American Journal of Hypertension最新文献

{"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}

{"title":"The hypertension specialist's perspective: aldosterone synthase inhibitors to fill the gap in difficult-to-control and resistant hypertension.","authors":"Romina Ruth Diaz, Amelie H Ohlrogge, Aletta E Schutte","doi":"10.1093/ajh/hpag083","DOIUrl":"https://doi.org/10.1093/ajh/hpag083","url":null,"abstract":"<p><p>Aldosterone dysregulation is a key driver of difficult-to-control and resistant hypertension. Mineralocorticoid receptor antagonists (MRAs) target the aldosterone pathway but their use can be limited by side effects, particularly hyperkalemia and antiandrogenic hormonal effects. Selective aldosterone synthase inhibitors (ASIs) have shown clinically meaningful blood pressure reductions in patients with difficult-to-control and resistant hypertension in recent phase 2b and 3 trials. In this narrative review, we summarize pivotal evidence from phase 2b and phase 3 trials of the second-generation ASIs lorundrostat, baxdrostat, and dexfadrostat, reporting efficacy and core safety signals (hyperkalemia, hyponatremia, and an early functional reduction in estimated glomerular filtration rate (eGFR]). We further discuss the implications of these findings, economic and access considerations, remaining evidence gaps, future research directions, and potential practical treatment algorithms. ASIs offer clinically significant blood pressure lowering with moderate side effects when added on top of current therapies in short-term trials, though long-term outcome data are lacking. In May 2026, the US Food and Drug Administration (FDA) approved the first ASI, baxdrostat, for hypertension treatment in combination with other antihypertensive drugs in inadequately controlled adults. However, gaps remain, most notably the absence of comparative effectiveness trials versus MRAs, the standard fourth-line agent. ASIs target upstream aldosterone production and may offer a distinct, complementary role for patients with intolerance or contraindications for MRA or insufficient response. ASIs may be best reserved for the treatment of uncontrolled or resistant hypertension in combination with other antihypertensives and where MRAs are contraindicated, poorly tolerated, or insufficient.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":"39 Supplement_1","pages":"S30-S42"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134609","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":"Long-term SBP time in target and risk of cardiovascular events in older adults: a secondary analysis of the ASPREE cohort.","authors":"Michael E Ernst, Katherine L Webb, Raj C Shah, Lawrence Beilin, Alice Owen, Suzanne G Orchard, Michelle A Fravel, Robyn L Woods, Mark R Nelson, Kevan R Polkinghorne, Nigel Stocks, Rory Wolfe, Jordana B Cohen, Christopher M Reid","doi":"10.1093/ajh/hpag070","DOIUrl":"10.1093/ajh/hpag070","url":null,"abstract":"<p><strong>Background: </strong>BP time in target range (TTR) predicts cardiovascular disease (CVD) in high-risk populations; however, TTR's predictive utility in older adults without prior CVD is uncertain.</p><p><strong>Methods: </strong>We performed a post hoc analysis of the ASPirin in Reducing Events in the Elderly trial and its observational follow-up. SBP TTR for <140 and <130 mm Hg was estimated for each participant using BPs from the first 3 visits. Participants with 0% or 100% TTR were categorized separately, and remaining participants grouped into tertiles using linear interpolation to estimate TTR. Cox proportional hazards models evaluated associations between TTR and adjudicated incident CVD and major adverse cardiovascular events (MACE) after the TTR estimation period, with 0% TTR as reference.</p><p><strong>Results: </strong>Among 16,730 predominantly White Australian adults (mean age, 74 years) followed for a mean of 7.7 years after TTR estimation, 100% TTR <140 mm Hg had reduced risk of CVD (HR, 0.81; 95% CI, 0.68-0.96; P = .01), while 100% TTR <130 mm Hg had reduced risks of CVD (HR, 0.82; 95% CI, 0.67-0.99; P = .04) and MACE (HR, 0.72; 95% CI, 0.57-0.91; P < .01). Associations were strongest among women, antihypertensive users, frail/pre-frail participants, and those younger than median age. Findings were consistent after adjusting for competing risk of non-CVD death, when the TTR estimation period was extended an additional year, and when estimated using proportion of individual visit BPs at target.</p><p><strong>Conclusions: </strong>Longer SBP TTR was associated with reduced risk of cardiovascular events in older adults, underscoring the importance of sustained BP control with aging.