenotypes such as older patients, obese, and patients with diabetes where the elevated levels of aldosterone can contribute to poor blood pressure control and development of target organ damage particularly at the cardiac, vascular, and renal level. Beyond circulating levels of aldosterone itself, mineralocorticoid receptor (MR) overactivation in the absence of elevated aldosterone highlights the complexity of tissue-specific signaling. This review summarizes the spectrum of aldosterone dysregulation, delineates key patient phenotypes, and discusses diagnostic and therapeutic implications with a focus on cardiovascular outcomes. Recognizing aldosterone dysregulation as a systemic cardio-renal-metabolic disorder has important implications for risk stratification and targeted therapies.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":"39 Supplement_1","pages":"S11-S17"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134597","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":"Aldosterone synthase inhibitors may alter how primary care treats hypertension.","authors":"Peter J Lin","doi":"10.1093/ajh/hpag093","DOIUrl":"https://doi.org/10.1093/ajh/hpag093","url":null,"abstract":"<p><p>Hypertension guidelines recommend adding antihypertensive therapies until the blood pressure (BP) is below a specific target. If the BP is not below target with 3 medications, including a diuretic, then it is labeled resistant hypertension, and then we investigate for secondary causes, such as primary aldosteronism (PA). PA testing seems complex with 3 results: aldosterone, renin, and the aldosterone-renin ratio. Hence, these tests are ordered infrequently, and the diagnosis of PA is often delayed or never made. Also, heart failure, chronic kidney disease, and other conditions can have elevated aldosterone, which are not PA-related. The traditional treatment with aldosterone receptor blockers/mineralocorticoid receptor antagonists has been helpful, but they block the effects that are mediated through the mineralocorticoid receptor. The non-receptor effects of high aldosterone may continue to cause harm. Therefore, blocking the production of aldosterone with an aldosterone synthase inhibitor (ASI) could be a more complete strategy to address elevated aldosterone levels. In addition, an \"ASI Challenge\" may help us decide which patients need formal testing for PA. If the systolic blood pressure drops a significant amount (>10 mm Hg), then that suggests aldosterone is a key component of the uncontrolled BP, and those patients should be considered for formal PA testing. For those who drop a modest amount (<10 mm Hg), they would be less likely to need PA testing. Such an approach could use an ASI agent as a diagnostic/screening tool as well as a therapeutic agent, which would be very helpful in the primary care setting.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":"39 Supplement_1","pages":"S43-S48"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134863","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 note from the accreditor.","authors":"Charles V Pollack","doi":"10.1093/ajh/hpag086","DOIUrl":"https://doi.org/10.1093/ajh/hpag086","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":"39 Supplement_1","pages":"S3-S4"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134931","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":"Aldosterone synthase inhibitors: biological rationale, mechanism of action, and results of clinical trials.","authors":"Stanisław Surma, Krzysztof Narkiewicz","doi":"10.1093/ajh/hpag087","DOIUrl":"https://doi.org/10.1093/ajh/hpag087","url":null,"abstract":"<p><p>Resistant and uncontrolled hypertension remain major unmet needs, with aldosterone dysregulation or frank excess increasingly recognized as a central driver. To this end, aldosterone synthase inhibitors (ASIs) represent a novel therapeutic approach targeting CYP11B2, the key enzyme responsible for aldosterone biosynthesis. By reducing aldosterone production at its source, ASIs may overcome limitations associated with conventional renin-angiotensin-aldosterone system (RAAS) blockade and attenuate both genomic and non-genomic effects of aldosterone. Advances in drug development have led to second-generation ASIs, including baxdrostat, lorundrostat, dexfadrostat, and vicadrostat, characterized by high selectivity for CYP11B2 over CYP11B1, thereby preserving cortisol synthesis. Clinical trials across phases I-III demonstrate that second-generation ASIs, including baxdrostat, lorundrostat, dexfadrostat, and vicadrostat, effectively lower aldosterone levels and produce substantial blood pressure reductions, particularly in resistant or uncontrolled hypertension. ASIs are generally well tolerated. Hyperkalemia is the most common adverse event, particularly in patients with chronic kidney disease, but is typically manageable and appears less frequent than with mineralocorticoid receptor antagonists in comparable populations. No clinically significant suppression of the hypothalamic-pituitary-adrenal axis has been observed with second-generation compounds. These findings support ASIs as a promising addition to the therapeutic armamentarium for hypertension. The recent FDA approval of baxdrostat, the first second-generation ASI, represents an important milestone for this therapeutic class. However, further studies are required to establish long-term safety, optimal patient selection, and their role in combination therapies and cardiovascular risk reduction.