Blood Pressure最新文献

{"title":"Implementation of hypertension guidelines by general practitioner societies and the use of single pill combinations in Europe-results of the survey of the general practitioner nucleus of European society of hypertension.","authors":"János Nemcsik, Enrique Rodilla, Fabiolucio Albini, Michael Doumas, Jean-Marc Boivin, Helga Gyöngyösi, Reinhold Kreutz, Rosa de Pinho","doi":"10.1080/08037051.2025.2487592","DOIUrl":"10.1080/08037051.2025.2487592","url":null,"abstract":"<p><strong>Purpose: </strong>The implementation of hypertension guidelines into the everyday practice of general practitioners (GPs) have an outmost importance to provide optimal care for patients. The aim of our study was, on the one hand to gain insight about the relationship between hypertension societies and GP societies, and on the other hand, to get feedback about the use of single pill combinations (SPC) in each country, as an indicator of guideline implementation.</p><p><strong>Materials and methods: </strong>The European Society of Hypertension (ESH) GP Nucleus initiated a survey containing 17 questions about the existence and number of national hypertension and GP societies, the relationship between them and with pharmacists and nurse associations, the authors of national guidelines and the availability of SPCs. The survey was sent to the national hypertension society representatives of ESH. Additionally, data about the number of SPCs sold yearly was also checked using IQVIA database.</p><p><strong>Results: </strong>Responses were collected from 25 European countries. In most of the countries there is only one hypertension society (23/25) and one GP society (18/25), most of which having a relationship with each other (22/25). Of the countries with national hypertension guidelines most of them are written by the national hypertension society (45%) followed by the GP society (27%) or by public administration (27%). Two thirds of the national hypertension societies (16/25) have relationship with nurse societies and half of them (12/25) with pharmacists. In 65% (15/23) of the guidelines dual SPC therapy is recommended for treatment initiation however, marked differences are present in the number of yearly sold SPCs in different countries.</p><p><strong>Conclusions: </strong>National hypertension societies have remarkable impact on GPs for the management of hypertensive patients. However, improvement is needed in the collaboration with nurse and pharmacist societies and in some countries in the use of SPCs for hypertension therapy.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2487592"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750426","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":"Association between 24-hour blood pressure variability and mortality in acute ischemic stroke patients admitted in intensive care units: a MIMIC-IV study.","authors":"Zhen Yuan, Yunqing Zeng, Zhizhen Shi, Aoli Chen, Yangbo Hou, Guoyi Li, Jiwei Cheng","doi":"10.1080/08037051.2025.2507686","DOIUrl":"10.1080/08037051.2025.2507686","url":null,"abstract":"<p><strong>Introduction: </strong>Acute ischaemic stroke (AIS) patients in the intensive care unit (ICU) face high mortality. This study examined the association between systolic blood pressure variability (SBPV), specifically average real variability (SBP-ARV), and short-term mortality in critically ill AIS patients.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the MIMIC-IV database. The primary outcomes were 28-day and 90-day all-cause mortality. Cox regression, Kaplan-Meier curves, restricted cubic spline (RCS) models, and subgroup analyses were used to assess associations.</p><p><strong>Results: </strong>A total of 861 AIS patients were included. The 28-day and 90-day mortality rates were 20.9% and 23.3%, respectively. Higher SBP-ARV was independently associated with increased mortality. Compared with the lowest tertile, the highest tertile of SBP-ARV had significantly increased 28-day mortality (HR: 1.53; 95% CI: 1.03-2.27; <i>p</i> = 0.035). SBP-ARV as a continuous variable was also significantly associated with 28-day and 90-day mortality. RCS analysis showed that mortality risk increased when SBP-ARV exceeded 11.63.