American Journal of Hypertension最新文献

{"title":"The Role of Renal Denervation in the Treatment of Hypertension in Canada: A Case-Based Discussion from the Canadian Hypertension Specialists Society.","authors":"Raj S Padwal, Michael Dorsch, Sheldon Tobe, Jennifer Ringrose, Ernesto L Schiffrin, Ross D Feldman, Bhanu Prasad, Alexander A Leung, Lisa Dubrofsky, Karen C Tran, Mina Madan, Lindsay Machan, Nadia Khan","doi":"10.1093/ajh/hpaf236","DOIUrl":"10.1093/ajh/hpaf236","url":null,"abstract":"<p><p>Over one-third of Canadians with hypertension do not achieve recommended blood pressure (BP) targets despite availability of effective treatments. Renal sympathetic nerve denervation (RDN) is a recently approved, minimally invasive treatment for hypertension being offered in multiple Canadian centers. How best to implement this procedure in contemporary Canadian clinical practice remains unclear. Herein, we provide a Canadian hypertension specialist viewpoint on use of RDN in Canada. We review the rationale for, and evidence supporting, the use of RDN and discuss, using 2 clinical cases, its potential therapeutic role. We note that RDN has effectively lowered BP in multiple, sham-controlled, randomized clinical trials and has a favorable safety profile. Economic models indicate that it is cost-effective in the Canadian context. Conversely, the BP-lowering effect is relatively modest; no well-established method to pre-identify responders exists; cardiovascular endpoint data supporting use of RDN are lacking; and no clear funding model is currently in place in Canada. Accordingly, we suggest that use of RDN be reserved for willing patients with severely elevated BP despite the use of first-line conventional therapies who have had secondary causes excluded. Examples include patients with resistant hypertension or moderate or severe hypertension and multiple drug intolerance syndrome. In view of its recent approval and known operator-dependency, RDN should be offered solely through programmatic, multidisciplinary collaboration between hypertension specialists and experienced interventionalists using a shared decision-making approach with the patient. Funding deployment should target such programs and sites should carefully monitor their outcomes to confirm comparability to the published literature.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"735-743"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145686730","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":"Clinician Fidelity with Hypertension Quality Improvement Program is Associated with Blood Pressure Control within a Clinician-Patient Panel.","authors":"Matthew Dimond, Talar W Markossian, Beatrice D Probst, Katherine Habicht, Holly J Kramer","doi":"10.1093/ajh/hpaf240","DOIUrl":"10.1093/ajh/hpaf240","url":null,"abstract":"<p><strong>Background: </strong>Differences in clinician fidelity with hypertension quality improvement (QI) interventions may influence blood pressure (BP) control.</p><p><strong>Methods: </strong>This analysis included data from 35,115 patients with 89,230 clinical encounters during a calendar year conducted by 87 physicians, 7 advanced practice nurses, and 173 residents to examine the association of fidelity measures with QI interventions and BP control for a clinician-patient panel. BP control (BP < 140/90 mm Hg) was based on vital signs at last clinic visit. The QI program fidelity measures included (1) documented automated office BP (AOBP) to confirm initial elevated BP, (2) 30-day follow-up visits when clinic BP is uncontrolled, (3) appropriate escalation of medications during visits with uncontrolled BP, and (4) use of combination BP-lowering medications. Linear mixed-effects models were used to examine the association of QI program fidelity measure quartiles with patient panel BP control, while adjusting for patient panel characteristics.</p><p><strong>Results: </strong>The mean patient age was 63.2 years (SD 12.8), 45.1% were men; race/ethnicity was Non-Hispanic (NH) White in 60.5%, NH Black in 20.3%, and Hispanic in 14.0%. Average patient panel BP control rate was 69.1%. After adjustment, the highest AOBP and 30-day follow-up visit quartiles were associated with a 15.1% (95% CI, 8.9%-21.4%) and 12.3% (95% CI, 6.8%-17.7%) higher percentage of clinician-patient panels with controlled BP compared to the lowest quartile. No association was noted with other fidelity measures and BP control.</p><p><strong>Conclusion: </strong>Increasing fidelity with hypertension QI interventions may help clinicians improve BP control rates within their patient panel.