American Journal of Hypertension最新文献_第4页

Salty Science: The Promise of Proteomics to Unravel Cardiovascular Consequences. 咸科学：蛋白质组学揭示心血管后果的前景。

IF 3.1 3区医学

American Journal of Hypertension Pub Date : 2025-09-14 DOI: 10.1093/ajh/hpaf185

Swapnil Hiremath

引用次数: 0

Risk of Hypertension and Chronic Kidney Disease following Aldosterone Dysregulation. 醛固酮失调后高血压和慢性肾病的风险。

IF 3.1 3区医学

American Journal of Hypertension Pub Date : 2025-09-10 DOI: 10.1093/ajh/hpaf183

Raymond R Townsend, Abiy Agiro, Shan Luan, Kaylen Brzozowski, Erick Moyneur, Paule Tetreault-Langlois, Joanna Huang

{"title":"Risk of Hypertension and Chronic Kidney Disease following Aldosterone Dysregulation.","authors":"Raymond R Townsend, Abiy Agiro, Shan Luan, Kaylen Brzozowski, Erick Moyneur, Paule Tetreault-Langlois, Joanna Huang","doi":"10.1093/ajh/hpaf183","DOIUrl":"https://doi.org/10.1093/ajh/hpaf183","url":null,"abstract":"Background: Excess aldosterone of > 15ng/dL, in the presence of low renin, is linked to hypertension (HTN) and chronic kidney disease (CKD). This study investigated the association of aldosterone dysregulation at lower plasma aldosterone levels (≥5ng/dL) with the risk of uncontrolled HTN and CKD prevalence.Methods: Patient plasma aldosterone measurements obtained during 2013-2023 were identified in the TriNetX Dataworks-USA Network of electronic medical records. Eligible patients (≥18 years) had a plasma renin activity measurement of ≤ 1ng/mL/h within 12 months prior, and a systolic blood pressure (SBP) measurement within 12 months following, the index aldosterone measurement. The primary outcome was uncontrolled HTN (SBP ≥130mmHg) prevalence. The secondary outcome was CKD prevalence (CKD diagnosis or eGFR measurement of < 60mL/min/1.73m2). The adjusted odds ratio (aOR) of uncontrolled HTN during a 12-month follow-up were calculated among plasma aldosterone groups (≥5 vs < 5ng/dL, ≥10 vs < 10ng/dL, and ≥15 vs < 15ng/dL).Results: Patients (N = 1,334) had mean age of 59 years and 55.9% were female. Patients with plasma aldosterone of ≥ 5ng/dL (N = 903) had a higher risk (aOR [95% CI]) of uncontrolled HTN (2.01 [1.38,2.92]; p < 0.001) versus <5ng/dL (N = 431). Similar findings were observed for plasma aldosterone levels of ≥ 10ng/dL and ≥15ng/dL. Patients with plasma aldosterone of ≥ 10ng/dL (N = 514) had a higher risk of CKD (1.49 [1.15,1.92]; p < 0.001) versus <10ng/dL (N = 820). Similar findings were observed for plasma aldosterone levels of ≥ 15ng/dL.Conclusions: Clinically relevant aldosterone dysregulation, in the presence of low renin, occurs at lower aldosterone levels than previously thought, and remains significantly associated with uncontrolled HTN and CKD prevalence.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145032574","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}

引用次数: 0

Dynamical Regulation of Blood Pressure and Cognitive Function. 血压与认知功能的动态调节。

IF 3.1 3区医学

American Journal of Hypertension Pub Date : 2025-09-05 DOI: 10.1093/ajh/hpaf165

Joshua Sweigert, Tara Gruenewald, Margie Lachman, Teresa Seeman, Maxine Weinstein, Tse-Hwei Choo, Martina Pavlicova, Ramakrishna Mukkamala, Richard P Sloan

{"title":"Dynamical Regulation of Blood Pressure and Cognitive Function.","authors":"Joshua Sweigert, Tara Gruenewald, Margie Lachman, Teresa Seeman, Maxine Weinstein, Tse-Hwei Choo, Martina Pavlicova, Ramakrishna Mukkamala, Richard P Sloan","doi":"10.1093/ajh/hpaf165","DOIUrl":"https://doi.org/10.1093/ajh/hpaf165","url":null,"abstract":"Background: Blood pressure (BP) is not steady. It varies over intervals from months to consecutive cardiac cycles and this variation contains meaningful information beyond mean BP. Variability over multiple clinic visits (VVV-BP) and during 24-hour ambulatory monitoring (ABPV) is positively related to risk of stroke and coronary artery disease and negatively associated with cognitive performance. Beat-to-beat BP variation, often quantified as low frequency variability (0.04-0.15 Hz, LF-BPV), is less well-studied. Here, we examine the relationship between LF-BPV and cognitive outcomes in 1953 participants from the Midlife in the US study.Methods: Participants completed the Brief Test of Adult Cognition by Telephone (BTACT) from which we derived episodic memory (EMF) and executive function (EFF) factors and a composite index. With participants in the seated position, the continuous BP signal was recorded non-invasively with a Finometer. The resultant time series was submitted to Fourier-based spectral analysis to compute LF-BPV. Linear regression models estimated the associations with cognitive indices.Results: Systolic (LF-SBPV) and diastolic (LF-DBPV) were positively associated with EFF (b=0.073 ± 0.033, p = 0.02), EMF (b=0.079 ± 0.036, p = 0.04), and the composite index (b=0.101 ± 0.035, p = 0.004) after adjustment for age, sex, education, and income. Findings were similar for LF-DBPV.Conclusions: This positive association is consistent with evidence demonstrating that LF BPV contributes to increased delivery of oxygenated blood to the brain and clearance of metabolic and cellular waste via the brain's glymphatic system and intramural periarterial drainage pathway, both of which contribute to superior cognitive performance.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013706","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}