</p><p><strong>Conclusion: </strong>Our findings suggest that elevated systolic blood pressure variability, particularly higher SBP-ARV within the first 24 h of ICU admission, is significantly associated with increased 28-day and 90-day mortality in AIS patients. SBP-ARV may serve as a valuable prognostic marker for risk stratification and early clinical intervention in critically ill stroke patients.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2507686"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109690","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":"Comparison between an adapted protocol for home and ambulatory measurement for evaluating night-time blood pressure behaviour.","authors":"Thamyres Costa Borges, Priscila Valverde de Oliveira Vitorino, Sayuri Inuzuka, Ana Luiza Lima Sousa, Moisés Martins de Oliveira, Carlos Augusto Pícoli de Andrade, Rodrigo Bezerra, Audes Diógenes Magalhães Feitosa, Weimar Kunz Sebba Barroso","doi":"10.1080/08037051.2025.2514224","DOIUrl":"10.1080/08037051.2025.2514224","url":null,"abstract":"<p><strong>Background: </strong>The diagnosis and treatment of hypertension rely on the accuracy of blood pressure (BP) measurements obtained both in and out of the office during awake and sleep periods.</p><p><strong>Objective: </strong>To evaluate whether a home blood pressure monitoring (HBPM) protocol incorporating morning, afternoon, and evening measurements supports the assessment of blood pressure behaviour during sleep and enhances the diagnosis of hypertension.</p><p><strong>Methods: </strong>This cross-sectional study included 40 patients (73% women; age = 62.0 ± 13.2 years) who underwent 24-h ambulatory blood pressure monitoring (ABPM) and (five-day HBPM) with measurements taken across three time periods. The association between the sleep-wake dip recorded by ABPM and the night-day difference measured by HBPM was examined. Additionally, the sensitivity, specificity, predictive values, concordance index, Kappa coefficient, and area under the ROC curve (AUC) of mean BP values obtained from HBPM were compared with those from ABPM.</p><p><strong>Results: </strong>Mean BP values obtained from HBPM were 126.2 ± 13.3/79.2 ± 9.1 mmHg, (daytime), 125.9 ± 16.4/78.7 ± 10.5 mmHg (evening), and 126.1 ± 14.3/78.9 ± 9.6 mmHg (total). For ABPM, mean values were 120.3 ± 12.5/74.5 ± 8.9 mmHg (awake), 116.5 ± 10.9/69.3 ± 8.0 mmHg (asleep), and 119.4 ± 11.4/73.4 ± 8.0 mmHg (total). Total HBPM outperformed daytime and evening HBPM in detecting abnormalities on ABPM (daytime, night-time, and 24 h), with higher sensitivity, negative predictive value (NPV), AUC, concordance index, and Kappa coefficient. The correlation between the day-night dip in ABPM and the night-day difference in HBPM was weak.</p><p><strong>Conclusion: </strong>Including night-time measurements in the HBPM protocol improves the accuracy of hypertension diagnosis when compared to ABPM. However, the night-day BP difference captured by HBPM does not correspond to the day-night dip measured by ABPM.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2514224"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246259","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":"Effects of Dan Shen (<i>Salvia miltiorrhiza</i>) on blood pressure management in hypertensive patients: a randomized controlled trial.","authors":"Pan Li, Zonghua Jiang, Linfei Dong, Shifeng Wang, Jiangli Qi, Longhong Zhu","doi":"10.1080/08037051.2025.2532523","DOIUrl":"10.1080/08037051.2025.2532523","url":null,"abstract":"<p><strong>Objective: </strong>This randomised, double-blind, placebo-controlled trial aimed to evaluate the efficacy and safety of <i>Salvia miltiorrhiza</i> (Dan Shen) in the management of primary hypertension.