Blood Pressure最新文献

{"title":"The blood pressure control triangle: targets, home blood pressure monitoring, and workload.","authors":"Nikolaos Evangelidis, Vasileios Gkolias, Emmanouil Smyrnakis, Areti Triantafyllou","doi":"10.1080/08037051.2026.2710498","DOIUrl":"10.1080/08037051.2026.2710498","url":null,"abstract":"","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2710498"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of fourth-line antihypertensive therapy on clinic systolic blood pressure in resistant hypertension: a systematic review and meta-analysis.","authors":"Taha Alam, Muhammad Saad, Taha Ibrahim, Dhvanit Rajdeep, Zainab Jamshaid, Muhammad Hassan, Noor Un Nisa, Muhammad Hussain, Sohaima Kamal, Hira Arshad Jawed, Rafiullah Hotak","doi":"10.1080/08037051.2026.2696695","DOIUrl":"10.1080/08037051.2026.2696695","url":null,"abstract":"<p><strong>Introduction/background: </strong>Resistant hypertension (rHTN) is defined as uncontrolled blood pressure despite ≥3 antihypertensives, including a diuretic. While fourth-line-intensification is recommended, comparative evidence remains scattered.</p><p><strong>Research questions/hypothesis: </strong>To evaluate the efficacy and safety of fourth-line antihypertensives in reducing clinic systolic blood pressure (SBP) in rHTN.</p><p><strong>Methods/approach: </strong>PubMed, Embase, Scopus, and Web of Science were searched (2015-2026) for randomized controlled trials (RCTs) with ≥4 weeks follow-up. Risk of bias was assessed using Cochrane RoB 2. A planned network meta-analysis was not performed because statistical inconsistency and transitivity violations rendered indirect comparisons unreliable. Therefore, pairwise meta-analyses were conducted using random-effects models, with results reported as mean differences (MD) or risk ratios (RR) with 95% confidence intervals (CIs).</p><p><strong>Results/data: </strong>Eleven RCTs involving 3,931 adults with rHTN were included. Compared with placebo, the largest SBP reductions were observed with lorundrostat (MD -11.70 mmHg [95% CI -16.07, -7.33]) and baxdrostat 2 mg (MD -10.10 [-12.63, -7.58]). Baxdrostat 1 mg (MD -8.56 [-11.08, -6.04]) produced reductions similar to spironolactone (MD -7.95 [-10.10, -5.80]). Bisoprolol achieved a modest SBP reduction (MD -6.71 mmHg), whereas aprocitentan 12.5 mg reduced SBP by -3.80 mmHg [-6.65, -0.95]. No intervention significantly increased serious adverse events. Higher rates of any adverse events were observed with aprocitentan 25 mg (RR 1.89 [1.39, 2.57]) and doxazosin (RR 1.55 [1.09, 2.20]).</p><p><strong>Conclusions: </strong>Aldosterone-targeted therapies, including aldosterone-synthase inhibitors and spironolactone, provide clinically meaningful SBP reductions in rHTN without increasing serious adverse event risk. Future trials should clarify comparative efficacy and long-term outcomes.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2696695"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-reported health status and blood pressure medication use among persons living with hypertension in Kenya.","authors":"Samuel Salu, Annabelle Mortty, Joshua Okyere, David Mensah Otoo","doi":"10.1080/08037051.2026.2712023","DOIUrl":"10.1080/08037051.2026.2712023","url":null,"abstract":"<p><strong>Background: </strong>While existing studies established an association between self-reported health status and healthcare service utilisation, its association with Blood Pressure (BP) medication use among persons living with hypertension remains under-explored. This study examines the association between self-reported health status and BP medication use among persons living with hypertension in Kenya.</p><p><strong>Methods: </strong>We analysed data from the 2022 Kenya Demographic and Health Survey (KDHS). The primary outcome was BP medication use, while the main independent variable was self-reported health status. Logistic regression models were fitted to assess the association between self-reported health status and BP medication use.</p><p><strong>Results: </strong>We found that only 32.0% of women and 36.4% of men in this study reported consistent BP medication use. Women who reported moderate or poor health were significantly more likely to use BP medication compared to those who perceived their health as good (aOR = 1.8, 95% CI: 1.4-2.4; aOR = 1.9, 95% CI: 1.2-3.0) respectively. However, no significant association between self-reported health status and BP medication use was found among men. Women aged 20-24 years (aOR = 0.4, 95% CI: 0.2-0.9) and men aged 25-34 years (aOR = 0.2, 95% CI: 0.06-0.9) were less likely to use BP medication. Furthermore, women (aOR = 2.0, 95% CI: 1.1-3.8) and men (aOR = 2.0, 95% CI: 1.0-3.8) with diabetes were more likely to use BP medication.