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":"39 Supplement_1","pages":"S18-S29"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134515","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":"From bench to formulary: a pharmacological appraisal of aldosterone synthase inhibitors for uncontrolled and resistant hypertension.","authors":"William L Baker","doi":"10.1093/ajh/hpag077","DOIUrl":"https://doi.org/10.1093/ajh/hpag077","url":null,"abstract":"<p><strong>Background: </strong>Currently available options for managing uncontrolled and resistant hypertension are limited by safety concerns and their inability to prevent the nongenomic effects of aldosterone. Aldosterone synthase inhibitors (ASI) have emerged with Phase 3 data suggesting they provide adequate blood pressure (BP) lowering with reasonable safety profiles.</p><p><strong>Methods: </strong>This review synthesizes the current evidence for ASIs (baxdrostat and lorundrostat) to improve BP, including pertinent pharmacologic, pharmacokinetic, effectiveness, and safety considerations.</p><p><strong>Results: </strong>Through inhibition of the enzyme cytochrome-P450 11B2 (CYP11B2), baxdrostat and lorundrostat reduce aldosterone synthase expression, lowering aldosterone concentrations. Beyond BP-lowering effects, aldosterone synthase inhibition attenuates myocardial and vascular fibrosis promotion, endothelial dysfunction, and kidney injury. Evidence from phase 2 and 3 clinical trials in patients with uncontrolled and resistant hypertension despite being on multiple antihypertensive drugs suggests that the ASIs typically produce 5-15 mm Hg reductions in systolic BP. While generally well tolerated, the main safety concerns include hyperkalemia, hyponatremia, hypotension, and reductions in kidney function. As mineralocorticoid receptor antagonists (MRAs) are currently recommended as the treatment of choice for resistant hypertension, comparative trials of ASIs with the MRAs are needed to better identify their place in practice.</p><p><strong>Conclusions: </strong>The ASIs represent a promising class of antihypertensive drug classes with proven efficacy in reducing both office and ambulatory blood pressure, although studies on their comparative efficacy and safety with MRAs such as spironolactone are needed, along with evidence of cost-effectiveness.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":"39 Supplement_1","pages":"S78-S87"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134565","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":"Effects of Anti-Hypertensive Agents on Orthostatic Changes: Secondary Analysis of the Treatment of Mild Hypertension Study (TOMHS).","authors":"Esther Y Liu, Grace Lee, Md Marufuzzaman Khan, Aldis Petriceks, Hannah Col, Mingyu Zhang, Long H Ngo, Lewis Lipsitz, Stephen P Juraschek","doi":"10.1093/ajh/hpag119","DOIUrl":"https://doi.org/10.1093/ajh/hpag119","url":null,"abstract":"<p><strong>Background: </strong>Orthostatic hypotension (OH) and orthostatic hypertension (OHT) are common among adults with hypertension and may complicate antihypertensive treatment selection.However, the impact of specific antihypertensive agents on orthostatic blood pressure (BP) responses and risk of OH or OHT remains incompletely characterized.</p><p><strong>Methods: </strong>We performed a secondary analysis of the Treatment of Mild Hypertension Study (TOMHS), a multicenter randomized clinical trial (1987-1993). A total of 902 adults aged 45-69 years with diastolic BP 90-99 mmHg were randomized to acebutolol, amlodipine, chlorthalidone, doxazosin, enalapril, or placebo. Orthostatic BP change (standing minus seated BP) was assessed at randomization, 1 month, and every 3 months up to 54 months. OH was defined as a systolic BP decrease ≥20 mmHg or diastolic BP decrease ≥10 mmHg; OHT was defined as a systolic BP increase ≥20 mmHg or diastolic BP increase ≥10 mmHg. Generalized estimating equations evaluated associations between agents and orthostatic BP changes overall, by baseline BP, and over time.</p><p><strong>Results: </strong>Among 897 participants with orthostatic BP measurements (mean age 54.8 years; 38.5% female; 19.6% Black), doxazosin increased odds of OH (OR 1.45; 95% CI, 1.05-2.02) and reduced odds of OHT (OR 0.66; 95% CI, 0.51-0.86) versus placebo. Chlorthalidone reduced OHT among participants with baseline OHT (P=0.018). Amlodipine and doxazosin attenuated orthostatic systolic BP changes across baseline orthostatic BP change strata. Over time, amlodipine and chlorthalidone reduced odds of OH (P=0.001, 0.044).</p><p><strong>Conclusions: </strong>Specific antihypertensive agents demonstrated distinct effects on orthostatic BP regulation. Consideration of orthostatic effects during antihypertensive selection may help individualize therapy, improve hemodynamic stability, and optimize treatment for patients at risk of orthostatic dysregulation.