</p><p><strong>Methods: </strong>From April 2023 to September 2024, 320 patients aged 30-75 years with diagnosed primary hypertension were enrolled at Ganzhou Hospital of Southern Medical University (Ganzhou People's Hospital). Patients were randomised to receive either intravenous <i>Salvia miltiorrhiza</i> (20 mL diluted in 200 mL of 5% glucose daily for 12 weeks) or a placebo with identical appearance and administration. Primary outcomes included changes in blood pressure measured by 24-h ambulatory blood pressure monitoring (ABPM). Secondary outcomes included symptom scores, lipid and glucose profiles and health-related quality of life (QoL) assessed using validated laboratory measures and the SF-36 questionnaire.</p><p><strong>Results: </strong>A significant reduction in systolic and diastolic blood pressure (DBP) was observed in the intervention group from week 4, reaching 136.78 ± 10.28 and 85.36 ± 8.37 mmHg by week 12, respectively - both significantly lower than in the control group (<i>p</i> < 0.01). Symptom scores for headache, dizziness and fatigue decreased by 1.2, 1.1 and 1.2 points (<i>p</i> < 0.01), with no significant changes in the control group. Lipid profiles improved notably: total cholesterol (TC), LDL-C and triglycerides (TGs) declined by 9.8%, 10.7% and 17.1%, respectively, while HDL-C increased by 17.0% (all <i>p</i> < 0.05). Fasting glucose levels fell by 4.3% (<i>p</i> < 0.05). QoL, assessed <i>via</i> SF-36, improved significantly, particularly in vitality (+20.9) and physical functioning (+18.6). Adverse events (AEs) were mild to moderate, mainly gastrointestinal discomfort and dizziness, and did not result in dropout. Treatment adherence was high, with 94.2% of participants completing at least 80% of the protocol.</p><p><strong>Conclusion: </strong>Dan Shen significantly reduced both systolic and DBP, alleviated hypertension-related symptoms, improved lipid and glucose metabolism, and enhanced QoL in patients with primary hypertension.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2532523"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625356","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":"Postoperative systemic arterial hypertension in infants with congenital heart diseases: prevalence and risk factors.","authors":"Xiaohong Chen, Yanling Chen, Lijie Zhao, Ruikun Zou, Yuan Ren, Xin Sun, Xinmeng Zhang, Haiyun Yuan, Yifei Wang","doi":"10.1080/08037051.2024.2436385","DOIUrl":"https://doi.org/10.1080/08037051.2024.2436385","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence rate and risk factors for systemic arterial hypertension in infants with congenital heart diseases.</p><p><strong>Methods: </strong>A retrospective cohort study of postoperative systemic arterial hypertension incidence in infants who underwent cardiac surgery was conducted. The primary diagnosis was retrieved. The general characteristics, surgical information, and blood pressure data at five periods were also collected. The five periods were at admission, 48 hours after cardiac surgery (postoperative), at discharge, at full-time, and at any time during hospitalisation. The risk factors for postoperative hypertension and hypertension at discharge were determined by multivariate logistic regression.</p><p><strong>Results: </strong>This study enrolled 1205 eligible infants. The age and weight at surgery were 27.0 (13.0, 59.0) days and 3.53 ± 0.96 kg, respectively. The prevalence rates of postoperative hypertension and hypertension at discharge were 12.8 (10.9-14.7)% and 6.9 (5.5-8.3)%, respectively. The incidence of postoperative hypertension varies greatly across different types of congenital heart diseases. A low weight <i>Z</i> score, preoperative hypertension, patent ductus arteriosus, and coarctation of the aorta were risk factors for postoperative hypertension, whereas transposition of the great arteries grouped with pulmonary atresia, pulmonary stenosis, and total anomalous pulmonary venous connection was a protective factor. The ventricular septal defect was a risk factor for postoperative hypertension but not for hypertension at discharge.</p><p><strong>Conclusions: </strong>The incidence of postoperative systemic arterial hypertension is high in infants after cardiac surgery. The prevalence of hypertension decreased at discharge. Prospective long-term follow-up studies are needed to delineate the natural history of hypertension in high-risk children.