American Journal of Hypertension最新文献

{"title":"Reducing Clinical Inertia in Hypertension Through Primary Care Practitioner-Led Remote Patient Monitoring.","authors":"Ian M Kronish, Sharon Rikin","doi":"10.1093/ajh/hpaf247","DOIUrl":"10.1093/ajh/hpaf247","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"497-499"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145817450","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":"Association of Physical Activity With Aortic Stiffness in the Jackson Heart Study.","authors":"Zakary Patrick, Elizabeth Heitman, Olivia Affuso, Benjamin H Walker, Leroy L Cooper, Jennifer C Reneker","doi":"10.1093/ajh/hpaf230","DOIUrl":"10.1093/ajh/hpaf230","url":null,"abstract":"<p><strong>Background: </strong>Vascular aging, often defined in terms of arterial stiffness and impaired arterial hemodynamics, is an important factor associated with hypertension and CVD. Aortic stiffness, a more particular measure of arterial stiffness focusing on central hemodynamics (ie, the aorta), is an independent predictor of hypertension and CVD risk. Higher levels of physical activity are associated with lower arterial stiffness in various White populations, for peripheral and central measures of stiffness, but further investigations into Black populations are warranted. We examined the association between physical activity and aortic stiffness among participants in the Jackson Heart Study (JHS).</p><p><strong>Methods: </strong>We analyzed data from JHS participants who completed applanation tonometry assessment as part of an ancillary study (2012-2017). A total of 1,226 Black adults (age 59.0 ± 10.0, 60.4% female) were included for analysis. Associations were assessed using multivariable linear regression models, adjusted for age and sex and then further adjusted for other demographic and CVD-related risk factors. Physical activity was measured via self-report, and aortic stiffness was measured by carotid-femoral pulse wave velocity (cfPWV) using applanation tonometry.</p><p><strong>Results: </strong>Higher total physical activity was associated with lower cfPWV when controlling for risk factors associated with arterial and aortic stiffness (estimated B = -0.96; 95% CI: -1.59 to -0.33). When considering American Heart Association physical activity recommendations (ie, ideal activity vs. not meeting recommendations), this relationship remained.</p><p><strong>Conclusion: </strong>Higher levels of physical activity were associated with lower levels of aortic stiffness in the Jackson Heart Study.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"547-553"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145581811","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":"Active Bodies, Healthier Arteries: Physical Activity and Aortic Stiffness in Black Americans.","authors":"Keith C Norris, Roland J Thorpe","doi":"10.1093/ajh/hpaf244","DOIUrl":"10.1093/ajh/hpaf244","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"494-496"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145802949","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":"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":"10.1093/ajh/hpaf172","url":null,"abstract":"<p><strong>Background: </strong>Resistance exercise (RE) is accompanied by pronounced elevations in pulse pressure (PP) during and following exercise. Whether an increase in aortic PP during RE 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 PP.</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 PP, forward and backward pressure amplitudes, and augmentation index both prior to resistance exercise or equivalent seated rest and at 3-min postintervention.</p><p><strong>Results: </strong>An increase in aortic PP following resistance exercise was smaller at 10% one-repetition maximum compared to 40% one-repetition maximum (P = 0.02), whereas the rise in brachial PP 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>Conclusions: </strong>These findings highlight disparities in postexercise PP 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":"554-562"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017699/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SIRT3 Activation by SGLT2 Inhibitor Mitigates Endothelial-To-Mesenchymal Transition in Dahl Salt-Sensitive Rats Induced by High-Salt Diet.","authors":"Xiu-Heng Wang, Jia-Yang Yang, Zheng-Wen Lei, Xue-Ting Zheng, Hui-Yi Xie, Hong Huang, Hui-Fang Tang, Yue Zhao, Zhi-Sheng Jiang, Heng-Jing Hu","doi":"10.1093/ajh/hpaf209","DOIUrl":"10.1093/ajh/hpaf209","url":null,"abstract":"<p><strong>Background: </strong>Salt-sensitive hypertension (SSHT) is associated with reduced expression of SIRT3 and promotes endothelial-mesenchymal transition (EndMT). Sodium-glucose cotransporter 2 (SGLT2) inhibitors, such as dapagliflozin (DAPA), have been shown to ameliorate high-salt-induced hypertension. We hypothesized that DAPA attenuate SSHT-induced EndMT and reduce myocardial fibrosis by upregulating SIRT3 expression. This study aims to provide new insights into the mechanisms underlying the cardioprotective effects of SGLT2 inhibitors in hypertension.</p><p><strong>Methods: </strong>Seven-week-old male Dahl salt-sensitive rats were fed either a high-salt diet (8% NaCl; HSD group), a normal-salt diet (0.3% NaCl; NSD group), or an HSD supplemented with DAPA (2 mg/kg/day administered via drinking water). Systolic blood pressure (SBP) was measured, and left atrial tissue was examined for fibrosis and the expression of SIRT3 and EndMT-related markers, including CD31, Snail, FSP1, Twist, VE-cadherin, and α-SMA.