Blood Pressure最新文献

{"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":"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":"Commentary on \"hypertension and frailty among middle-aged and older adults in India: the mediating role of multimorbidity\".","authors":"Anamika Rajpoot","doi":"10.1080/08037051.2026.2714591","DOIUrl":"10.1080/08037051.2026.2714591","url":null,"abstract":"","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2714591"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673072","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":"Comparison of cardio-cerebral hemodynamics in non-prodromal and prodromal vasovagal syncope: a prospective comparative study.","authors":"Yanni Yu, Yanqin Fan, Lijie Ren, Liming Cao","doi":"10.1080/08037051.2026.2719281","DOIUrl":"10.1080/08037051.2026.2719281","url":null,"abstract":"<p><strong>Background: </strong>Vasovagal syncope (VVS) without aura is characterised by a high fall risk and misdiagnosis rate. However, its hemodynamic characteristics remain unclear.</p><p><strong>Methods: </strong>A total of 221 participants were prospectively and consecutively enrolled, including 34 patients with non-prodromal VVS, 118 patients with prodromal VVS, and 69 non-syncope controls. All participants completed the head-up tilt test (HUTT) combined with transcranial Doppler (TCD). Blood pressure, heart rate, and cerebral hemodynamic parameters were monitored dynamically during the test. Data were statistically analysed.</p><p><strong>Results: </strong>The non-prodromal VVS group consisted predominantly of males (70.59% vs. 37.29%), had a higher body mass index (median 24.14 vs. 21.26 kg/m²), and was older (median 47 vs. 37 years) (all <i>p</i> < 0.05). The baseline cerebral blood flow velocity (CBFV) in the non-prodromal VVS group was significantly lower than that in the prodromal VVS group (55 vs. 60 cm/s, <i>p</i> = 0.009), and the decrease of CBFV during the tilt test preceded the change of blood pressure. During the return to the supine position after HUTT, systolic blood pressure was significantly higher in the non-prodromal VVS group than in the prodromal VVS group (<i>p</i> = 0.019), and the heart rate increment was greater during the drug-induced phase.</p><p><strong>Conclusions: </strong>Non-prodromal VVS, with its unique hemodynamic profile involving early cerebral hypoperfusion and impaired central compensatory mechanisms, represents a high-risk subtype associated with higher fall risk. The identified hemodynamic differences may serve as objective biomarkers for its diagnosis. This study highlights the need for tailored management strategies.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2719281"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759582","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":"Considerations for 'transportation noise: its cardiovascular effects and their reversibility; a narrative review'.","authors":"Shalom Akhai, Syed Mohd Arif, Mahapara Abbass","doi":"10.1080/08037051.2026.2715845","DOIUrl":"10.1080/08037051.2026.2715845","url":null,"abstract":"","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2715845"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673031","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":"Beyond seeing the same clinician: strengthening continuity of hypertension care through better information flow.","authors":"Yuyun Eka Kartika Sari, Deby Febriyan Eprilianto, Yuni Lestari","doi":"10.1080/08037051.2026.2737545","DOIUrl":"10.1080/08037051.2026.2737545","url":null,"abstract":"","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2737545"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015622","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":"Beyond increased detection: strengthening accountability for professional training.","authors":"Amriana, Bakhrudin All Habsy, Retno Tri Hariastuti","doi":"10.1080/08037051.2026.2751784","DOIUrl":"https://doi.org/10.1080/08037051.2026.2751784","url":null,"abstract":"","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":"35 1","pages":"2751784"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219997","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":"Epidemiology of uncontrolled and treatment‑resistant hypertension: a registry‑based observational study.","authors":"Poyan Shojaiyan, Johan Sundström, Mattias Brunström, Olof Karlberg, Dan Henrohn","doi":"10.1080/08037051.2026.2749134","DOIUrl":"10.1080/08037051.2026.2749134","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to describe blood pressure control rates and prevalence of treatment resistant hypertension among diagnosed individuals.</p><p><strong>Methods: </strong>Randomly selected adults who had at least one primary or secondary healthcare visit and who were registered residents of Stockholm County, Sweden, on December 31^st, 2019, were included. Blood pressure control in diagnosed individuals was assessed using two targets: <140/90 mmHg and <130/80 mmHg. The prevalence of treatment-resistant hypertension defined by three commonly used criteria was calculated and its association with clinical characteristics, drug treatment patterns, and comorbidities were assessed.</p><p><strong>Results: </strong>By the end of 2019, among those with a hypertension diagnosis, 57% (<140/90 mmHg) or 19% (<130/80 mmHg) had controlled blood pressure depending on the threshold used. The point prevalence of treatment-resistant hypertension ranged from <1% to 17% depending on definition and was associated with older age, higher body mass index, and multiple comorbidities including type 2 diabetes, cardiovascular disease, heart failure, and chronic kidney disease.</p><p><strong>Conclusion: </strong>Blood pressure control remains a major clinical challenge, with fewer than one in five patients with a hypertension diagnosis achieving <130/80 mmHg. The prevalence of treatment-resistant hypertension varied widely depending on the definition used and was closely associated with a greater burden of comorbidities, indicating an unmet need for improved strategies for this clinically challenging subgroup.</p>","PeriodicalId":9000,"journal":{"name":"Blood Pressure","volume":" ","pages":"2749134"},"PeriodicalIF":2.3,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178854","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}