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"820-828"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13189694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145754694","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":"Central and Brachial Pressures: Effects on Arterial Stiffness in Older Adults.","authors":"Sakar Gupta, Timothy Hess, Amy Hein, Claudia E Korcarz, Justyn Nguyen, Akinwale Iyeku, Jeremy R Williams, Molly A Cole, Ryan Pewowaruk, Adam D Gepner","doi":"10.1093/ajh/hpaf234","DOIUrl":"10.1093/ajh/hpaf234","url":null,"abstract":"<p><strong>Background: </strong>Using brachial blood pressure (BP) as a surrogate for central BP when calculating carotid arterial stiffness (CAS) has not been studied in older adults.</p><p><strong>Methods: </strong>Veterans (n = 180) age 60+ were recruited from Madison VA Hospital. Resting supine brachial and central BP (estimated from radial artery waveforms, Atcor Medical) were obtained. Right common carotid diameters were measured using ultrasound (Philips CX50, L12-3 transducer) after a transverse sweep to identify plaque presence to optimize longitudinal angle of approach free of plaque. CAS (Peterson's elastic modulus [PEM], Young's elastic modulus [YEM]) and distensibility coefficient (DC) were calculated using brachial and central BP. Differences in CAS were compared using paired Wilcoxon tests. Linear regression models evaluated associations with cardiovascular risk factors.</p><p><strong>Results: </strong>Participants were 70.4 (7.7) years old and 27.8% were female. Average brachial systolic BP was significantly higher than central (132.3 [18.6] mm Hg vs. 123.8 [17.7] mm Hg P < .001). Compared to brachial BP, using central BP to calculate stiffness measures resulted in significantly lower YEM and PEM and significantly higher DC (PEM: 480.6 [209.5] mm Hg vs. 378.3 [178.4] mm Hg; YEM: 2220.2 [926.6] mm Hg vs. 1746.9 [785.4] mm Hg; DC: 2.4 [1.0] × 10-3 mm Hg-1 vs. 3.1 [1.1] × 10-3 mm Hg-1; all P < .001). Absence of hypertension was associated with smaller differences in PEM (β = -26.02, SE = 12.37, P = .04), while older age was associated with greater differences in DC when calculated using brachial vs. central BP (β  = 2.09 × 10-5, SE = 0.67 × 10-5, P = .002).</p><p><strong>Conclusions: </strong>Brachial and central BP differ in older adults and result in significant differences in calculated CAS and distensibility. Brachial BP overestimates CAS, especially in hypertensive adults.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"750-756"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145740657","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":"Geriatric Nutritional Risk Index in Relation to Ambulatory Blood Pressure in Elderly Patients with Hypertension.","authors":"Dian Wang, Jian-Zhong Xu, Yuan-Yuan Kang, Wei Zhang, Jia-Hui Xia, Ji-Guang Wang","doi":"10.1093/ajh/hpaf239","DOIUrl":"10.1093/ajh/hpaf239","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition may negatively influence cardiovascular outcomes. We investigated the association between geriatric nutritional risk index (GNRI) and ambulatory blood pressure in elderly patients with hypertension.</p><p><strong>Methods: </strong>Our study included 235 elderly hypertensive patients with malnutrition (GNRI ≤98) and 391 patients with normal nutrition (GNRI > 98). All patients underwent ambulatory blood pressure monitoring and assessment of nutritional status including total protein, prealbumin, and serum albumin.</p><p><strong>Results: </strong>Patients with malnutrition, compared with normal nutrition, were older, and had a significantly (P ≤ .05) higher serum creatinine, and lower body weight, estimated glomerular filtration rate, serum low density lipoprotein cholesterol, serum total protein, prealbumin, and albumin, body mass index and GNRI (P ≤ .01). After multivariable adjustment, malnourished patients had significantly higher 24-h, daytime and nighttime systolic blood pressure (P ≤ .001). Lower GNRI was independently associated with higher 24-h, daytime and nighttime systolic blood pressure after adjustment for confounding factors (P < .05).</p><p><strong>Conclusions: </strong>Elderly hypertensive patients with malnutrition had higher systolic blood pressure than those with normal nutrition. GNRI was associated with 24-h, daytime and nighttime systolic blood pressure.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"800-805"},"PeriodicalIF":2.