</p><p><strong>Results: </strong>Compared with the NSD group, the HSD group exhibited increased SBP, left atrial end-systolic volume index (LAESVI), incidence and duration of atrial fibrillation (AF), and atrial fibrosis. Expression of α-SMA, Snail, FSP1, and Twist was elevated, while SIRT3, CD31, and VE-cadherin expression were decreased, along with reduced left atrial ejection fraction and left atrial function index. DAPA treatment reversed these changes.</p><p><strong>Conclusions: </strong>Our findings indicate that a high-salt diet decreases SIRT3 expression, induces EndMT, and promotes myocardial fibrosis in SSHT rats. DAPA mitigates high-salt-induced EndMT and fibrosis-related AF by upregulating SIRT3, suggesting a potential mechanism for the cardioprotective effects of SGLT2 inhibitors in SSHT.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"578-585"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145375591","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":"Sex Differences in Blood Pressure Variability, Office-Home Difference, and Hypertension-Mediated Organ Damage: A Multicenter Analysis.","authors":"Jung-Joon Cha, Se Won Oh, Dong-Hyuk Cho, Mi-Na Kim, Jae Hyoung Park, Kyung-Hee Cho, Seung Yong Shin, Eung Ju Kim, Hyung Joon Joo","doi":"10.1093/ajh/hpaf212","DOIUrl":"10.1093/ajh/hpaf212","url":null,"abstract":"<p><strong>Background: </strong>Sex differences in blood pressure (BP) regulation may modify associations between BP variability (BPV) and hypertension-mediated organ damage (HMOD), but organ-specific effects remain unclear.</p><p><strong>Methods: </strong>We studied 398 hypertensive patients from a multicenter home BP monitoring registry. The office-home BP difference (ΔBP = office-home) was analyzed as a single continuous exposure variable, with positive values indicating the white-coat effect and negative values indicating the masked effect. Multivariable regression examined sex-specific associations of BPV patterns with HMOD, including electrocardiographic left ventricular hypertrophy (ECG-LVH) and microalbuminuria/proteinuria.</p><p><strong>Results: </strong>Women demonstrated higher home systolic BPV than men despite similar mean BP levels (P < .01). Office BP was the primary determinant of white-coat phenotypes (office SBP: adjusted odds ratio [aOR] 1.29 [95% CI: 1.22-1.37]; office DBP: aOR 1.27 [1.19-1.37], both P < .01), while home BP predicted masked phenotype (home SBP: aOR 1.23 [1.12-1.39]; home DBP: aOR 1.34 [1.23-1.48], both P < .01). White-coat effects showed protective associations with total HMOD (systolic aOR 0.97 [0.94-1.00], P < .05), while office BPV demonstrated consistent positive associations (systolic aOR 1.10 [1.05-1.16]; diastolic aOR 1.12 [1.05-1.20], both P < .01). Critically, significantly sex interaction emerged for ECG-LVH, while microalbuminuria/proteinuria showed consistent associations across sexes.</p><p><strong>Conclusions: </strong>Sex fundamentally modifies BP patterns-HMOD relationships in an organ-specific manner. Cardiac target organ damage requires sex-attentive monitoring approaches, while renal damage shows universal associations with office BPV. These findings support precision medicine approaches to hypertension management incorporating sex-specific BP assessment strategies.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"505-513"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145342697","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 Medication Changes in Patients Prescribed Remote Monitoring.","authors":"Calvin J Winkler, Lucia C Petito, Yaw Peprah, Ji Young Lee, Hironori Sato, Stephen D Persell","doi":"10.1093/ajh/hpaf228","DOIUrl":"10.1093/ajh/hpaf228","url":null,"abstract":"<p><strong>Background: </strong>Remote patient monitoring (RPM) includes home blood pressure (BP) measurement with readings sent directly to the electronic health record (EHR). We hypothesize that RPM facilitates quicker, more frequent, more appropriate antihypertensive medication changes.</p><p><strong>Methods: </strong>Patients with hypertension in 6 primary care clinics were prescribed RPM between November 2020 and August 2021 (N = 288) and matched to 4 control patients (N = 1152). Office and RPM BP readings and medication data over 18 months were extracted from the EHR. RPM patients were classified as baseline-controlled (office and RPM <130/<80 mmHg), sustained (office and RPM ≥130 and/or ≥80), white-coat (office ≥130 and/or ≥80, RPM <130/<80), or masked hypertension (office <130/<80, RPM ≥130 and/or ≥80).</p><p><strong>Results: </strong>RPM patients had earlier first antihypertensive medication changes, with half of RPM patients having ≥1 change by 228 days versus 530 days for controls. RPM patients had more total medication changes, with 25% of RPM patients having ≥4 (median 1; 25th-75th percentiles 0-4) changes versus ≥2 (median 1; 0-2) changes in controls. Compared to baseline sustained hypertension RPM users, white-coat hypertension users were less likely to have ≥1 medication increase (24% [N = 11] versus 53% [N = 74], P = .001) within 12 months. Compared to baseline-controlled RPM users, masked hypertension users were less likely to have ≥1 medication decrease (0% [N = 0] versus 44% [N = 8]; P = .003) within 12 months.</p><p><strong>Conclusions: </strong>Even without additional staff dedicated to medication adjustment, RPM facilitated quicker medication changes, more total changes, and differential prescribing decisions for white-coat and masked hypertension patients supporting RPM use in primary care.