American Journal of Hypertension最新文献

{"title":"Effect of very low-intensity resistance exercise on aortic-brachial blood pressure disparity in young men.","authors":"Kaname Tagawa, Junichiro Hashimoto","doi":"10.1093/ajh/hpaf172","DOIUrl":"https://doi.org/10.1093/ajh/hpaf172","url":null,"abstract":"<p><strong>Background: </strong>Resistance exercise is accompanied by pronounced elevations in pulse pressure during and following exercise. Whether an increase in aortic pulse pressure during resistance exercise is mitigated by a reduction in exercise intensity remains uncertain. We examined the effects of resistance exercise at 10% and 40% one-repetition maximum on aortic pulse pressure.</p><p><strong>Methods: </strong>Sixteen participants performed resistance exercise to exhaustion at 10% and 40% of one-repetition maximum, along with a sham control, on separate days in a randomized controlled crossover design. Brachial pressure waveforms were recorded using the SphygmoCor XCEL device to estimate the aortic pulse pressure, forward and backward pressure amplitudes, and augmentation index both prior to resistance exercise or equivalent seated rest and at 3-min post-intervention.</p><p><strong>Results: </strong>An increase in aortic pulse pressure following resistance exercise was smaller at 10% one-repetition maximum compared to 40% one-repetition maximum (p = 0.02), whereas the rise in brachial pulse pressure did not differ between these intensities. The increases in backward pressure amplitude and augmentation index were smaller at 10% one-repetition maximum (both, p<0.05), while forward pressure amplitude remained consistent across intensities.</p><p><strong>Conclusion: </strong>These findings highlight disparities in post-exercise pulse pressure responses between the aortic and brachial arteries, which can be attributed to differences in backward pressure amplitude. The beneficial effects of 10% one-repetition maximum resistance exercise became evident when assessing aortic pressure waveforms. To attenuate excessive increases in aortic pulsatile pressure stress during and after resistance exercise, 10% one-repetition maximum may serve as a relatively low-risk intensity.</p>","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":"144939106","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":"Central pressure variability after low-level tragus stimulation in acute decompensated heart failure.","authors":"Michiaki Nagai, Keigo Dote, Masaya Kato, Shota Sasaki, Noboru Oda, Sunny S Po, Tarun W Dasari","doi":"10.1093/ajh/hpaf164","DOIUrl":"https://doi.org/10.1093/ajh/hpaf164","url":null,"abstract":"<p><strong>Background: </strong>Increased variability in central aortic systolic pressure (CASP) and pulse pressure (PP) are predictors of poor cardiovascular disease outcomes. Low-level tragus stimulation (LLTS) is a noninvasive method to reduce sympathetic tone via vagal afferent fibers. It is unknown if LLTS has a favorable effect on elevated variability in CASP and PP in patients with acute decompensated heart failure (HF) (ADHF).</p><p><strong>Methods: </strong>Patients hospitalized for ADHF after initial stabilization (median 80 yrs, males 60%) were randomly assigned to active or sham group, and LLTS (20Hz, 1mA) was delivered using an ear clip attached to the tragus (active group) or the earlobe (sham group) for 1 hour daily over 5 days. Variability of PP and CASP were measured before and after each stimulation.</p><p><strong>Results: </strong>Each of SD, CV and δ in PP, CASP and radial augmentation index (rAI), %PP variation (PPV) and PP × heart rate (HR) was significantly decreased after stimulation in the active group (n=8) (all p<0.05), while δ in CASP was significantly increased after stimulation in the sham group (n=8) (p<0.05). All the changes in SD, CV and δ in PP, CASP and rAI, %PPV and PP×HR before and after stimulation were also significantly different between active and sham groups (all p<0.05).</p><p><strong>Conclusions: </strong>In this proof-of-concept study, LLTS led to a better hemodynamic profile, as evident in variability reduction in PP, CASP and rAI. Further studies are warranted to study the long-term hemodynamic effects of LLTS on HF.</p>","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":"144939154","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":"Intersection of Social Vulnerability, Social Drivers, and Race on Hypertension Control.","authors":"J J Beuschel, R L Roll, M Strawderman, J S Clark, R J Fortuna","doi":"10.1093/ajh/hpaf166","DOIUrl":"https://doi.org/10.1093/ajh/hpaf166","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a leading contributor to morbidity and mortality, disproportionately affecting vulnerable populations. We examined the intersection of social vulnerability and race on blood pressure (BP) control.