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"1189-1197"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148366618","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":"Implications of sex differences in arginine kinetics for individualized treatment of hypertension.","authors":"Brooke E Chapple, Oleg Palygin, Daria V Ilatovskaya","doi":"10.1093/ajh/hpag053","DOIUrl":"10.1093/ajh/hpag053","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"1254-1256"},"PeriodicalIF":2.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13446122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148154881","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":"Genome-Wide DNA Methylation Profiling in Patients with Hypertension and Asymptomatic Intracranial Atherosclerotic Stenosis.","authors":"Min Zhu, Jin Zhang, Jing Ma, Qin Wang, Yan Wang, Dingliang Zhu","doi":"10.1093/ajh/hpag117","DOIUrl":"https://doi.org/10.1093/ajh/hpag117","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a major risk factor for intracranial atherosclerotic stenosis (ICAS), a leading cause of ischemic stroke in Asian populations. However, conventional risk factors only partially account for the pathogenesis of ICAS, underscoring the potential roles of epigenetic mechanisms.</p><p><strong>Methods: </strong>We performed genome-wide DNA methylation profiling of 218 Chinese patients with hypertension using an Illumina Infinium Methylation EPIC 850K BeadChip. Identified differentially methylated positions (DMPs) were validated via pyrosequencing in 281 patients without asymptomatic ICAS (aICAS) who underwent a 4.7-year follow-up, among whom 79 developed new onset aICAS during follow-up.</p><p><strong>Results: </strong>After quality control, 725,736 CpG sites were analyzed, identifying 28 DMPs (|Δβ| ≥ 0.06, FDR < 0.01) that were annotated to 16 genes. Interferon regulatory factor 1 (IRF1) showed significant hypermethylation at cg00255919 and cg21138405. Receiver operating characteristic curve analysis revealed that incorporating cg00255919 into conventional risk factors elevated the area under the curve (AUC) from 0.649 to 0.741 (P = 0.005). Pyrosequencing confirmed that cg00255919 hypermethylation was associated with a higher incidence of aICAS (adjusted HR = 1.99, 95% CI = 1.2-3.3). Kyoto Encyclopedia of Genes and Genomes analysis linked the DMPs to immune response pathways.</p><p><strong>Conclusions: </strong>This study identified novel methylation signatures for aICAS in patients with hypertension, highlighting IRF1 methylation as a potential biomarker for auxiliary screening.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023721","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":"Extra-Large Blood Pressure Cuff Need and Cost Burden in United States Adults with Hypertension.","authors":"Sumit Sahoo, Tammy Brady, Benjamin Grobman, Stephen P Juraschek, Jennifer L Cluett","doi":"10.1093/ajh/hpag118","DOIUrl":"https://doi.org/10.1093/ajh/hpag118","url":null,"abstract":"<p><strong>Background: </strong>Accurate home blood pressure (BP) monitoring depends on appropriate cuff sizing, but the prevalence and cost implications of extra-large cuff need among US adults with hypertension are unknown.</p><p><strong>Methods: </strong>Using pooled data from 2017-2023 National Health and Nutrition Examination Survey (NHANES) with survey weighting, we estimated the prevalence of having a mid-arm circumference >43cm among US adults with hypertension, overall and by race/ethnicity. We also categorized home BP monitors listed on the US Validated Device Listing as standard (accommodating arm circumferences from 22-43cm) or extra-large cuff compatible (accommodating arm circumferences >43cm).</p><p><strong>Results: </strong>Approximately 6.6% of US adults with hypertension (∼ 7.2 million individuals) had an arm circumference >43cm. Prevalence was highest among Non-Hispanic (NH) Black adults (11.4%) followed by Other Race/Multiracial (8.2%), NH White (6.2%), Hispanic (5.3%) and NH Asian adults (0.9%). Of the 51 validated devices, only 22 (43.1%) accommodated arm circumferences >43cm. The mean total cost of an extra-large cuff compatible system was 32.7% higher ($99.06 versus $74.70 for standard devices).</p><p><strong>Conclusions: </strong>More than 7 million US adults with hypertension require an extra-large BP cuff; the substantially higher cost of extra-large cuff-compatible devices represents an important and underrecognized barrier to accurate home BP monitoring.