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":"34 1","pages":"2436385"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799360","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":"Higher blood pressure variability during hospitalisation is associated with lower cerebral white matter integrity in COVID-19 patients.","authors":"Theresa J van Lith, Esther Janssen, Jan-Willem van Dalen, Hao Li, Mats Koeneman, Wouter M Sluis, Naomi T Wijers, Marieke J H Wermer, Menno V Huisman, H Bart van der Worp, Frederick J A Meijer, Anil M Tuladhar, Sebastian J H Bredie, Frank-Erik de Leeuw","doi":"10.1080/08037051.2025.2493828","DOIUrl":"https://doi.org/10.1080/08037051.2025.2493828","url":null,"abstract":"<p><strong>Background: </strong>High blood pressure variability (BPV) is associated with cerebrovascular damage and dementia, but it is unknown whether short-term BPV during hospitalisation is also associated with cerebral white matter (WM) damage. We examined whether BPV, measured in-hospital using continuous monitoring, is associated with WM microstructural integrity in COVID-19 patients.</p><p><strong>Methods: </strong>We included hospitalised COVID-19 patients from the CORONavirus and Ischemic Stroke (CORONIS) study who underwent continuous vital signs monitoring using a wearable device during hospital admission and had an MRI shortly after discharge. Systolic BPV was calculated as Average Real Variability (ARV) and Coefficient of Variation (CV) with 1-, 5- and 20-minute intervals. We used diffusion tensor imaging to assess fractional anisotropy (FA) and peak width of skeletonised mean diffusivity (PSMD) as markers of WM integrity. Associations between BPV and WM integrity were examined with linear regression adjusted for age, mean systolic blood pressure (BP), number of BP measurements and type of respiratory support.</p><p><strong>Results: </strong>We included 47 COVID-19 patients (mean age: 59.6 years). BP was measured 6306 ± 4343 times per patient (median admission: 11 days (Interquartile Range [IQR] 7.5-15.0). Both higher ARV and CV were associated with lower WM microstructural integrity, reflected by lower FA (ARV: <i>β</i> = -0.40, <i>p</i> = .010; CV: <i>β</i> = -0.33, <i>p</i> = 0.026) and higher PSMD (CV: <i>β</i> = 0.28, <i>p</i> = .038) after adjustment for confounders. Correction for WM hyperintensities did not change these results.</p><p><strong>Conclusions: </strong>High BPV during hospitalisation is associated with lower WM integrity in COVID-19 patients, although causality needs to be demonstrated. Our findings need validation in hospitalised patients without COVID-19 to examine generalisability.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":"34 1","pages":"2493828"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977315","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":"An interactive care plan plus remote blood pressure monitoring in a rural primary care clinic: a pilot study.","authors":"Ramona S DeJesus, Jane W Njeru, Mark R Beahm, Rachel E Gullerud, Jessica A Grimm, Barbara J Copeland, Julianne J Lunde, Ivana T Croghan","doi":"10.1080/08037051.2025.2490589","DOIUrl":"https://doi.org/10.1080/08037051.2025.2490589","url":null,"abstract":"<p><strong>Background: </strong>Remote blood pressure monitoring (RBPM), an effective method of enhancing BP control for patients with hypertension, can potentially helpovercome geographic limitations of health care services. We conducted a 90-day pilot to explore combining an interactive care plan (ICP) with RBPM.</p><p><strong>Method: </strong>The pilot invited fifty adult patients with uncontrolled hypertension (BP ≥140/90 mm Hg) empanelled to a rural primary care practice in midwestern United States. Participants received instructions for downloading an ICP app and were given a wireless BP monitoring device that automatically transmitted readings to their care team. Patients were surveyed after 30 and 90 days about program experience.