Hypertension Research最新文献

In hemodialysis patients, blood pressure (BP) measured at the postdialysis period (POSBP) can be used to diagnose hypertension. However, the optimal time point for POSBP remains uncertain. This cross-sectional study evaluated 210 long-term dialysis patients (66.7% men; age = 56.9 ± 15.7 years), who underwent POSBP measurements at three time points [immediately after dialysis period ended (POSBP1); after blood return (POSBP2) and after fistula hemostasis or catheter sealing (POSBP3)] and home BP monitoring (HBPM) over one week. POSBP1, POSBP2, POSBP3 and HBPM values were 139.1 ± 22.4/73.2 ± 12.5, 142.8 ± 22.8/74.3 ± 12.3, 142.8 ± 21.8/74.0 ± 12.2 and 131.2 ± 21.2/77.9 ± 12.1 mmHg, respectively. Systolic POSBP3 and POSBP2 were significantly greater (p < 0.05) than systolic POSBP1. POSBP3 had the greatest correlation with HBPM, while elevated (>130/80 mmHg) POSBP3 showed the highest numerical accuracy (AUC [95% CI] = 0.696 [0.638-0.754]) and concordance (kappa coefficient = 0.41) with elevated HBPM (≥130/80 mmHg) compared with POSBP1 and POSBP2. These findings suggest that POSBP3 may be a preferable measurement for assessment of POSBP in hemodialysis patients.

Hypertension (HT) is the most attributable and modifiable risk factor for spontaneous intracerebral hemorrhage (SICH). However, epidemiological data on blood pressure (BP) control before SICH and its relationship to patient lifestyles are lacking. This study prospectively enrolled patients with acute SICH from six stroke centers in Tochigi, Japan. BP control and patient lifestyles were investigated using a questionnaire conducted on patients and their families. A total of 365 patients were analyzed, 270 (74.0%) of whom had HT and 198 (54.2%) untreated HT. The prevalence of untreated HT was much higher in younger patients and decreased with age (79.0%, 71.8%, 62.2%, 44.8%, and 31.0% in those aged <50, 50-59, 60-69, 70-79, and ≥80 years, respectively). Patients with untreated HT were significantly less likely have a family doctor and attended fewer annual health checkups than did those with treated or no HT. Untreated HT with awareness was much higher in younger and middle-age men than in women, whereas untreated HT without awareness was much higher in younger women than in men. Among patients who received antihypertensives, the prevalence of well-controlled HT was also very low, especially in younger patients (20.0% and 23.5% in those aged <50, and 50-59 years, respectively). In-hospital mortality was much higher in younger patients (age <70 years) with untreated than with treated or no HT. Untreated and uncontrolled HT were highly detected and seemed to be important targets for the primary prevention of Japanese SICH. Different strategies to improve BP control are warranted for each generation and sex.

Nocturnal urination frequency is associated with sleep blood pressure (BP). However, it was uncertain to what extent the sleep BP increases within individuals with each increase in the number of nocturnal urination. We calculated intraindividual differences in sleep BP between nights with different urination frequencies to clarify their relationship. We enrolled 2418 community residents (mean age, 61.1 years). Participants wore a cuff on the upper arm when sleeping that automatically measured BP at fixed times during a 1-week period. The frequency of nocturnal urination was recorded in a sleep diary by the study participants. Sleep systolic BP increased with increased nocturnal urination frequency (0 time vs. 1 time, Δ2.1 mmHg, P < 0.001; 1 time vs. 2 times, Δ1.8 mmHg, P < 0.001; 2 times vs. ≥3 times, Δ1.4 mmHg, P = 0.012), and a similar association was observed for sleep diastolic BP. These associations were independent of age, the use of antihypertensive drugs reduced renal function, and the presence of sleep-disordered breathing. Sleep BP in participants who experienced nocturnal urination 0, 1, and 2 times during the 1-week measurement period showed a linear increase with the frequency of urination (0 time vs. 2 times: systolic BP, Δ4.7 mmHg; diastolic BP, Δ3.1 mmHg; P < 0.001). There was an intraindividual correlation between nocturnal urination frequency and sleep BP. These correlations were independent of baseline BP and participants' clinical backgrounds. Nocturnal urination frequency may be an indicator of individuals who require detailed ambulatory BP measurement.

Previous studies have shown an increase in blood pressure during the coronavirus disease 2019 (COVID-19) pandemic even among patients receiving antihypertensive treatment. This study aims to evaluate the association between equivalized annual household income and refraining from regular medical visits for hypertensive patients since the COVID-19 outbreak. We analyzed data from the Japan COVID-19 and Society Internet Survey (JACSIS), including 2832 hypertensive patients aged 20-79 years from the 2020 survey and at least one survey between 2021 and 2023. They were categorized into lower-income (

Cardiac remodeling encompasses structural alterations such as hypertrophy, fibrosis, and dilatation, alongside numerous cellular and molecular functional aberrations, constituting a pivotal process in the advancement of heart failure (HF). 4-Hydroxychalcone (4-HCH) is a class of naturally occurring compounds with variable phenolic structures, and has demonstrated the preventive efficacy in hyperaldosteronism, inflammation and renal injury. However, the role of 4-HCH in the regulation of cardiac remodeling remains uncertain. A cardiac remodeling model was established in male C57BL/6 J mice via subcutaneous Ang II (1000 or 300 ng/kg/min) for 2 weeks. Mice were treated with 4-HCH (20 or 40 mg/kg/day) or vehicle control. Systolic blood pressure (SBP) was measured using a tail-cuff method, and echocardiography assessed cardiac function. Histopathological staining evaluated cardiomyocyte hypertrophy, fibrosis, inflammation, and superoxide production. Network pharmacology analysis identified potential core targets and pathways mediating the effects of 4-HCH. Expression of inflammatory cytokines and proteins related to hypertrophy, fibrosis, inflammation, and oxidative stress was assessed by quantitative real-time PCR (qPCR) and Western blotting. Our results indicated that 4-HCH significantly ameliorated Ang II-induced hypertension, cardiomyocyte hypertrophy, fibroblast activation, fibrosis, inflammation, superoxide production, and cardiac function. Network pharmacology analysis identified the PI3K-AKT pathway as a crucial mechanism underlying the effects of 4-HCH, with experimental verification demonstrating that it inhibits cardiac remodeling by downregulating this pathway and its downstream effectors, including mTOR/ERK, TGF-β/Smad2/3, NF-κB, and NOX1 independent of its blood pressure-lowering effects. These results reveal for the first time that 4-HCH alleviates cardiac remodeling, emphasizing its potential as a therapeutic agent for HF.