Blood Pressure最新文献

{"title":"Acupuncture for primary hypertension: a systematic review and meta-analysis of randomised controlled trials.","authors":"Zhi-Hong Li, Hua-Wei Gao, Fang-Fang Shen, Yan Lu, Wei Chen","doi":"10.1080/08037051.2026.2654103","DOIUrl":"10.1080/08037051.2026.2654103","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis evaluated the efficacy and safety of acupuncture for primary hypertension, based on randomised controlled trials (RCTs) published between 2015 and 2024.</p><p><strong>Methods: </strong>We searched seven major databases for RCTs comparing acupuncture to control interventions. The primary outcomes were changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP). Meta-analyses utilised random-effects models, and the Cochrane Risk of Bias tool assessed study quality.</p><p><strong>Results: </strong>Seven RCTs (<i>n</i> = 812) were included. Acupuncture was associated with lower SBP [mean differences (MD) = -6.73 mmHg, 95% confidence interval (CI): -8.84 to -4.62] and DBP (MD = -6.59 mmHg, 95% CI: -9.42 to -3.76). Heterogeneity was substantial for SBP (<i>I</i>² = 73.3%) and considerable for DBP (<i>I</i>² = 90.9%). Notably, the SBP analysis included seven studies, whereas the DBP analysis included six studies, and the similar absolute pooled reductions should be interpreted cautiously, given the small and not fully overlapping study sets. Exploratory subgroup analyses suggested blood pressure reductions across several acupuncture modalities, though each subgroup contained very few studies. Adverse-event reporting was limited and inconsistent across studies. Formal tests for publication bias were underpowered given the small number of included studies.</p><p><strong>Conclusions: </strong>Acupuncture may have blood pressure-lowering effects in patients with primary hypertension, but the evidence is limited by substantial heterogeneity, a small number of studies and considerable variation in intervention type and exposure. Larger, well-designed, multi-centre RCTs with standardised protocols and longer follow-up are needed to confirm these findings and establish optimal treatment parameters.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2654103"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147589768","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":"Smoking status of patients with acute myocardial infarction in recent randomized clinical trials - actions needed.","authors":"Serena Tonstad, Sverre E Kjeldsen","doi":"10.1080/08037051.2026.2631269","DOIUrl":"10.1080/08037051.2026.2631269","url":null,"abstract":"","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2631269"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146155737","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":"Secondary causes and renal outcomes in apparently resistant hypertension: a retrospective cohort study.","authors":"Tomáš Kvapil, Eva Kociánová, Zdeněk Ramík, Jan Olšr, Martin Rada, Jakub Flašík, Martin Modrák, Libor Jelínek, Jan Mizera, Jan Václavík","doi":"10.1080/08037051.2026.2612792","DOIUrl":"10.1080/08037051.2026.2612792","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we aimed to determine the prevalence and spectrum of secondary hypertension among patients with apparently resistant arterial hypertension (aRH) and to compare the rate of decline in estimated glomerular filtration rate (eGFR) between those with primary aldosteronism (PA) and true resistant arterial hypertension (RAH).</p><p><strong>Methods: </strong>This retrospective cohort study involved 790 patients with aRH referred to a hypertension excellence centre. All patients fulfilled pharmacological criteria for aRH and underwent a screening protocol to evaluate secondary hypertension. We compared clinical and laboratory markers of patients with PA to those with RAH, with a median follow-up of 7 years.</p><p><strong>Results: </strong>Secondary hypertension was identified in 213 patients (27%), with PA being the most common cause (17%), followed by renovascular hypertension (4.1%) and renal parenchymal disease (3.7%). Compared to RAH patients, those with PA had significantly fewer cardiovascular comorbidities. Patients with RAH exhibited a faster decline in renal function, specifically an additional 0.7 mL/min/1.73 m² reduction per year (95% confidence interval: 0.05-1.35, <i>p</i> = .03), despite similar baseline eGFR and blood pressure (BP) control. In RAH, a continuous association between higher average 24-h systolic BP and a faster decline in renal function was observed.</p><p><strong>Conclusion: </strong>Systematic screening in aRH reveals a high prevalence of secondary hypertension, particularly PA. Patients with RAH showed significantly worse renal outcomes compared to those with PA, with faster renal decline associated with higher BP within the RAH group, underscoring the need for early diagnosis and strict BP management.