</p><p><strong>Results: </strong>Thirty-six patients enrolled. Mean participant age was 59.1 years; most were male, married, and White. Mean baseline BP was 153/89 mm Hg. Participants who engaged in the program for at least 75 days (<i>n</i> = 15) had a postintervention mean BP of 135/80 mm Hg. Sixteen participants (44%) had 1 outpatient visit (no multiple outpatient visits): only 4 (11%) had an emergency department visit. Among survey respondents, most strongly agreed or agreed that 1) ICP app was easy to use, 2) BP device was helpful in home care, 3) interacting remotely with care team was smooth, and 4) they were satisfied with functionality of the RBPM device.</p><p><strong>Conclusion: </strong>An ICP paired with an RBPM device is a reasonable intervention for managing hypertension in a primary care practice particularly for patients in rural areas. New strategies must be developed to reduce barriers to meaningful engagement, achieve sustainability, and ensure successful widespread adoption.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":"34 1","pages":"2490589"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953607","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":"Cost-effectiveness analysis of radiofrequency renal denervation for uncontrolled hypertension in Sweden.","authors":"T Kahan, M L Johansen, A M Ryschon, K N Cao, M D Kolovetsios, P Lindgren, J B Pietzsch","doi":"10.1080/08037051.2025.2487583","DOIUrl":"10.1080/08037051.2025.2487583","url":null,"abstract":"<p><strong>Introduction: </strong>Radiofrequency renal denervation (RF RDN) is a catheter-based therapy for uncontrolled hypertension. This model-based analysis examined the cost-effectiveness of RF RDN in Sweden.</p><p><strong>Methods: </strong>Clinical events, costs, quality-adjusted life-years (QALYs) were projected over 10-year and lifetime horizons using a decision-analytic Markov model. Primary health states, included hypertension alone, myocardial infarction (MI), stroke, other symptomatic coronary heart disease (CHD), heart failure (HF), end-stage renal disease (ESRD), and death. Health state transitions were informed by multivariate risk equations. Clinical evidence from the SPYRAL HTN-ON MED trial informed the treatment effect modelled (-4.9 mmHg reduction in office systolic blood pressure (SBP) vs. sham). The base case was conducted from the Swedish healthcare payer perspective. The primary outcome was the incremental cost-effectiveness ratio (ICER),RF RDN vs. standard of care (SoC), evaluated against an assumed willingness-to-pay threshold of SEK 500,000 per QALY gained. Extensive sensitivity analyses were performed.</p><p><strong>Results: </strong>At 10-years, the relative risks with RF RDN were 0.80 for stroke, 0.88 for MI, 0.89 for CHD, 0.72 for HF, 0.96 for ESRD, 0.86 for cardiovascular death and 0.93 for all-cause death. Over lifetime, RF RDN led to incremental costs of SEK 63,136 (total costs SEK 497,498 vs. SEK 434,362) and incremental QALY gain of 0.45 (14.79 vs. 14.34), yielding an ICER of SEK 139,280 per QALY gained. RF RDN was cost-effective across all scenarios and sensitivity analyses.</p><p><strong>Conclusion: </strong>Model projections suggest RF RDN to be a cost-effective therapy for uncontrolled including resistant hypertension in Sweden based on contemporary clinical evidence.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2487583"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750063","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":"Clinical characterization of blood pressure phenotypes: the BP phenotype score.","authors":"Maha A Al-Mohaissen, Maisa A Al Zohaifi, Terry Lee, Nada A Almalki, Hend Aleiban, Rabah A Al-Mehisen","doi":"10.1080/08037051.2025.2486284","DOIUrl":"10.1080/08037051.2025.2486284","url":null,"abstract":"<p><strong>Background: </strong>Evidence has linked blood pressure (BP) phenotypes with certain clinical, psychosocial, and occupational features, and characteristic BP variability.</p><p><strong>Objective: </strong>We aimed to evaluate the value of a diagnostic score developed from these characteristics in predicting BP phenotypes, when used in a manner comparable to the application of out-of-office techniques.</p><p><strong>Methods: </strong>Adult patients with no prior diagnosis of hypertension attending their office appointments, were prospectively enrolled. Their clinical, psychosocial, and occupational data were collected. 