引用次数: 0

Rethinking Primary Aldosteronism: The 2025 John H. Laragh Research Award. 重新思考原发性醛固酮增多症：2025年John H. Laragh研究奖。

IF 3.1 3区医学

American Journal of Hypertension Pub Date : 2025-09-03 DOI: 10.1093/ajh/hpaf156

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":"https://doi.org/10.1093/ajh/hpaf156","url":null,"abstract":"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.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-03","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}

引用次数: 0

Treatment targets for blood pressure lowering in patients with diabetes mellitus. 糖尿病患者降压的治疗靶点。

IF 3.1 3区医学

American Journal of Hypertension Pub Date : 2025-09-02 DOI: 10.1093/ajh/hpaf179

Ioannis Vasileiadis, Aliki Zografou, Costas Platanias, Andreas Papalysandrou, Elias Sanidas, Costas Thomopoulos

引用次数: 0

Preoperative continuation of RAAS inhibitors in hypertensive patients undergoing non-cardiac surgery. 非心脏手术高血压患者术前继续使用RAAS抑制剂。

IF 3.1 3区医学

American Journal of Hypertension Pub Date : 2025-09-01 DOI: 10.1093/ajh/hpaf171

Sarawut Siwamogsatham, Myo Thiha Zaw, Osot Nerapusee, Bunchai Chongmelaxme, Su Myat Thin, Tanattha Kittisopee

{"title":"Preoperative continuation of RAAS inhibitors in hypertensive patients undergoing non-cardiac surgery.","authors":"Sarawut Siwamogsatham, Myo Thiha Zaw, Osot Nerapusee, Bunchai Chongmelaxme, Su Myat Thin, Tanattha Kittisopee","doi":"10.1093/ajh/hpaf171","DOIUrl":"https://doi.org/10.1093/ajh/hpaf171","url":null,"abstract":"Background: There has been incongruent evidence on the outcomes relating to whether continuing or withholding renin-angiotensin-aldosterone system inhibitors (RAASi) preoperatively. This study aimed to systematically analyse the effect of preoperative RAASi on perioperative and postoperative outcomes in patients undergoing non-cardiac surgeries.Method: PubMed, Scopus, ScienceDirect, and Cochrane databases were used with no limitation of the starting date, till 30th September 2024. The revised Cochrane risk-of-bias tool (RoB-2) and the Newcastle-Ottawa Scale (NOS) were used for quality assessment. The primary study outcomes were hemodynamic outcomes while the secondary outcomes included postoperative 30-day mortality, myocardial infarction, stroke and postoperative atrial fibrillation (POAF).Results: Among 1,897 articles, 6 eligible randomized control trials and 6 observational studies were enrolled. The patients preoperatively continuing RAASi had a higher risk of intraoperative hypotension [OR (Odds Ratio) = 1.54; 95% CI (Confidence interval) = 1.31,1.82], along with lower systolic and diastolic blood pressures compared to those withholding RAASi. Postoperative complications including 30-day mortality, myocardial infarction, stroke, atrial fibrillation, acute kidney injury, septicemia, myocardial injury, postoperative hypertension and unplanned ICU admission, showed no significant differences. However, there was a marginal significance in lower POAF in the RAASi continuing group (OR = 0.73, 95% CI = 0.52, 1.02).Conclusion: Withholding RAASi prior to non-cardiac operation significantly reduced the risk of intraoperative hypotension but may increase a chance to develop POAF without significant impact on 30-day mortality and other postoperative complications. Discontinuation of RAASi before non-cardiac surgery is recommended unless obligate indication.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939109","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}

引用次数: 0

Obesity, visceral adiposity, and the future of hypertension treatment. 肥胖，内脏脂肪，和高血压治疗的未来。