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145761537","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":"Factors Associated with the Failure to Achieve Nocturnal Blood Pressure Control.","authors":"Tatsuya Maruhashi, Yoshihiko Kinoshita, Ryoji Ozono, Mitsuaki Nakamaru, Masanori Ninomiya, Jiro Oiwa, Takuji Kawagoe, Osamu Yoshida, Toshiyuki Matsumoto, Yasuo Fukunaga, Kotaro Sumii, Hironori Ueda, Nobuo Shiode, Kosuke Takahari, Yasuhiko Hayashi, Yujiro Ono, Yukiko Nakano, Masakazu Takahashi, Yasuki Kihara, Yukihito Higashi","doi":"10.1093/ajh/hpaf225","DOIUrl":"10.1093/ajh/hpaf225","url":null,"abstract":"<p><strong>Background: </strong>The Hiroshima Registry for Evaluation and Treatment of Nocturnal and Early Morning Hypertension (Hiroshima NOCTURNE) was a prospective, multicenter study designed to determine whether elevated nighttime blood pressure (BP), assessed using a home BP monitoring (HBPM) device, can be normalized through active antihypertensive therapy in patients already receiving antihypertensive medication. In this subanalysis, we aimed to identify factors associated with failure to normalize nocturnal hypertension.</p><p><strong>Methods: </strong>Patients with nocturnal hypertension at baseline who underwent a 6-month intervention based on nighttime BP were included. Nocturnal hypertension was defined as a mean nighttime systolic BP of ≥120 mmHg. Treatment decisions were left to the discretion of the attending physicians.</p><p><strong>Results: </strong>Among the 90 patients with baseline nocturnal hypertension, 42 (46.7%) failed to achieve normalization (<120 mmHg) after the intervention. In the multivariable analysis, higher baseline nighttime systolic BP (OR 1.07, 95% CI, 1.001-1.15, P = .046) and baseline diuretic use (OR 3.99, 95% CI, 1.17-13.6, P = .03) were significantly associated with failure to normalize nocturnal hypertension. Diabetes mellitus tended to be associated with the failure to normalize nocturnal hypertension (OR 3.01, 95% CI, 0.93-9.72, P = .06). Participants using diuretics at baseline and those with diabetes mellitus were already receiving multiple antihypertensive medications, and additional drug classes were not often prescribed during the intervention.</p><p><strong>Conclusions: </strong>In patients already receiving antihypertensive medication, failure to normalize nocturnal hypertension despite treatment guided by nighttime BP measurements was associated with elevated baseline nighttime BP, diuretic use, and possibly diabetes mellitus. These findings highlight the need for more individualized therapeutic approaches, particularly in patients receiving diuretics or those with diabetes mellitus.</p><p><strong>Clinical trial registration: </strong>University Hospital Medical Information Network Clinical Trials Registry (UMIN000019173).</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"723-731"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547729","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":"Current Landscape of Mobile Health Applications for Hypertension Management in the United States: A Scoping Application Review.","authors":"Shreeya R Joshee, Kyra Dingle, Jeffrey E Jones, Arun Umesh Mahtani, Dhruvil Ashishkumar Patel, Stephen P Juraschek, Timothy B Plante, Tammy M Brady, Jiun-Ruey Hu","doi":"10.1093/ajh/hpaf243","DOIUrl":"10.1093/ajh/hpaf243","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension, a major contributor to cardiovascular mortality, requires multimodal monitoring and management strategies for optimal blood pressure (BP) control. Patients are turning toward mobile health (mHealth) applications to manage hypertension which vary widely in design and regulation. This study examines the landscape of hypertension mHealth applications on Apple App Store and Google Play Store and qualitatively evaluates their functionality and security features from patient and clinician perspectives.</p><p><strong>Methods: </strong>Publicly available applications were identified using keyword \"hypertension\" on the Apple App Store and Google Play Store or in a recent meta-analysis that met specific review criteria. Applications with <1000 reviews (Apple App Store) or <10,000 reviews (Google Play Store) were excluded to capture the top 5% of applications with high public use. Of >700 applications, 43 underwent full application screening and 18 were reviewed for general information, storage, revenue models, security, patient/clinician interfaces, and associated research. Discrepancies were resolved through consensus and available manufacturer confirmation.</p><p><strong>Results: </strong>Clinician interfaces were largely absent, with limited EMR integration and alert systems. Revenue models ranged from free to subscription-based. Security and data privacy policies varied with applications lacking clear opt-out options for data collection. Patient interfaces offered BP tracking and reminders, and accessibility features. Sentiment analysis showed an overall positive view of frequently reviewed Google Play Store applications.