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2612792"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145931638","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":"Correction.","authors":"","doi":"10.1080/08037051.2026.2622829","DOIUrl":"10.1080/08037051.2026.2622829","url":null,"abstract":"","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":"35 1","pages":"2622829"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084064","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":"Long-term efficacy and safety of first- and second-generation baroreflex activation devices in refractory hypertension: a single center retrospective analysis.","authors":"Jessica Kaufeld, Ruha Younes, Thomas Aper, Bernhard M W Schmidt, Jan Menne","doi":"10.1080/08037051.2026.2629644","DOIUrl":"10.1080/08037051.2026.2629644","url":null,"abstract":"<p><strong>Background: </strong>Baroreflex activation therapy (BAT) has emerged as a device-based therapy for resistant hypertension. Comparative evidence between first-generation (Rheos^®) and second-generation (Barostim Neo^™) BAT systems remains limited.</p><p><strong>Methods: </strong>We retrospectively analysed all patients who underwent BAT implantation between 2006 and 2015 (<i>n</i> = 54) at our centre. The primary outcome was the change in 24h ambulatory blood pressure monitoring (ABPM) between device generations. Secondary outcomes included adverse events, major adverse cardiovascular events (MACE), kidney function, and device-related complications. Office blood pressure, 24h ABPM, and heart rate (HR) were assessed at baseline and during follow-up. Patients with insufficient 24h ABPM follow-up data were excluded from the primary endpoint analysis.</p><p><strong>Results: </strong>In patients with ABPM data (<i>n</i> = 33), BAT significantly reduced 24h diastolic blood pressure (DBP), 24h systolic blood pressure (SBP), and HR (all <i>p</i> < 0.05). Daytime SBP, DBP, and HR decreased significantly. At night, SBP declined from 165 to 151 mmHg (<i>p</i> = 0.004) and DBP from 98 to 88 mmHg (<i>p</i> = 0.003), while HR remained unchanged. Rheos^® was associated with significant reductions in 24h and night-time SBP; daytime SBP decreased numerically but did not reach statistical significance. Barostim Neo^™ (<i>n</i> = 14) reduced 24h and daytime HR (<i>p</i> = 0.006 and <i>p</i> = 0.009) but showed no statistically significant BP reduction. No significant differences were observed between devices in complication rates, kidney function, or MACE.</p><p><strong>Conclusion: </strong>Baroreflex activation was safe and associated with reductions in 24h blood pressure and heart rate in patients with resistant hypertension. The first-generation Rheos^® system demonstrated more pronounced blood pressure-lowering effects, whereas the second-generation Neo^™ system was associated primarily with heart rate reduction without a significant effect on blood pressure. Although Rheos^® is no longer commercially available, these findings highlight the importance of electrode design, implantation strategy, and patient selection in optimising the efficacy of contemporary BAT.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2629644"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141278","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":"Hypertension action bundle including training of healthcare professionals to improve the detection of primary aldosteronism: a cohort study.","authors":"Benoit Franko, Sandra Jost, Sandrine Moutel, Isabelle Rey, Sylvain Collet, Tristan Delory","doi":"10.1080/08037051.2026.2648287","DOIUrl":"10.1080/08037051.2026.2648287","url":null,"abstract":"<p><strong>Objective: </strong>As a blood pressure clinic, we have developed a hypertension action bundle including a training programme to facilitate secondary hypertension screening, delivered during three phases: P1 (2016-2018): for hospital practitioners; P2 (2019-2021): for practitioners working outside of hospitals; P3 (2022-2024): consolidation phase. We hypothesised that a training programme could enhance diagnosis of primary aldosteronism (PA).</p><p><strong>Design and method: </strong>This study included patients diagnosed with PA between 2016 and 2024. The primary objective was to investigate the incidence of PA diagnosis across three distinct time periods. In addition, we investigated patient origin, reason for consultation and clinical-biological profile, with a view to gaining insight into the diagnostic process.