</p><p><strong>Conclusion: </strong>These findings emphasise the need for gender specific health education and behaviour change interventions t to improve hypertension management.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2712023"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148598959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Waist-to-height ratio is the proximal correlate of workload-indexed exercise systolic blood pressure: a Czech preventive-cardiology cohort study.","authors":"Kristina Puskasova, Bogna Jiravska-Godula, Jan Samiec, Otakar Jiravsky, Vendula Szotkowska, Marek Kantor, Jana Wrobel, Eva Jakubovicova, Stanislaw Rucki, Jan Alexander Mohr, Ivan Ranic, Matej Pekar, Radim Spacek, Jan Chovancik, Eliska Sovova","doi":"10.1080/08037051.2026.2701515","DOIUrl":"https://doi.org/10.1080/08037051.2026.2701515","url":null,"abstract":"<p><strong>Background: </strong>Exercise systolic blood-pressure (SBP) response predicts incident hypertension and cardiovascular events independent of resting BP, but guidelines disagree on the threshold for an exaggerated response and absolute peak-SBP cut-offs misclassify fit individuals. We examined determinants of workload-indexed exercise SBP and tested whether central adiposity statistically accounts for the cardiometabolic signal.</p><p><strong>Methods: </strong>Cross-sectional analysis of 324 working-age adults from a Czech preventive-cardiology cohort with a valid bicycle cardiopulmonary exercise test. The pre-specified primary endpoint was peak SBP indexed by relative workload (peak SBP ÷ W·kg^-1). Confirmatory multivariable linear regression was fitted; statistical mediation of HOMA-IR and the triglyceride/HDL ratio through waist-to-height ratio (WHtR) was formally tested; binary outcomes were analysed under parallel ESC, AHA and workload-adjusted definitions.</p><p><strong>Results: </strong>WHtR was the dominant predictor (β = +8.96 mmHg per W·kg^-1 per 1-SD, <i>p</i> < 0.001; R² = 0.61) and remained significant across all eleven workload-indexing methods (including the SBP/MET slope and after VO₂peak adjustment), and predicted peak SBP itself (<i>p</i> < 0.001). WHtR accounted for 80-90% of the effect of both insulin-resistance surrogates (Sobel <i>p</i> < 0.001). The association was age-modified (<i>p</i> = 0.014) and independent of sex (sex × WHtR <i>p</i> = 0.31). ESC and AHA definitions reclassified 47/324 patients (14.5%) discordantly (κ = 0.67). A workload-adjusted definition (SBP/MET slope > 10 mmHg·MET^-1) classified 24.4% yet reclassified one in five versus ESC and showed no age dependence.</p><p><strong>Conclusions: </strong>WHtR is the proximal anthropometric correlate of workload-indexed exercise SBP, statistically accounting for 80-90% of the insulin-resistance signal; the association is robust to the choice of workload-indexing method and largely independent of resting BP. ESC and AHA definitions classify approximately one in seven patients discordantly, motivating harmonisation.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":"35 1","pages":"2701515"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifestyle modifications in individuals with blood pressure beyond treatment target despite pharmacological treatment: design and baseline characteristics of the MeDiPA randomised controlled trial.","authors":"Ana R S de Sousa, Tor Ole Klemsdal, Reza Ghiasvand, Mette Svendsen, Kåre I Birkeland, Kari Anne Sveen","doi":"10.1080/08037051.2026.2705014","DOIUrl":"10.1080/08037051.2026.2705014","url":null,"abstract":"<p><strong>Background: </strong>Many patients pharmacologically treated for hypertension do not reach blood pressure (BP) treatment targets. In Europe, a target of BP < 130/80 mmHg has recently been recommended. Presently, the effect of combining pharmacological approaches and lifestyle changes is unclear. The Hypocaloric Mediterranean Diet or Physical Activity (MeDiPA) randomised controlled trial aims at investigating the effects of lifestyle modifications in patients with uncontrolled hypertension taking antihypertensives. Here, we present the MeDiPA design and baseline population characteristics.