</p><p><strong>Conclusions: </strong>Current mHealth applications lack several features for optimal hypertension monitoring and management. Based on the range of qualitative application features assessed, we formulate a framework for developing an ideal mHealth application for optimal hypertension management.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"632-644"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145761582","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":"Association of Socioeconomic Position with Incident Hypertension Hospitalization and Blood Pressure Control among Participants in the Coronary Artery Risk Development in Young Adults Study.","authors":"Lama Ghazi, Cora E Lewis, Byron C Jaeger, Catarina I Kiefe, Kathryn Foti, Kelley P Gabriel, Norrina B Allen, Marwah Abdalla, Phillip D Levy, Shakia T Hardy, Paul Muntner","doi":"10.1093/ajh/hpaf231","DOIUrl":"10.1093/ajh/hpaf231","url":null,"abstract":"<p><strong>Background: </strong>The rate of hypertension hospitalizations is increasing among US adults. Individuals with low socioeconomic position are more likely to have high blood pressure (BP), which may increase their risk of hypertension hospitalization and adverse post-discharge outcomes.</p><p><strong>Methods: </strong>We analyzed data from the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study, which enrolled 5115 adults aged 18 to 30 years from 4 urban US communities in 1985-1986. Hospitalizations were identified by self-report during study exams and annual interviews, with hypertension hospitalizations determined through medical record review, through August 2020. Socioeconomic position included education, family income, having private health insurance, and neighborhood deprivation assessed at the last study visit prior to the hypertension hospitalization. Uncontrolled BP (≥140/90 mmHg) was determined at the first CARDIA study visit after hypertension hospitalization.</p><p><strong>Results: </strong>Overall, 67 CARDIA participants were hospitalized for hypertension. The hazard ratio of hypertension hospitalization among participants who had less than high school vs high school or more education was 3.12 [95% CI, 1.78-5.48], whose family income was <$25,000 vs ≥$25,000 was 2.43 [95% CI, 1.44-4.11], who had no private vs private insurance was 2.58 [95% CI, 1.56-4.28] and those in tertile 3 vs tertile 1 of neighborhood deprivation index (most vs least deprived) was 3.06 [95% CI, 1.23-7.58]. Among 46 participants who attended a CARDIA study visit following hospital discharge, 23 (50%) had uncontrolled BP.</p><p><strong>Conclusion: </strong>Adults with low socioeconomic position were more likely to be hospitalized for hypertension. Uncontrolled BP was common following hypertension hospitalization.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"687-695"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13168809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145627566","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":"Improving Blood Pressure Management and Control With Out-of-Office Blood Pressure Monitoring.","authors":"James Nugent, Edem K Binka, Tammy M Brady","doi":"10.1093/ajh/hpaf222","DOIUrl":"10.1093/ajh/hpaf222","url":null,"abstract":"<p><p>Out-of-office blood pressure (BP) monitoring is a critical component of modern hypertension diagnosis and management. Measuring BP outside of clinic reduces the stress response that contributes to white coat hypertension and also allows for the identification of masked hypertension, yielding more accurate cardiovascular disease (CVD) risk assessment and improved CVD prevention. Home BP monitoring and 24-hour ambulatory BP monitoring outperform office BP in predicting CVD outcomes and are cost-effective aspects to cardiovascular health promotion by preventing unnecessary treatment, reducing clinic visits, and lowering event-related costs. Despite these advantages, routine implementation remains limited due to patient, provider, and system-level barriers, including validated device access, workflow integration, patient-provider communication tools, and adherence. Efforts to minimize or eliminate these barriers are crucial to CVD prevention. Evidence is also needed to support alternative out-of-office BP measurement strategies, including community-based strategies, such as BP assessment by school nurses, pharmacists, or community health workers. The utility of these modalities in diagnosing and managing children with hypertension is greatly needed as the long-term prognostic data in this population are sparse. Expanding adoption and evidence for out-of-office monitoring is essential to optimize hypertension care and CVD risk reduction.