IF 3.1 3区医学

American Journal of Hypertension Pub Date : 2025-09-01 DOI: 10.1093/ajh/hpaf175

Benjamin D Gallagher

引用次数: 0

State of the Art Review: Thiazide diuretics exploit the endocannabinoid system via NAPE-PLD. 最新进展：噻嗪类利尿剂通过NAPE-PLD利用内源性大麻素系统。

IF 3.1 3区医学

American Journal of Hypertension Pub Date : 2025-09-01 DOI: 10.1093/ajh/hpaf174

Gianpiero Garau

{"title":"State of the Art Review: Thiazide diuretics exploit the endocannabinoid system via NAPE-PLD.","authors":"Gianpiero Garau","doi":"10.1093/ajh/hpaf174","DOIUrl":"https://doi.org/10.1093/ajh/hpaf174","url":null,"abstract":"The present State of the Art Review will take stock of targeting the endocannabinoid system (ECS) in the management of hypertension and vascular diseases. Major efforts have been made in the last thirty years to develop compounds modulating the ECS for diseases, both in the central and peripheral tissues. Agonists of the cannabinoid receptor CB1 elicited hypotension but were at strong risks of inducing tachycardia, heart and kidney damage. The clinical translation of CB2 agonists as well as anti-obesity CB1 blockers, proposed as promising treatments for cardiovascular risk factors, were complicated by adverse side effects. Inhibitors of the membrane enzyme fatty acid amide hydrolase (FAAH) that degrades the endocannabinoid anandamide normalized elevated blood pressure, at least in hypertensive rats. The turning point came when we discovered the phospholipase NAPE-PLD as a systemic target of thiazide diuretics, revealing physicians have indeed targeted the ECS for over sixty years in clinics, unknowingly. The membrane-associated target promotes diuretic effect through its internal channel and generates at the same time anandamide and other lipid signaling amides that exert marked protective actions, useful for the chronic treatment of hypertension. Results have extended our knowledge of the mechanism of thiazide medications, rationalizing both their acute and chronic therapeutic effects. The stabilization of NAPE-PLD by chemical agents that bind to the thiazide-binding site is efficacious in the treatment of hypertension and vascular resistance, providing a validated approach in clinics for the ECS modulation in human diseases associated with neurovascular alterations.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939145","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}

引用次数: 0

New Insights on the ideal blood pressure levels for renal protection. 关于保护肾脏的理想血压水平的新见解。

IF 3.1 3区医学

American Journal of Hypertension Pub Date : 2025-08-30 DOI: 10.1093/ajh/hpaf173

Marco Antônio Vieira-da-Silva, José Fernando Vilela Martin

引用次数: 0

Self-measured home orthostatic hypo- and hypertension - prevalence and associations with atherosclerosis and arterial stiffness. 自我测量的家庭直立性低血压和高血压患病率及其与动脉粥样硬化和动脉僵硬的关系。

IF 3.1 3区医学

American Journal of Hypertension Pub Date : 2025-08-30 DOI: 10.1093/ajh/hpaf167

F Frey, P Af Geijerstam, F Iredahl, K Rådholm, C J Östgren, F H Nyström, M O Wijkman

{"title":"Self-measured home orthostatic hypo- and hypertension - prevalence and associations with atherosclerosis and arterial stiffness.","authors":"F Frey, P Af Geijerstam, F Iredahl, K Rådholm, C J Östgren, F H Nyström, M O Wijkman","doi":"10.1093/ajh/hpaf167","DOIUrl":"https://doi.org/10.1093/ajh/hpaf167","url":null,"abstract":"Background: Orthostatic blood pressure (BP) dysregulation measured in-office predicts cardiovascular risk. However, the prevalence of self-measured home orthostatic hypo- and hypertension, and their association with markers of atherosclerosis have not yet been described in a large sample of the general population.Methods: We performed cross-sectional analyses of home orthostatic BP reactions and pulse wave velocity (PWV), coronary artery calcium score (CACS), and carotid plaques in 4556 Swedish CArdioPulmonary bioImage Study (SCAPIS) participants who had performed home BP measurements and two home standing BP measurements Omron M10-IT device). Home orthostatic hypotension (home OH) was defined as drop in BP after standing of systolic ≥20 mmHg or diastolic ≥10 mmHg, home orthostatic hypertension (home OHT) as an increase in systolic BP after standing of ≥20 mmHg.Results: Participants with home OH (n=293, 6.4%) or OHT (n=139, 3.1%) were more likely than participants with normal home orthostatic BP reactions to have ≥1 carotid plaque (65.5% and 64.7% vs. 55.3%, P<0.001 and P=0.027). Participants with home OH had higher PWV (9.2±1.4 vs. 8.9±1.3 m/s, P=0.005) and were more likely to have CACS ≥100 (17.4 vs. 11.6%, P=0.004). No such associations were observed for home OHT.Conclusions: Self-measured home orthostatic hypo- and hypertension were associated with markers of atherosclerosis, and home orthostatic hypotension was also associated with arterial stiffness.","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939101","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}

引用次数: 0