Hypertension Research最新文献

Superselective adrenal artery embolization (SAAE) has increasingly emerged as an alternative treatment for primary aldosteronism (PA) patients who either unwilling or unable to undergo surgical adrenalectomy, and cannot tolerate or refuse to mineralocorticoid receptor antagonists (MRAs). Although SAAE has been applied in PA treatment for over two decades, its safety and efficacy are still uncertain due to absence of multi-center, randomized controlled trials, hindering its widespread clinical adoption. Currently, only a few centers could perform this procedure proficiently, leading to variability in technical protocols and clinical outcomes across different institutions. During SAAE procedure, it is crucial to determine the target adrenal artery, while misidentification of the artery could lead to severe complications. To promote the safe and effective performance of SAAE, we aim to explore the application value of ipsilateral superselective adrenal arteriography and adrenal venography during the SAAE procedure. The application value of ipsilateral superselective adrenal arteriography and adrenal venography in patients with primary aldosteronism undergoing adrenal artery embolization. SAAE superselective adrenal artery embolization, AVS adrenal venous sampling.

The brainstem plays a vital role in regulating blood pressure, and disruptions to its neural pathways have been linked to hypertension. However, it remains unclear whether subtle microstructural changes in the brainstem are associated with an individual's blood pressure status. This exploratory, cross-sectional study investigated the relationship between brainstem microstructure, myelination, and hypertensive status in 116 cognitively unimpaired adults (aged 22-94 years). Advanced MRI techniques, including relaxometry (R1, R2) and myelin water fraction (MWF) analysis, were employed to assess microstructural integrity and myelin content in ten brainstem subregions. Our results revealed significant associations between higher microstructural damage or lower myelin content (indicated by lower R1, R2, or MWF values) and hypertensive status, particularly in the midbrain tegmentum. Notably, combining these MRI metrics yielded high classification accuracy (AUC > 0.85). Our findings suggest a potential link between disrupted brainstem tissue integrity, myelin content, and elevated blood pressure, warranting further longitudinal investigations to explore this relationship.

Blood pressure (BP) variability (BPV) is an independent predictor of cardiovascular (CV) events. The role of BPV in defining risk of cancer therapy-related cardiovascular toxicity (CTR-CVT) is currently unknown. The aims of this study were: (i) to evaluate BPV in a population of patients with Multiple Myeloma, undergoing proteasome inhibitors therapy; (ii) to assess the predictive value of BPV for CTR-CVT; (iii) to analyze clusters of subjects based on BPV. One hundred twenty-four patients underwent a baseline evaluation, including Ambulatory Blood Pressure Monitoring (ABPM), PWV, and Echocardiography. BPV was assessed through ABPM-based standard deviation (SD), weighted standard deviation (wSD), coefficient of variation (CoV), average real variability (ARV), and variability independent of the mean (VIM). Individuals who developed CTR-CVT had a higher baseline BPV. Furthermore, night-time BPV was associated with CTR-CVT, independently of age, smoking, BP, diabetes, dyslipidemia, and kidney function (night-time systolic CoV: adjusted OR 1.09 [1.01-1.21]; night-time systolic VIM: adjusted OR 1.18 [1.01-1.39]). Cut-offs for these BPV parameters were identified as predictors of CTR-CVT occurrence: 10.5 for night-time systolic CoV; 7.8 and 6.4 for systolic and diastolic night-time VIM. Clustering analysis identified subgroups of subjects characterized by the highest BPV, who had a greater prevalence of events, but no differences in other CV risk determinants. Short-term BPV is an independent predictor of CTR-CVT. BPV may enhance the precision of risk stratification in cancer patients, enabling identification of individuals at higher risk who would not be recognized, if traditional prognostic indicators were the sole applied criteria. On the left panel in the figure, the distribution of blood pressure variability (BPV) in the population according to cancer therapy-related cardiovascular toxicity occurrence; in the central panel, association of blood pressure variability with events and cutoffs values; in the right panel, clustering analysis results based on BPV levels. Histogram and radar plot represent events and BPV indexes distribution in the three clusters, respectively. ARV, average real variability; BPV, Blood Pressure Variability; CTR-CVT, cancer therapy-related cardiovascular toxicity; CoV, coefficient of variation; DBP, Diastolic blood pressure; SBP, Systolic blood pressure; SD, standard deviation; VIM, variability independent of the mean; wSD, weighted standard deviation.

This study aims to delineate the levels of Cd exposure in maternal blood, placenta, and cord blood, and to explore the association between Cd levels and the risk of preeclampsia (PE), as well as its potential impact on fetal growth among affected individuals. A case-control study was performed at the First Hospital of Shanxi Medical University, involving 373 pregnant women diagnosed with PE and 485 controls. Cd was measured in maternal blood, placenta, and cord blood using ICP-MS. The association between Cd and birth weight z-score was analyzed by multivariate linear regression. Logistic regression analysis was used to investigate the relationships between Cd and the risk of PE, and Cd and the risk of fetal growth. The concentration of Cd in the placenta was higher than that in maternal blood and cord blood. The highest tertile of placental Cd was identified as a risk factor for PE (OR = 2.704, 95% CI: 1.865, 3.921). Among pregnant women with PE, higher levels of Cd exposure in the placenta were negatively associated with birth weight z-scores (per doubling: β = -0.134, 95% CI: -0.264, -0.004), and the highest tertile of placental Cd was associated with an elevated risk of SGA (OR = 2.103, 95% CI: 1.164, 3.801). Furthermore, an interaction between Cd and PE was identified. In conclusion, Cd can accumulate in the placenta of pregnant women, and high placental Cd exposure not only increases the risk of PE but also exacerbates the risk of SGA outcome in PE pregnant women.