</p><p><strong>Methods: </strong>We examined 76,600 patients with hypertension in Western New York State. BP control was defined according to the Healthcare Effectiveness Data and Information Set (HEDIS) as BP<140/90 mmHg. We utilized social vulnerability index (SVI) scores based on each patient's census tract. Log-binomial regression was used to estimate the independent effects of demographic characteristics on the prevalence of uncontrolled blood pressure. Models were adjusted for race, SVI group, age, sex, marital status, and community type. For a convenience subset of patients, we also assessed patient-reported health-related social needs.</p><p><strong>Results: </strong>Uncontrolled blood pressure among patients differed by race (White 27.7%; Black 41.3%) and increasing social vulnerability. The adjusted risk ratio (aRR) for uncontrolled BP in Black vs White patients by SVI group was SVI 0-24: 1.08 (CI 0.98-1.18); SVI 25-49: 1.30 (CI 1.22-1.38); SVI 50-74: 1.35 (CI 1.27-1.43); and SVI 75-100: 1.25 (CI 1.18-1.32). Black patients reporting food insecurity had a higher prevalence of uncontrolled BP than White patients with similar food insecurity (Black 39.2%; White 28.1%). Similar disparities were seen with housing insecurity (Black 42.3%; White 29.8%); and unmet transportation needs (46.3% Black; 30.0% White).</p><p><strong>Conclusions: </strong>The impact of increased social vulnerability was experienced disproportionately by Black patients. Among patients living in the most socially vulnerable census tracts, Black patients had 25-35% increased risk of uncontrolled blood pressure compared to White patients.</p>","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":"144939131","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":"Is it time to retire confirmatory testing for primary aldosteronism?","authors":"G A Kline, A A Leung, D Orton, J MacFarlane, M Gurnell","doi":"10.1093/ajh/hpaf163","DOIUrl":"https://doi.org/10.1093/ajh/hpaf163","url":null,"abstract":"<p><p>Primary aldosteronism(PA) is the most common endocrine hypertension. For decades, PA diagnosis has required proving non-suppressibility of aldosterone following manoeuvres modulating the renin-angiotensin-aldosterone pathway. This includes oral salt suppression, intravenous saline suppression, captopril suppression and others. Grounded in rational first principles from pathophysiologic considerations and small, early pathophysiologic studies following Conn's initial PA description, such testing has been widely recommended. However, a modern understanding of PA pathophysiology and critical appraisal of diagnostic test studies suggests that traditional suppression testing is not suited to diagnosis or disease definition. There are four main problems recently raised regarding aldosterone suppression testing: 1)PA is now known to exist along a continuous biochemical spectrum and it is scientifically impossible to draw a single, diagnostic threshold within this continuum. 2)Aldosterone assay uncertainty is sufficiently large to yield contradictory final diagnoses when applied to a threshold during suppression testing. 3)The pathophysiology of PA is multi-factorial with multiple mechanisms not necessarily relevant to salt and volume loading tests. 4)Finally, meta-analysis of suppression testing studies demonstrated extensive biases and confounders which have over-estimated the diagnostic value. A recent prospective, blinded study of saline suppression for PA diagnosis defined by medical or surgical response to PA-targeted therapy showed no discrimination according to nadir aldosterone level. Given the clinical value of a PA diagnosis and the high prevalence of the disease, modern evidence suggests that aldosterone suppression testing should now be retired from the diagnostic pathway; new ways of approaching the definition of PA are provided to spur further discussion.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939141","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":"New-Onset Atrial Fibrillation and Hypertension in East Asian Population: Emerging Insights and Clinical Implications.","authors":"Amir Askarinejad, Gregory Y H Lip, Alena Shantsila","doi":"10.1093/ajh/hpaf162","DOIUrl":"https://doi.org/10.1093/ajh/hpaf162","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939139","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":"Associations of blood pressure fluctuation patterns with cognitive function: the mediating role of cumulative blood pressure.","authors":"Lixia Lin, Bingqing Lu, Huanzhuo Wang, Yanmei Zhang, Yi Jiang, Yuping Shao","doi":"10.1093/ajh/hpaf161","DOIUrl":"https://doi.org/10.1093/ajh/hpaf161","url":null,"abstract":"<p><strong>Background: </strong>The impact of different fluctuation patterns of blood pressure (BP) on episodic memory remains underexplored, and the role of cumulative BP in this association remains unclear.