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"623-631"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145476694","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":"Implementation of a Self-Measured Blood Pressure Pilot Program in an Academic Internal Medicine Practice.","authors":"Jennifer L Cluett, Rosemary Farahmand, Laken Barkowski, Marc Cohen, Jonathan Li, Ruthie Olowoyeye, Michael Rakotz, Neha Sachdev, Kristine Sullivan, Katherine Tighe Miller, Stavros Tsipas, Gregory Wozniak, Stephen P Juraschek","doi":"10.1093/ajh/hpaf219","DOIUrl":"10.1093/ajh/hpaf219","url":null,"abstract":"<p><strong>Background: </strong>Self-measured blood pressure (SMBP) monitoring is a proposed strategy to improve hypertension control, but few studies compare SMBP with automated office blood pressure (AOBP) measurements over time. Moreover, little is known about reimbursement for these services.</p><p><strong>Methods: </strong>We describe a quality improvement initiative in our academic internal medicine practice. Patients received validated home blood pressure (BP) devices and were instructed to check their BP twice daily for 7 days each month. Devices transmitted readings seamlessly via a smartphone application that averaged weekly readings. Clinicians reviewed the data and adjusted therapy if indicated. We tracked changes in SMBP, AOBP, antihypertensive medications, and reimbursement.</p><p><strong>Results: </strong>Among 140 patients referred (mean age 57.6 years, 57.1% women, 25.7% Black), 59 completed the program. Over 6 months, the mean self-measured systolic BP decreased by 5.8 mm Hg (95% CI: -8.2 to -3.5) and the mean diastolic BP decreased by 2.8 mm Hg (95% CI: -4.2 to -1.4) and the number with BP <130/<80 mm Hg increased by 22 percentage points (P = 0.007). However, unattended AOBP showed no change in either systolic (change: 0.1 mm Hg; P = 0.98) or diastolic (change: -0.6 mm Hg; P = 0.64) readings. Reimbursement was variable and ranged from no payment to a maximum payment of $51; when paid, the average payment was $13.81.</p><p><strong>Conclusions: </strong>In this program, SMBP decreased over time while AOBP remained similar. Reimbursement, when received, was modest. Future work should evaluate whether using SMBP as a therapeutic target reduces cardiovascular events.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"661-669"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145547652","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":"Linking Inflammation to Nondipper Hypertension: Diagnostic Utility of Neutrophil Percentage-to-Albumin Ratio.","authors":"Görkem Yıldız, Hasan Ata Bolayır","doi":"10.1093/ajh/hpaf245","DOIUrl":"10.1093/ajh/hpaf245","url":null,"abstract":"<p><strong>Background: </strong>Hypertension (HT) constitutes a pervasive global health challenge, standing as a principal contributor to cardiovascular morbidity and mortality. Limited data are available regarding the relationship between neutrophil percentage-to-albumin ratio (NPAR) and nondipper HT. we aimed to investigate whether NPAR is independently associated with nondipper status in newly diagnosed hypertensive patients.</p><p><strong>Methods: </strong>Prospectively, 160 hypertensive patients were included in the study. After a 24-h ABP monitoring assessment, the patients were divided into 2 groups, a dipper group and a nondipper group, and 80 healthy control subjects were enrolled in the study. Baseline laboratory and echocardiographic parameters were measured and then the NPAR was calculated.</p><p><strong>Results: </strong>Levels of white blood cell, neutrophil-to-lymphocyte ratio, and high-sensitivity C-reactive protein (hs-CRP) were significantly higher in patients with nondipper HT than dipper HT and control subjects. Echocardiographic assessments revealed that the left ventricular (LV) wall was thicker and LV mass index was higher in the hypertensive group than the control group. NPAR levels were significantly different among the 3 groups (P < .001) and also the multivariate analysis revealed that higher NPAR and hs-CRP levels were independently associated with a nondipping pattern. Receiver operating characteristic analysis showed that NPAR levels higher than 22.2 can predict nondipping status (P < .001).</p><p><strong>Conclusions: </strong>Our study shows that higher NPAR levels are independently associated with nondipper HT in newly diagnosed hypertensive patients. These findings emphasize the role of inflammation in the pathophysiology of circadian BP variation and suggest that NPAR may serve as a useful tool in identifying hypertensive patients at higher risk for cardiovascular complications.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"677-683"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809057","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}