Hypertension Research最新文献

Excessive dietary salt intake remains a major public health concern in Japan and worldwide, contributing to noncommunicable diseases, including hypertension and cardiovascular disease. Although national health promotion strategies in Japan have emphasized behavioral change through nutrition education and awareness campaigns to achieve population-level salt-reduction targets, average intake continues to exceed recommended levels. This suggests that the food environment needs structural modifications through multisectoral collaboration to increase the nutritional quality of consumer foods and the availability of healthier options. Voluntary reformulation by the food industry is a key component of these efforts. To support voluntary reformulation, we developed a practical guide for setting salt-reduction targets and planning feasible reformulation strategies, informed by consultation with registered dietitians working in national and local governments, reviews of guidance documents and voluntary corporate initiatives in other high-income countries, and feedback from Japanese food companies on the draft guide. This guide promotes target setting aligned with the Specific, Measurable, Achievable, Relevant, and Time-bound (SMART) framework for goal-setting and outlines methodological options for product scope, nutrient focus (salt alone, or salt and other nutrients such as fat and sugar), metrics, sodium criteria, and implementation timelines. The guide also addresses organizational structures and collaboration with external stakeholders. Business incentives are highlighted, including opportunities for product innovation, contributions to environmental, social, and governance performance, and the building of consumer trust. By providing a structured and adaptable framework, the guide aims to foster coordinated industry engagement in salt reduction to prevent hypertension and cardiovascular disease. This mini review presents a guide to help Japanese food companies set voluntary salt-reduction targets and plan feasible product reformulation strategies. It integrates international guidance, registered dietitians' and companies' feedback, and the SMART framework to help translate policy goals into actionable objectives, promoting consistent salt reduction across the food industry.

Constant light (LL) disrupts biological rhythms, although more data are available on circadian than on ultradian rhythms. LL has been linked to elevated blood pressure (BP), although most evidence comes from tail-cuff plethysmography in males. However, in nocturnal animals, LL should suppress activity, increase sleep, and lower BP. Therefore, the aim of this study is to provide a comprehensive analysis of the impact of LL on (1) cardiovascular parameters and sleep and (2) circadian and ultradian variability in female rats. We used telemetry for continuous monitoring of heart rate (HR), BP, and locomotor and sleep-wake activity in female rats exposed to LL for four weeks. LL progressively reduced basal systolic BP and HR and weakened the strength of circadian rhythms. Moreover, the loss of daily variability enhanced the acute cardiovascular response. Spectral analysis revealed disrupted ultradian rhythms, with HR power shifting from longer (~7-9 h) to shorter (~1-3 h) periods and locomotor activity showing a parallel decline, including a complete loss of 7-9 h rhythms by week 4. HR variability and baroreflex analysis showed parasympathetic dominance under LL. Sleep analysis revealed significant sleep disruption, characterised by altered distribution of sleep-wake states, reduced non-REM sleep during the light phase, increased fragmentation, and a complete loss of circadian organisation. LL reduced BP in female rats despite leaving total sleep duration largely unchanged, while markedly disrupting cardiovascular circadian and ultradian variability and sleep architecture. These findings suggest that LL-induced chronodisruption imposes a maladaptive physiological load also in nocturnal rodents.

The sympathetic nervous system plays a pivotal role in the pathophysiology of hypertension. Although the contribution of the sympathetic nervous system to an elevation of blood pressure is well established, the determinants of persistent sympathetic overactivity remain incompletely understood. This review summarizes the findings of recent basic research that have expanded the understanding of sympathetic regulation in hypertension, highlighting emerging mechanisms and providing insights into the development of novel therapeutic strategies.

The association between maternal morning blood pressure (BP) levels and adverse pregnancy outcomes (APOs), including severe preeclampsia, target organ damage, preterm birth, placental abruption, postpartum hemorrhage, small-for-gestational-age infants, and pregnancy loss, is not well understood. In a retrospective cohort study of 1833 high-risk singleton pregnancies with outpatient ambulatory BP monitoring, 26.7% had morning hypertension. Morning BP strongly correlated with non-morning daytime BP (Pearson r = 0.89) and nighttime BP (r = 0.78), but only moderately with office BP (r = 0.54). Compared to office BP, adding morning BP improved diagnostic accuracy for nighttime, masked, and non-morning daytime hypertension (Δ area under the curve 0.062 to 0.127, all P < 0.001). A J-shaped, non-linear association was observed between morning BP and the risk of composite APOs, with identified thresholds at systolic/diastolic BP ≥ 132/79 mmHg. Isolated morning hypertension, compared to isolated nighttime or non-morning daytime hypertension, did not independently increase composite APO risk. However, co-occurrence of morning hypertension with nighttime (odds ratio [OR] 3.16, 95% confidence interval [CI]: 2.34 to 4.27) or non-morning daytime (OR 3.41, 95% CI: 2.54 to 4.60) hypertension amplified the risks for APOs. The strongest association between co-occurring morning and nighttime hypertension and APO risk was observed between 28⁺⁶ and 34⁺⁶ weeks of gestation (OR 5.50, 95% CI: 2.13 to 7.43). Sensitivity analyses with alternative morning time windows and adjustments for non-morning mean arterial pressure consistently confirmed these findings. Our findings support morning BP measurement as a valuable and practical marker for screening and identifying high-risk BP patterns during pregnancy.

Emerging evidence links maternal immune dysregulation to hypertensive disorders of pregnancy (HDP), yet gestational immune alterations preceding symptom onset remain unclear. This study aimed to evaluate the associations between first-trimester immune biomarkers and incident HDP risk across clinical subtypes. This retrospective cohort study enrolled pregnant women aged ≥18 years undergoing first-trimester antenatal screening at a tertiary hospital from March to November 2023. First-trimester peripheral immune markers-neutrophils, monocytes, lymphocytes, and platelets-were measured, with derived indices including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), and aggregate index of systemic inflammation (AISI). Outcomes included HDP, gestational hypertension (GHTN), and preeclampsia confirmed via electronic medical records. Multivariable logistic regression models were performed to evaluate the relationship between peripheral immune markers and outcomes. Among the 2739 pregnant women who met inclusion criteria, 195 developed HDP, including 96 GHTN and 99 preeclampsia. Multivariable logistic regression demonstrated that first-trimester neutrophils, monocytes, platelets, lymphocytes, SII, and AISI were independently and positively associated with HDP risk in a linear dose-response manner (all FDR P < 0.05), with platelets exhibiting the strongest association (OR _{T3 vs. T1}: 2.20; per log-SD: OR = 1.55). Distinct biomarker profiles were identified between GHTN and preeclampsia: GHTN exhibited associations with neutrophils, platelets, SII, and AISI, while preeclampsia correlated with monocytes, platelets, lymphocytes, SII, and AISI (all FDR P < 0.05). Elevated first-trimester immune markers correlate with HDP, particularly platelet-related indices. Divergent immune signatures between GHTN and preeclampsia suggest subtype-specific pathophysiological mechanisms.