</p><p><strong>Methods: </strong>Using data from the China Health and Retirement Longitudinal Study, 6563 participants aged 45 years or more were analyzed. BP was measured in wave 1 (2011), wave 2 (2013), and wave 3 (2015). Cumulative systolic BP (SBP) during wave 1-3 (area under the curve) and the SBP difference between wave 1-2 and wave 2-3 were calculated. Then, SBP differences in the two intervals were used to identify patterns by K-means cluster analysis. Episodic memory, including immediate and delayed memory, was assessed in wave 4 (2018). Linear regression and mediation analysis were conducted, with multivariable adjustment.</p><p><strong>Results: </strong>Three fluctuation patterns of SBP were identified, characterized as an increase-decrease (19.9%), decrease-increase (25.7%), and stable (54.4%) pattern. Before cumulative SBP adjustment, compared to the stable SBP pattern, the β (95% CIs) for episodic memory at wave 4 was -0.14 (-0.27, -0.01) for immediate memory, -0.12 (-0.31, 0.06) for delayed memory, and -0.27 (-0.57, 0.03) for total memory in the increase-decrease SBP pattern, and -0.06 (-0.18, 0.07), 0.01 (-0.15, 0.18), and -0.03 (-0.30, 0.25) in the decrease-increase SBP pattern. The overall association between the increase-decrease SBP pattern and immediate memory was partly mediated by cumulative SBP (29%).</p><p><strong>Conclusion: </strong>The increase-decrease pattern of SBP was associated with lower immediate memory three years later, and cumulative SBP partly mediated the association.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939082","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":"Associations of Blood Pressure Level and Variability with Cortical Thickness: A Cross-Sectional Analysis from The Maracaibo Aging Study.","authors":"Romeo De Leon, Shana Garza, Silvia Mejia-Arango, Kristina P Vatcheva, Sokratis Charisis, Claudia Satizabal, Luis J Mena, Joseph H Lee, Joseph D Terwilliger, Eron Manusov, Sudha Seshadri, Jose Gutierrez, Gladys E Maestre, Adam M Brickman, Jesus D Melgarejo","doi":"10.1093/ajh/hpaf159","DOIUrl":"https://doi.org/10.1093/ajh/hpaf159","url":null,"abstract":"<p><strong>Background: </strong>Although high blood pressure (BP) level and variability are associated with Alzheimer's Disease (AD), their relationship with cortical thickness in brain regions that are associated with AD is unclear. Furthermore, the role of 24-hour BP has not been examined. We investigated the associations of office and ambulatory BP measures with cortical thickness in brain regions implicated in AD.</p><p><strong>Methods: </strong>We performed a cross sectional analysis of 304 participants without dementia from a population-based study with office and 24-hour BP and magnetic resonance imaging (MRI) data. We considered cortical thickness values derived from 10 regions throughout the frontal, parietal, and temporal lobes, and posterior cingulate cortex that are associated with risk and progression of AD. The association between BP and cortical thickness was tested using adjusted linear regression models.</p><p><strong>Results: </strong>The mean age was 58.1y and 231 (76%) were women. Higher office systolic BP was associated with thinner temporal (β=-0.059; 95% confidence interval [CI], -0.112,-0.005) and posterior cingulate cortex (β=-0.095; 95% CI, -0.145,-0.045). 24-hour and nighttime BP levels were associated with thinner seven regions, with β-estimates ranging from 0.103 (95% CI, -0.182,-0.012) to -0.045 (95% CI, -0.080,-0.010). A higher 24-hour BP variability was associated with thinner middle frontal (β=-0.156; 95% CI, -0.282,-0.030) and middle temporal (β=-0.146; 95% CI, -0.268,-0.024) gyri, and posterior cingulate cortex (β=0.134; 95% CI, 0.026,-0.009).</p><p><strong>Conclusions: </strong>Increased ambulatory BP level and variability are associated with cortical thinning in regions associated with AD. Better BP evaluation with out-of-office approaches might reduce brain structural changes associated with AD.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939134","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":"Joint Contribution of Mid-Trimester Systolic and Diastolic Blood Pressure to Co-occurring Adverse Pregnancy Outcomes: A Cohort Study.","authors":"Yiwen Fang, Huaxi Chen, Jingbo Yang, Ruimin Zhang, Hongli Duan, Chuanyi Huang, Lushu Zuo, Xueli Yang, Qing Yang, Lijuan Lv, Cha Han, Xin Zhou","doi":"10.1093/ajh/hpaf160","DOIUrl":"https://doi.org/10.1093/ajh/hpaf160","url":null,"abstract":"<p><strong>Background: </strong>To examine how mid-trimester systolic blood pressure (SBP) and diastolic blood pressure (DBP) levels, considered both independently and jointly, are associated with individual and co-occurring adverse pregnancy outcomes (APOs).