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023742","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":"Nocturnal Blood Pressure Dipping in Adults: A Comparison Between Cuffless and Ambulatory Blood Pressure Monitoring.","authors":"C Hove, T M Seeberg, K G Bøtker-Rasmussen, E Westgaard, S Heimark, B Waldum-Grevbo, A C K Larstorp","doi":"10.1093/ajh/hpag115","DOIUrl":"https://doi.org/10.1093/ajh/hpag115","url":null,"abstract":"<p><strong>Background: </strong>Cuffless blood pressure (BP) devices have demonstrated potential in estimating daytime BP but have not been able to predict nocturnal BP precisely, creating difficulties when the intended use is ambulatory BP monitoring (ABPM). We evaluated the ability of a photoplethysmography-based cuffless BP device, with the intended use 24-hour ABPM, to estimate nocturnal BP compared to a cuff-based oscillometric device.</p><p><strong>Methods: </strong>Participants underwent 24-hour ABPM with the cuffless device placed on the non-dominant upper arm and a validated cuff-based oscillometric device on the dominant arm. The difference between mean awake and asleep BP (awake-asleep BP change) was calculated for both devices and used in the analyses. The statistical analyses were guided by the Awake/Asleep test (European Society of Hypertension 2023 Recommendations), however, there were methodological deviances from these recommendations. Most importantly, we used only cuffless BP values that were obtained simultaneously with the reference device.</p><p><strong>Results: </strong>Data from 50 participants, aged 18-80 years, with mean (standard deviation; SD) inclusion office systolic/diastolic BP (SBP/DBP) 120.1 (11.5)/75.3 (7.9), were analyzed. The cuffless device achieved a mean difference [95% limits of agreement] of 1.6 [-8.0, 11.2] mmHg for SBP and 1.2 [-6.7, 9.1] mmHg for DBP in awake-asleep BP changes compared to the reference. Pearson correlation coefficients (95% confidence interval) for SBP/DBP were 0.75 (0.59, 0.85)/0.74 (0.58, 0.84). Our population had an overrepresentation of normal and low BP.</p><p><strong>Conclusion: </strong>Although the cuffless device shows promise in successfully tracking nocturnal BP, full validation is required before clinical use.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015295","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":"Renal Denervation for Hypertension Management: Past, Current Evidence and Future Directions.","authors":"Shahzad Hassan, Iliana Hurtado Rendon, Nikolaos Spilias, Laura Bredel, Yiannis Chatzizisis, Maria Delgado-Lelievre","doi":"10.1093/ajh/hpag112","DOIUrl":"https://doi.org/10.1093/ajh/hpag112","url":null,"abstract":"<p><p>Hypertension remains the most prevalent modifiable cardiovascular risk factor worldwide, and continues to account for substantial morbidity, mortality, and health care burden despite established pharmacologic and lifestyle-based therapies. Poor long-term adherence, therapeutic inertia, polypharmacy, and persistent implementation gaps have generated interest in device-based therapies that provide durable BP reduction, independent of daily medication use. Renal denervation (RDN) has emerged as the most extensively studied catheter-based intervention targeting the sympathetic pathways that contribute to blood pressure regulation. This review summarizes the physiological basis for RDN, including the role of efferent and afferent renal sympathetic pathways in the development and maintenance of hypertension. We review the evolution of RDN technology from first-generation radiofrequency systems to multielectrode radiofrequency, ultrasound-based, and alcohol-mediated platforms, with attention to procedural refinements and lesion patterns over time. We then examine the clinical evidence across major trials, from early open-label studies to modern sham-controlled programs, which now consistently demonstrate modest but clinically meaningful reductions in ambulatory and office BP with an acceptable safety profile in selected patients. Beyond BP lowering, renal denervation may have broader biologic effects on cardiac remodeling, neurohormonal activation, inflammation, arrhythmias, metabolic dysfunction, and cardiorenal pathways, although these data remain preliminary, without any evidence from outcome studies. Important knowledge gaps persist, particularly the absence of cardiovascular outcomes trials, variability in treatment response, and the need for improved phenotyping to identify likely responders. As technology, patient selection, and mechanistic understanding continue to advance, RDN may become an increasingly important adjunct in the management of uncontrolled hypertension.