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102948","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":"Designing a usable clinician report for home blood pressure monitoring in pregnancy: a mixed methods study.","authors":"Cassie Shao, Katherine A Tak, Ritika Revoori, Sanjna Iyengar, Mawulorm Denu, Abigail Arthur, Angela Halloran, Cathy Violette, Heidi Leftwich, Kyle Fraielli, Lara C Kovell","doi":"10.1093/ajh/hpag055","DOIUrl":"10.1093/ajh/hpag055","url":null,"abstract":"<p><strong>Background: </strong>Hypertensive disorders of pregnancy (HDPs) are leading causes of maternal and fetal morbidity; yet uptake of home blood pressure monitoring (HBPM) for perinatal detection and management of hypertension remains limited by workflow and integration barriers. We designed and evaluated a clinician-facing HBPM report that integrates blood pressure trends, medication adherence, and pregnancy symptoms to support clinical adoption.</p><p><strong>Methods: </strong>Between March 2023 and October 2024, we designed and refined HBPM report prototypes through a mixed-method study that included interviews with 16 obstetric providers, using iterative input from a multidisciplinary Clinician Advisory Group. Data on preferences for report features, usability, and workflow integration drawn from provider interviews were compiled and synthesized via convergent quantitative and qualitative methods.</p><p><strong>Results: </strong>Sixteen providers (37.5% nurses, 25% residents, 25% attendings, 12.5% APPs) were interviewed. Providers identified the blood pressure graph, abnormal-value highlights, medication adherence tracker, and symptom log as the most useful features (n = 15-16, ≥90%), while the prenatal vitamin tracker was least useful (n = 9, 56%). Most providers preferred to review the report themselves (n = 11, 73%) and to receive it at a frequency based on clinical need (n = 12, 80%). While most clinicians were willing to integrate the report into their practice, they raised concerns about workflow burden, triage of abnormal readings, and EMR integration as barriers to successful integration.</p><p><strong>Conclusions: </strong>Providers found most elements of the HBPM tool useful for HDP management, but identified workflow and implementation challenges as key barriers, highlighting the need for strategies to support clinical integration.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"1174-1179"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248692","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":"Aldosterone, the brain, and the blood pressure ceiling: a neurological case for aldosterone synthase inhibitors in resistant hypertension.","authors":"Virginia Cancelloni, Valeria Caso","doi":"10.1093/ajh/hpag091","DOIUrl":"https://doi.org/10.1093/ajh/hpag091","url":null,"abstract":"<p><p>Hypertension is the leading modifiable risk factor for stroke and a major contributor to cognitive impairment and dementia, with its global burden increasing alongside population aging. Hypertension promotes cerebrovascular damage through endothelial dysfunction, blood-brain barrier disruption, small vessel disease, and accelerated atherosclerosis, all potentially contributing to both ischemic and hemorrhagic stroke risk. These vascular alterations also contribute to neurodegenerative processes, linking hypertension-particularly when present in midlife-to vascular dementia and Alzheimer's disease. Effective blood pressure control (target <130/80 mm Hg) remains central to primary and secondary stroke prevention and is associated with reduced risks of recurrent stroke and cognitive decline. The renin-angiotensin-aldosterone system plays a central role in hypertension-related cerebrovascular injury, with aldosterone excess contributing to vascular inflammation, oxidative stress, and impaired cerebral autoregulation. Resistant hypertension, often driven by aldosterone dysregulation, is associated with increased cardiovascular and neurological risk. Aldosterone synthase inhibitors such as lorundrostat and baxdrostat represent a novel therapeutic approach targeting aldosterone production. Clinical trials demonstrate significant reductions in systolic blood pressure with favorable safety profiles in patients with uncontrolled or resistant hypertension. Although direct evidence for stroke prevention is currently lacking, indirect data suggest that sustained blood pressure reduction and modulation of aldosterone-mediated vascular damage may lower cerebrovascular risk. Aldosterone synthase inhibitors may be particularly relevant in phenotype-driven, personalized treatment strategies for patients with resistant hypertension or suspected aldosterone excess. However, long-term efficacy, safety, and impact on hard outcomes such as stroke and dementia require confirmation in dedicated trials.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":"39 Supplement_1","pages":"S57-S65"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134542","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}