</p><p><strong>Methods: </strong>We included participants with office BP ≥ 130/80 mmHg on two occasions, taking at least two antihypertensives, with body mass index (BMI) 25-40 kg/m² and waist circumference ≥88 cm (women)/≥102 cm (men). We excluded participants with BP ≥ 160/100 mmHg, type 1 diabetes, recent cardiovascular disease or chronic kidney disease. Participants were randomised to a hypocaloric Mediterranean-style diet, increased physical activity or control, for 6 months. The main outcome is changes in 24-h ambulatory BP after 6 months. Exploratory outcomes include changes in metabolic parameters and quality of life.</p><p><strong>Results: </strong>Sixty-six participants were included (56% women): 21, 22 and 23 in the diet, physical activity and control groups, respectively. Mean (standard deviation) age was 59 (8) years, 85% of participants were Norwegian and 83% had higher education. Mean BMI was 32.0 (4.5) kg/m² and waist circumference was 106.3 (11.8) cm (women)/113.3 (8.6) cm (men). Mean BP was 137 (15)/90 (8) mmHg and 61% of participants had BP ≥ 140/90 mmHg.</p><p><strong>Conclusion: </strong>This trial will improve our understanding of how lifestyle modifications modulate BP in pharmacologically treated patients with uncontrolled hypertension.<b>Trial registration</b> NCT04155112; first submitted 2019-10-23.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2705014"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between hypertension and frailty among middle-aged and older adults: evidence from the longitudinal ageing study in India.","authors":"Vansh Maheshwari, Saurav Basu","doi":"10.1080/08037051.2026.2687984","DOIUrl":"10.1080/08037051.2026.2687984","url":null,"abstract":"<p><strong>Background: </strong>The global demographic shift has highlighted the co-occurrence of hypertension (HTN) and physical frailty, both of which severely impact the health outcomes and quality of life of middle-aged and older adults. This relationship remains underexplored in India's rapidly ageing population.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis using data from the Longitudinal Ageing Study in India (Wave 1), comprising a nationally representative sample of 66,606 participants. Physical frailty was assessed using a modified Fried phenotype. Multivariable logistic regression and the Karlson-Holm-Breen method were utilised to evaluate associations and quantify the mediating effect of additional comorbidities.</p><p><strong>Results: </strong>The weighted prevalence of physical frailty among participants with HTN was 19.26% (95% CI: 18.43, 20.11). Multivariable analysis revealed that advanced age, lack of education, non-working status, underweight BMI, and presence of additional comorbidities were significantly associated with higher odds of frailty in HTN patients. Mediation analysis showed that additional comorbidities accounted for 21.31% of the total effect of HTN on frailty for all HTN cases, and 38.36% for previously diagnosed cases.</p><p><strong>Conclusion: </strong>Treating HTN in isolation might be insufficient for addressing functional decline. Healthcare policies and clinical practices must adopt comprehensive geriatric assessments that target patients' entire comorbid profiles, while prioritising interventions that address the modifiable risk factors.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2687984"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of C1q/tumor necrosis factor-related protein 1 with left ventricular hypertrophy in essential hypertension patients.","authors":"Shuya Tian, Xinyu Wang","doi":"10.1080/08037051.2026.2670144","DOIUrl":"10.1080/08037051.2026.2670144","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular hypertrophy (LVH) is a critical complication of hypertension that correlates with increased morbimortality. Its pathophysiology is complex and multifaceted likely involving various players that are still to be determined, particularly those with proinflammatory and profibrotic effects. Complement C1q/tumour necrosis factor-related protein 1 (CTRP1) is an antihypotensive adipokine that has recently been linked to adverse cardiometabolic changes and may contribute to the development of LVH.</p><p><strong>Objective: </strong>To explore the relationship between CTRP1 and LVH in patients with essential hypertension.</p><p><strong>Methods: </strong>A total of 360 patients with mild-to-moderate essential hypertension were enrolled from Ruijin Hospital between December 2015 and November 2017. Participants were divided into two groups: those with hypertension alone (<i>n</i> = 183) and those with hypertension complicated by LVH (<i>n</i> = 177). Plasma levels of CTRP1, adiponectin, and interleukin-6 (IL-6) were measured using enzyme-linked immunosorbent assay (ELISA). The left ventricular mass index (LVMI) was calculated from echocardiographic measurements. Patients were further stratified by sex and by CTRP1 tertiles for subgroup analysis.