</p><p><strong>Results: </strong>A total of 110 PA patients were diagnosed with PA. The annual incidence of primary aldosteronism (PA) per 1000 consultations increased significantly from 1.2 in P1 to 2.64 in P2 (Odds Ratio P1-P2: 2.2 [95CI, 1.2-4.1]) and 4.31 in P3 (Odds Ratio P2-P3: 1.6 [95CI, 1.1-2.4]). This increase can be primarily attributed to enhanced screening by general practitioners and cardiologists. PA screening indications had also evolved over time, shifting from hypokalaemia and hypertension with target organ damage in P2, to pre-eclampsia, refractory hypertension or hypertension in young patients in P3. There was little to no change in patient's clinic-biological profile between periods.</p><p><strong>Conclusion: </strong>The hypertension action bundling including training of physicians in the management of high blood pressure has resulted in significant advancements in the diagnosis and management of PA, through the identification of less common hypertension profiles.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2648287"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147479762","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":"Dual-impedance cardiography for the assessment of arterial stiffness: associations with blood pressure, cardiometabolic risk factors, and preclinical atherosclerosis in midlife adults.","authors":"Caitlin M DuPont, Trevor M Weis, Jaya A King, Kristen T Stopfer, Colter K Clayton, Anna L Marsland, Thomas W Kamarck, Peter J Gianaros, Mark R Scudder","doi":"10.1080/08037051.2025.2600733","DOIUrl":"10.1080/08037051.2025.2600733","url":null,"abstract":"<p><strong>Purpose: </strong>Pulse wave velocity (PWV) is a measure of arterial stiffness that reflects vascular ageing and predicts risk for cardiovascular disease. We developed a PWV measurement method that uses dual-impedance cardiography (d-ICG) to address limitations of other common methods (e.g. ultrasound, tonometry, etc.), as well as to enable PWV assessments across a broader range of populations. This pre-registered, cross-sectional study tested for the first time the extent to which d-ICG PWV associates with cardiometabolic risk factors (i.e. blood pressure and other metabolic syndrome components) and vascular markers of preclinical atherosclerosis (i.e. carotid-artery intima-media thickness [C-IMT] and plaque).</p><p><strong>Methods: </strong>Participants were 366 healthy adults (aged 28-57; 63.4% female). In a subsample (<i>N</i> = 179), estimates of d-ICG PWV were compared for the first time against carotid-femoral PWV (cfPWV) measured by a Complior device.</p><p><strong>Results: </strong>d-ICG PWV and cfPWV measures were comparably associated with age and blood pressure (<i>r</i>'s ≥ .28, <i>p</i>'s ≤ .001), and they exhibited moderate consistency (ICCs = 0.51 to 0.55, <i>p</i>'s < .001). Across all cardiometabolic risk factors and markers of preclinical atherosclerosis, there were no clinically meaningful differences in the average composite (Fisher's Z-score) correlations with arterial stiffness measured by d-ICG and cfPWV based on Cohen's <i>q</i> values (<i>q</i>'s = 0.042 to 0.097).</p><p><strong>Conclusion: </strong>d-ICG PWV may be a low-cost, reliable, and alternative method for obtaining estimates of arterial stiffness that track with cardiometabolic risk factors and preclinical atherosclerosis.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2600733"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713094","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 factors associated with isolated systolic hypertension among middle-aged adults and older Filipinos: a population-based study.","authors":"Maria Stephanie N Parani, Chona F Patalen, Ma Lynell V Maniego, Eisley Jadd V Taylo, Ma Lilibeth P Dasco, Charmaine A Duante","doi":"10.1080/08037051.2026.2629094","DOIUrl":"10.1080/08037051.2026.2629094","url":null,"abstract":"<p><strong>Background: </strong>Isolated systolic hypertension (ISH), defined as blood pressure of ≥140/<90 mmHg, is associated with an increased risk of cardiovascular complications yet few estimates of prevalence are recorded globally. Data on blood pressure measurements of adult Filipinos were taken as one of the variables in the National Nutrition Survey; however, the prevalence of ISH and its associated risk factors has not been investigated. This study aimed to determine the prevalence and factors associated with ISH among middle-aged (40-59 years) and older (60 and above) Filipinos.</p><p><strong>Methods: </strong>A secondary data analysis of the cross-sectional survey design of the 2018, 2019, and 2021 Expanded National Nutrition Survey (ENNS) of the Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI) was utilised in the study. Multivariable logistic regression analysis was employed to determine the factors significantly associated with ISH.