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975536","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":"Chronotype and Arterial Stiffness: Moderating Effect of Cardiorespiratory Fitness in Middle-Aged and Older Adults.","authors":"Yicheng Zhong, Nobuhiko Akazawa, Kumpei Tanisawa, Hiroki Tabata, Nobuhiro Nakamura, Ryoko Kawakami, Chiyoko Usui, Tomoko Ito, Kaori Ishii, Katsuhiko Suzuki, Suguru Torii, Motohiko Miyachi, Mitsuru Higuchi, Shizuo Sakamoto, Koichiro Oka, Seiji Maeda","doi":"10.1093/ajh/hpag113","DOIUrl":"https://doi.org/10.1093/ajh/hpag113","url":null,"abstract":"<p><strong>Background: </strong>This cross-sectional study examined whether cardiorespiratory fitness modified the association between chronotypes and arterial stiffness in middle-aged and older adults.</p><p><strong>Methods: </strong>This study included 1,112 participants (734 men and 378 women) aged ≥40 years from the Waseda Alumni's Sports, Exercise, Daily Activity, Sedentariness and Health Study. Definitely morning/moderately morning/neither/moderately evening were assessed using the Morningness-Eveningness Questionnaire. Arterial stiffness was evaluated by cardio-ankle vascular index. Cardiorespiratory fitness was directly measured as peak oxygen uptake (⩒O2peak) during a maximal exercise stress test and categorized into sex- and age-specific tertiles (relatively low/moderate/high cardiorespiratory fitness). Cardio-ankle vascular index by chronotype of each cardiorespiratory fitness level category was compared, and the results were adjusted for age, sex, body mass index, triglyceride level, Pittsburgh sleep quality index score, smoking status, alcohol intake, and total energy intake.</p><p><strong>Results: </strong>A significant interaction in a two-way analysis of covariance (ANCOVA) between chronotype and cardiorespiratory fitness on cardio-ankle vascular index was observed (P = 0.007). Definitely morning-type individuals showed 0.64 (95% CI: 0.18-1.11) higher in cardio-ankle vascular index than moderately morning-type, 0.64 (95% CI: 0.18-1.10) higher than neither type, and 0.70 (95% CI: 0.05-1.35) higher than moderately evening-type individuals after adjusting for confounders in the relatively low cardiorespiratory fitness group.</p><p><strong>Conclusions: </strong>In this population, the association between the definitely morning chronotype and high cardio-ankle vascular index may be more apparent when the cardiorespiratory fitness is low.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975471","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":"MiR-23b-3p exerts a protective effect in hypertensive nephropathy by inhibiting fibrosis and inflammation.","authors":"Liang Fan, Cunyou Xiong, Xiujuan Qi","doi":"10.1093/ajh/hpag108","DOIUrl":"https://doi.org/10.1093/ajh/hpag108","url":null,"abstract":"<p><strong>Background: </strong>This study intends to investigate the correlation between hypertensive nephropathy (HN) and microRNA-23b-3p (miR-23b-3p), and clarify the biological function of miR-23b-3p in renal injury.</p><p><strong>Methods: </strong>The serum expression levels of miR-23b-3p were compared between HN patients and healthy controls. A mouse model of HN was constructed via persistent Ang II infusion, after which the effects of miR-23b-3p on renal function (ACR/Scr/BUN) were examined. The mRNA levels of renal fibrosis markers (TGF-β1, COL1A1, Fibronectin, α-SMA) and pro-inflammatory cytokines (TNF-α, IL-1β and IL-6) in kidney tissues were quantified by RT-qPCR. For in vitro validation, NRK-52E cells were stimulated with Ang II. The interaction between miR-23b-3p and phosphodiesterase 4B (PDE4B) was verified using dual luciferase reporter assay and RNA pull-down assay.</p><p><strong>Results: </strong>In patients with HN, the expression level of miR-23b-3p was positively correlated with eGFR and negatively correlated with ACR. In the mouse model, inhibition of miR-23b-3p exacerbated renal injury; conversely, overexpression of miR-23b-3p exerted a protective effect, which was specifically manifested as decreased levels of ACR, Scr, BUN, fibrotic factors and pro-inflammatory factors. PDE4B is a downstream target gene of miR-23b-3p. The expression trend of PDE4B was opposite to that of miR-23b-3p in HN patients, Ang II-induced mouse models and NRK-52E cells. In NRK-52E cells, PDE4B attenuated the inhibitory effect of miR-23b-3p on fibrotic genes and inflammatory genes.</p><p><strong>Conclusions: </strong>The pathogenesis of HN is closely associated with the aberrant expression of miR-23b-3p. miR-23b-3p may ameliorate renal tubular fibrosis and inflammatory response via negatively regulating its target gene PDE4B.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944065","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}