</p><p><strong>Results: </strong>Patients with hypertension and LVH showed significantly higher levels of CTRP1, IL-6, and LVMI compared to those with hypertension alone. In contrast, adiponectin levels were significantly lower in the LVH group. CTRP1 levels were positively correlated with LVMI in both males and females. Furthermore, patients in the highest CTRP1 tertile exhibited progressively elevated SBP, DBP, CRP, IL-6, and LVMI. Multivariate logistic regression analysis identified CTRP1, IL-6, and adiponectin as independent factors associated with LVH.</p><p><strong>Conclusion: </strong>CTRP1 is independently associated with left ventricular hypertrophy in patients with essential hypertension, demonstrating a dose-response relationship with cardiac hypertrophy and inflammatory markers.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2670144"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147866897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and prognostic significance of untreated, uncontrolled and resistant hypertension among American adults with prediabetes.","authors":"Yong Lin, Kunming Bao, Luojing Zhong, Wentao Jiang, Fujin Lin, Zhidong Huang, Wenjun Gu, Ganyang Li, Chunhua Guo","doi":"10.1080/08037051.2026.2698913","DOIUrl":"10.1080/08037051.2026.2698913","url":null,"abstract":"<p><p><i>Background:</i> The prevalence of untreated, uncontrolled and resistant hypertension and their specific prognosis among American adults with prediabetes remain unclear. We aimed to explore the prevalence of hypertension treatment and control and their associated risks of all-cause and cardiovascular disease (CVD) mortality among this population. <i>Methods:</i> We analysed data from 12,321 participants in the National Health and Nutrition Examination Survey (NHANES) survey (1999-2016). Prediabetes was defined as a fasting plasma glucose (FPG) of 5.6-7.0 mmol/L, a haemoglobin A1c of 5.7-6.4%, a 2-h plasma glucose of 7.8-11.1 mmol/L or self-reported diagnosis. Hypertension was defined as blood pressure (BP) ≥140/90 mmHg, a self-reported history of hypertension, or current antihypertensive medication use, and categorized into untreated, controlled, uncontrolled and resistant hypertension. Cox regression was used to assess associations between hypertension categories and both CVD and all-cause mortality. <i>Results:</i> The study included 12,321 adults with prediabetes, representing an estimated 53.3 million individuals. Age- and sex-standardised hypertension prevalence was 43%. Among those with hypertension, 62% were receiving treatment. Among treated individuals, 66% had controlled hypertension, 26.5% had uncontrolled hypertension and 7.5% had resistant hypertension. Mortality risk increased progressively from non-hypertensive to untreated, controlled, uncontrolled and resistant hypertension stages. Compared to non-hypertensive individuals, hazard ratios (HRs) for CVD mortality were 1.17 (95% CI: 0.80-1.71), 1.52 (1.04-2.21), 2.03 (1.35-3.05) and 1.83 (1.07-3.13), respectively (P for trend <0.001). For all-cause mortality, HRs were 1.01 (0.86-1.20), 1.05 (0.87-1.26), 1.16 (0.95-1.41) and 1.42 (1.09-1.85), respectively (P for trend = 0.022). <i>Conclusions:</i> Hypertension was highly prevalent among American adults with prediabetes, and mortality risk increased with advancing hypertension stages.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2698913"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LETTER TO THE EDITOR REGARDING: associations between hypertension and frailty among middle-aged and older adults: evidence from the Longitudinal Ageing Study in India.","authors":"Kanu Goyal, Riya Kalra, Aditi Nagpal","doi":"10.1080/08037051.2026.2698273","DOIUrl":"10.1080/08037051.2026.2698273","url":null,"abstract":"","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2698273"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From continuity to accountable hypertension care: digital inclusion, patient feedback, and service quality beyond the eCohort.","authors":"Deby Febriyan Eprilianto, Yuyun Eka Kartika Sari","doi":"10.1080/08037051.2026.2736955","DOIUrl":"10.1080/08037051.2026.2736955","url":null,"abstract":"","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2736955"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}