</p><p><strong>Results: </strong>The prevalence of ISH from the pooled data was 9.10% (95% CI: 8.68-9.53) and increased significantly with age. After adjustment, multivariable analysis identified several factors significantly associated with ISH, the factors included: age, with those 70 years old of age or older exhibiting the highest odds [AOR 11.71 (95% CI: 8.38-16.35)], having little to no formal education [AOR 1.39 (95% CI: 1.18-1.64)], the presence of diabetes [AOR 1.62 (95% CI: 1.38-1.90)], or prediabetic [AOR 1.37 (95 CI: 1.13-1.66)], a family history of hypertension [AOR 2.26 (95% CI: 2.03-2.52)], and current alcohol drinker [AOR 1.24 (95% CI: 1.08-1.43)].</p><p><strong>Conclusion: </strong>ISH was prevalent among middle-aged and older Filipino population across the three survey periods. Given the impact of ISH on cardiovascular outcomes, these findings may provide crucial data on its prevalence and determinants, which can assist policymakers in formulating targeted interventions centred on lifestyle modifications.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2629094"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146155805","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":"Clinicians' time in different aspects of hypertension care: how far are we from optimal management required by guidelines? Results of an international survey of the working group of general practitioners' and team-based care of the European Society of Hypertension and the European General Practice Research Network.","authors":"Miriam Pikkemaat, Rosa de Pinho, Enrique Rodilla, Thomas Weber, Reinhold Kreutz, Thomas Frese, Minna Johansson, Bojan Jelakovic, Valerija Bralic Lang, Nina Dahle, Péter Torzsa, Andrew Oostindjer, Nikolaos Evangelidis, Areti Triantafyllou, Michael Doumas, Evangelos Fragkoulis, Fabio Albini, Jean-Marc Boivin, Anders Norrman, Andreas Stomby, János Nemcsik","doi":"10.1080/08037051.2026.2635826","DOIUrl":"10.1080/08037051.2026.2635826","url":null,"abstract":"<p><strong>Background: </strong>Hypertension management guidelines provide recommendations for optimal patient care. However, the limited time available of clinicians is rarely considered. The aim of this study was to evaluate the time clinicians currently spend on different components of hypertension care during an average workday and to assess physicians' perceptions of the time required for optimal, guideline-based care.</p><p><strong>Methods: </strong>We conducted an international, cross-sectional, anonymous questionnaire-based survey among physicians involved in hypertension care. A 37-item questionnaire assessed time spent on, and time perceived as necessary for, guideline-recommended hypertension-related activities during an average workday. The survey was distributed through the European Society of Hypertension (ESH) and the European General Practice Research Network (EGPRN) between 1 June and 15 September 2025.</p><p><strong>Results: </strong>370 responses were collected from 49 countries worldwide (91.3% from Europe). After data clarification 357 responses were analysed. Of these, 153 (42.9%) were general practitioners (GPs) and 204 (57.1%) were other specialists (internists, cardiologists, nephrologists). Across all assessed activities, clinicians consistently reported a gap between the time currently spent and the time perceived as necessary for optimal care, including office blood pressure measurement, home blood pressure measurement education, lifestyle counselling, and cardiovascular risk stratification. Differences were also observed between the practice of GPs and other specialists.</p><p><strong>Conclusions: </strong>This international survey demonstrates substantial perceived gaps between available and required time for several components of hypertension care, particularly in general practice. These findings highlight the importance of considering real-world clinician time constraints in the development and prioritisation of hypertension guideline recommendations and suggest that adequate health-system resources are needed to support their implementation.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2635826"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147269548","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":"Comment on 'long term efficacy and safety of first and second generation baroreflex activation devices in a refractory hypertension'.","authors":"Anushka, Mousumi Saha, Tai Yayum, Subhasish Chatterjee","doi":"10.1080/08037051.2026.2651502","DOIUrl":"https://doi.org/10.1080/08037051.2026.2651502","url":null,"abstract":"","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":"35 1","pages":"2651502"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687993","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}