</p><p><strong>Clinical trial registration number: </strong>ClinicalTrials.gov identifier: NCT05562921.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"563-569"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809017","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 Effect of Multivitamin Supplementation on Incident Self-Reported Hypertension and Blood Pressure Changes in the COSMOS Trial.","authors":"Rikuta Hamaya, Sidong Li, Jessica Lau, Susanne Rautiainen, Bernhard Haring, Simin Liu, Aladdin H Shadyab, Lisa Warsinger Martin, Sylvia Wassertheil-Smoller, Pamela M Rist, JoAnn E Manson, Howard D Sesso","doi":"10.1093/ajh/hpaf224","DOIUrl":"10.1093/ajh/hpaf224","url":null,"abstract":"<p><strong>Background: </strong>Multivitamin-multimineral (MVM) supplements have been associated with lower blood pressure (BP) in several small trials. We investigated the effects of a MVM on incident hypertension and BP in a secondary analysis of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS).</p><p><strong>Methods: </strong>COSMOS is a 2×2 factorial, double-blinded RCT testing effects of cocoa extract and MVM supplementation among women aged ≥65 years and men aged ≥60 years. Among 8905 COSMOS participants free from hypertension, effects of MVM supplementation on incident hypertension were investigated. Hypertension diagnosis was ascertained through self-reports. Additionally, in two substudies with BP measurements (N = 529 at clinic by research staff and 994 at home by technician), we evaluated the effects on 2-year BP changes.</p><p><strong>Results: </strong>Incident hypertension was observed in N = 1034 (22.9%) in MVM arm and N = 1039 (23.6%) in placebo arm over a median of 3.4 years (IQR: 3.0, 3.9) of follow-up, with hazard ratio (HR) 0.98 [95% CI: 0.90, 1.06]. Effects differed according to baseline diet quality, with HRs of incident hypertension 0.81 [0.70, 0.95] and 1.14 [1.01, 1.28] among participants with lower and higher Alternate Mediterranean Diet score, respectively (P-interaction = .001). There was no effect of MVM on 2-year changes in systolic BP (4.4 mmHg in MVM; 4.5 mmHg in placebo), while pronounced effects were observed for baseline normal BP (P-interaction = .004).</p><p><strong>Conclusions: </strong>MVM supplementation versus placebo did not reduce hypertension incidence or lower BP overall. Exploratory analyses showed greater reduction in hypertension risk and BP changes among those with lower dietary quality and normal BP at baseline, respectively.</p><p><strong>Clinical trial registration: </strong>NCT02422745.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"538-546"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562201","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":"Supplements Can't Handle the Pressure.","authors":"Jiahui Luo, Teemu Niiranen","doi":"10.1093/ajh/hpaf242","DOIUrl":"10.1093/ajh/hpaf242","url":null,"abstract":"","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"491-493"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145779986","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 Parameters with Cognitive Decline and Dementia: A Systematic Review of Reviews.","authors":"Sultana Shajahan, Megan Heffernan, Katie Harris, Cheryl Carcel, Mark Woodward, Craig S Anderson, Ruth Peters","doi":"10.1093/ajh/hpaf213","DOIUrl":"10.1093/ajh/hpaf213","url":null,"abstract":"<p><strong>Background: </strong>Evidence syntheses on the associations between BP parameters and cognitive decline and/or dementia have taken different methodological approaches and targeted different BP parameters and outcomes. The aim of this umbrella review was to provide a high-level synthesis of published systematic reviews with meta-analyses on these associations.</p><p><strong>Methods: </strong>PubMed, Embase, PsycINFO, and Cochrane were searched up to April 2025 for eligible reviews. Risk of bias was assessed using the AMSTAR-2 tool, and overlap of constituent studies between reviews was explored.</p><p><strong>Results: </strong>Among 31 included reviews, 8 reported positive associations between higher BP and greater incidence of cognitive decline or dementia, 5 drew neutral conclusions, and 1 reported an inverse relationship. Greater mid-life BP was associated with greater risk of all-cause dementia, whereas late-life hypertension might have a mixed or overall neutral association. Three reviews reported associations between higher BP variability and all-cause dementia, and 2 for cognitive decline. Reviews also reported associations between higher pulse wave velocity and orthostatic hypotension and poorer outcomes. No reviews examined PP, mean-arterial pressure, or cumulative BP load. Most reviews were of low quality, with considerable heterogeneity in BP parameter definitions and outcome criteria. Overlap of constituent studies for each BP parameter was low.</p><p><strong>Conclusions: </strong>In addition to high BP, incorporating variability, pulse wave velocity and orthostatic hypertension into risk assessments of cognitive decline or dementia and adopting standardized definitions for BP parameters and cognitive outcomes may improve comparability across future studies and strengthen clinical guidance.</p>","PeriodicalId":7578,"journal":{"name":"American Journal of Hypertension","volume":" ","pages":"514-537"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145399403","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}