3-consecutive pre-appointment BP measurements, and BP variability with standing and the 6-minute walk test (6MWT) were obtained. All participants underwent 24-hour BP monitoring which was paired with office BP as the reference standard for BP phenotyping. Two scores were developed from the variables selected using linear regression analysis to differentiate between masked hypertension (MH) and normotension, and sustained hypertension (SH) and white coat hypertension (WCH).</p><p><strong>Results: </strong>In total 212 participants completed the study. Among office-normotensives, a score of 7 (calculated from, variables (points): dyslipidemia (3), irritable bowel syndrome (IBS) (3), orthostatic increase in SBP >5 mmHg (1), SBP increase >10 after 6MWT (1), and BP ≥130/80 after 6MWT (3)) identified MH with 90% sensitivity, 86% specificity, 70% positive predictive value (PPV), and 96% negative predictive value (NPV). Conversely, among office-hypertensives, a score of 6 (male sex (2), no IBS (2), ≥3 metabolic syndrome criteria (3), obesity (3), standing BP ≥140/90 (3), BP ≥140/90 after 6MWT (1)) identified SH with 82% sensitivity, 78% specificity, 90% PPV, and 64% NPV.</p><p><strong>Conclusions: </strong>BP phenotypes correspond to distinct clinical phenotypes and can be predicted with acceptable sensitivity and specificity using BP phenotype scores. This novel approach to BP phenotyping provides an accessible addition, not a replacement, to available out-of-office techniques, particularly useful for screening for MH, and to support office diagnosis of SH when out-of-office measures are unavailable or not tolerated.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2486284"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750969","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":"OPTIHEART: determinants and prognostic importance of optimal medical treatment in patients with heart failure with reduced ejection fraction discharged from a heart failure clinic from 2018 to 2020.","authors":"Alaa Sharfo, Astrid Lahn Sørensen, Emil Eik Nielsen, Ilan Esra Raymond, Anne Merete Boas Soja, Michael Hecht Olsen","doi":"10.1080/08037051.2025.2481229","DOIUrl":"10.1080/08037051.2025.2481229","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) is an increasing health problem globally. Profound sex-related differences have been observed regarding the cause, treatment, and prognosis of HF.</p><p><strong>Aim: </strong>To assess baseline predictors for achieving optimal medical treatment (OMT) and the prognostic importance of OMT for male and female patients who have attended a HF clinical program (HFCP).</p><p><strong>Methods: </strong>OPTIHEART was a retrospective study that included 870 consecutive patients with left ventricular ejection fraction (LVEF)≤40% discharged from HFCP in 2018, 2019 or 2020 and followed in registers for a mean of 1083(SD 11.3) days. OMT was defined as receiving an angiotensin-converting-enzyme-inhibitor (ACEi), angiotensin-receptor blocker (ARB) or angiotensin-II-receptor blocker and nephrylisin-inhibitor (ARNI) AND a betablocker (BB) both in doses ≥ 50% of target doses.</p><p><strong>Results: </strong>Achieving OMT was associated with male sex (OR: 2.05 95%CI 1.44-2.97; <i>p</i> < 0.0001) independently of younger age, higher diastolic blood pressure (DBP), and lower creatinine. A lower rate of 5-point MACE was associated with achieved OMT (HR: 0.67 95%CI 0.50-0.90; <i>p</i> = 0.007) independently of female sex (HR: 0.64 95%CI 0.48-0.84; <i>p</i> = 0.002), younger age, never smoking and NYHA ≤ 2. The beneficial effect of OMT was insignificantly more pronounced in patients with male sex, older age, higher creatinine, lower DBP, and body mass index ≤25kg/m².</p><p><strong>Conclusion: </strong>OMT was more frequently achieved in patients with male sex independently of age, DBP, and creatinine. Achieving OMT was associated with less 5-point MACE independently of female sex, younger age, never smoking and NYHA ≤ 2.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2481229"},"PeriodicalIF":1.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656073","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}