</p><p><strong>Methods: </strong>We analyzed two cohorts from northern and southern China, consisting of 78,891 singleton pregnancies. Mid-trimester (20-28 weeks' gestation) SBP and DBP were evaluated as qualitative classifications (isolated systolic, isolated diastolic, and systolic-diastolic hypertension) and quantitative measurements (levels of SBP/DBP and pulse pressure). Using two-dimensional SBP-DBP heat maps, we assessed their associations with major APOs (gestational diabetes mellitus [GDM], preterm birth, small for gestational age [SGA], postpartum hemorrhage [PPH], placental abruption [PA], and severe preeclampsia) by latent class analysis (LCA).</p><p><strong>Results: </strong>LCA identified four latent APO classes: (1) preterm placental dysfunction, with 100% preterm birth, 26.6% SGA, 21.4% GDM and 13.2% severe preeclampsia, associated with concurrent SBP-DBP association (SBP+/DBP+); (2) term placental dysfunction, with 44.0% PPH, 34.0% PA, 25.2% severe preeclampsia and no preterm birth, associated with DBP elevation (DBP+); (3) term GDM, with 100% probability for GDM, no preterm birth and minimal other APOs, associated with SBP elevation (SBP+) and wider pulse pressure; (4) term SGA, with 100% SGA, 16.2% GDM and no preterm birth, associated with a divergent changes in SBP and DBP (SBP-/DBP+) and narrower pulse pressure.</p><p><strong>Conclusions: </strong>Mid-trimester SBP and DBP interact in distinct patterns to influence co-occurring APO risks. This study demonstrates the independent and joint influence of BP components on risk, emphasizing the role of BP stratification in guiding pregnancy management strategies.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939174","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":"Commentary: The Hemodynamic Basis of Hypertensive Vasculopathy, Heart Failure, and Chronic Kidney Disease.","authors":"Joseph L Izzo, Sambasiva R Srungavarapu","doi":"10.1093/ajh/hpaf139","DOIUrl":"https://doi.org/10.1093/ajh/hpaf139","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939157","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":"Hypertension and Racial/Ethnic Disparities in Sleep Outcomes among Adults in the 2011-2023 National Health and Nutrition Examination Survey.","authors":"Faith E Metlock, Oluwabunmi Ogungbe, Ketum Ateh Stanislas, Xiaoyue Liu, Thomas Hinneh, Ruth-Alma N Turkson-Ocran, Binu Koirala, Cheryl R Himmelfarb, Yvonne Commodore-Mensah","doi":"10.1093/ajh/hpaf110","DOIUrl":"https://doi.org/10.1093/ajh/hpaf110","url":null,"abstract":"<p><strong>Background: </strong>Racial/ethnic disparities in sleep outcomes may compound cardiovascular health (CVH) risks, particularly among adults with hypertension (HTN). This study examines differences in sleep health across racial/ethnic groups, with a primary focus on adults with HTN.</p><p><strong>Methods: </strong>We analyzed NHANES data (2011-2023) for adults aged ≥20 years. Sleep outcomes included daytime sleepiness (2015-2020), sleep duration (2011-2023), and sleep quality (2011-2020). HTN was defined as blood pressure ≥130/80 mmHg, self-reported diagnosis, or antihypertensive use. Regression models assessed associations between race/ethnicity and each sleep outcome, adjusting for relevant covariates. Analyses were stratified by HTN status to examine differences among adults with and without HTN. All models incorporated NHANES sampling weights and accounted for the complex survey design.</p><p><strong>Results: </strong>Among ~201.7 million US adults (mean age: 48.0 ± 17.1 years), 52.6% had HTN. Among adults with HTN, NH Black and NH Asian adults had higher odds of short sleep (<7 hours) compared to NH White adults (aOR: 1.86, 95% CI: 1.58-2.21; aOR: 1.58, 95% CI: 1.29-1.93). Odds of poor sleep quality were elevated in NH Asian (aOR: 2.45, 95% CI: 2.09-2.89), NH Black (aOR: 1.47, 95% CI: 1.29-1.67), and Mexican-American/Hispanic adults (aOR: 1.57, 95% CI: 1.34-1.83). In contrast, excessive daytime sleepiness was less common among NH Asian (aOR: 0.17, 95% CI: 0.11-0.25), NH Black (aOR: 0.49, 95% CI: 0.34-0.72), and Hispanic adults (aOR: 0.38, 95% CI: 0.27-0.53) than NH White adults.</p><p><strong>Conclusions: </strong>Racial/ethnic disparities in sleep health are more pronounced among adults with HTN, compounding their overall cardiovascular health risk.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111771","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}