Hypertension Research最新文献

Hypertension is a major contributor to the global disease burden, affecting more than one billion individuals worldwide. Despite decades of recognition of its adverse health effects, hypertension control rates remain suboptimal. Epidemiology provides essential knowledge for understanding disease distribution and identifying risk factors at the individual, social, and environmental levels. Recent evidence emphasizes both traditional lifestyle determinants, including excess sodium intake, low potassium intake, obesity, physical inactivity, smoking, and alcohol consumption, and emerging contributors, such as gut microbiota dysregulation and infectious diseases. Among those, the urinary sodium-to-potassium ratio has gained attention as an important factor associated with hypertension risk. Additionally, social determinants of health, including socioeconomic disparities, neighborhood deprivation, and structural racism, exacerbate the risk of hypertension and impede its effective control. Environmental factors such as air pollution, extreme temperatures, and occupational stress further contribute to the complexity of hypertension epidemiology. Regarding contemporary epidemiological methodology, our proposed concepts of the "Bench and Real-World Cycle" and "Real-World Evidence Cycle" highlight the necessity of continuously integrating real-world evidence into practice. In addition to classical cohort studies, real-world data derived from electronic health records including health checkups and insurance claims data are indispensable tools for addressing previous research limitations. This multifaceted perspective will accelerate evidence-based epidemiological approaches for preventing and treating hypertension.

Home blood pressure monitoring (HBPM) is essential for long-term hypertension management, but its accuracy and reliability is questionable due to user inconsistencies and non-standard usage conditions. This study compared two validated HBPM devices - a wrist-based and a reference upper-arm monitor - in a home-like setup where participants placed the devices themselves. A total of 121 participants underwent four concurrent blood pressure (BP) measurements, with two taken in each arm, followed by a crossover of devices between arms after the initial two readings. Wrist-derived BP readings were higher than upper-arm measurements. With higher blood pressure levels, both devices exhibited greater bias, accompanied by reduced precision in systolic BP measurements. Additionally, hypertension classification showed only moderate agreement (Cohen's kappa=0.58). The wrist monitor tended to over-diagnose hypertension and exhibited greater variability than the upper-arm device. These findings highlight the need for more guidance and education as well as critical evaluation of home blood pressure measurements provided by patients.

Cardiovascular diseases (CVDs) have been a major cause of global morbidity and mortality, necessitating continuous innovation in diagnostic methods, better mechanistic understanding, and the development of risk stratification strategies. This review summarizes significant updates in vascular and cardiovascular health from 2024 to 2025, focusing on novel non-invasive assessment technologies, deeper insights into molecular and cellular pathophysiology, and effective approaches to clinical risk assessment. Key advancements include the development and validation of artificial intelligence-driven models for vascular age assessment, plethysmographic methods for endothelial function evaluation, and refined pulse wave velocity measurements for proximal aortic stiffness. Mechanistic studies have further investigated the roles of long noncoding RNAs, mitochondrial dynamics, and Piezo ion channels in various CVD pathologies. Clinically, new evidence supports the importance of central arterial stiffness in atrial myopathy, the association of pulse wave velocity with cerebral microbleeds, and the prognostic value of supine hypertension and combined vascular biomarkers, such as the cardio-ankle vascular index and ankle-brachial index. Furthermore, these updates will improve our understanding of vascular health and provide novel approaches to early detection, personalized intervention, and improving patient outcomes in the management of CVD.

This study investigated the associations of twin pregnancies with early-onset (EO)- and late-onset (LO)-hypertensive disorders of pregnancy (HDP). Totally, 86,717 pregnant women were included in a prospective birth cohort study. The associations of dichorionic diamniotic (DD)- and monochorionic diamniotic (MD)-twin pregnancies with EO-HDP (Diagnosed from 20 to <34 weeks of gestation) and LO-HDP (Diagnosed at ≥34 weeks of gestation) were analyzed using a multinomial logistic regression model. Compared with singleton pregnancies, both DD- and MD-twin pregnancies had significantly higher odds for EO- and LO-HDP. The adjusted odds ratios (aORs) for EO-HDP were 2.05 (95% confidence interval [Cl]: 1.51-2.78) in DD-twin pregnancies and 2.80 (95% Cl: 2.01-3.90) in MD-twin pregnancies, respectively. Also, the aORs for LO-HDP were 1.32 (95% CI: 1.03-1.69) in DD-twin pregnancies and 1.64 (95% Cl: 1.24-2.17) in MD-twin pregnancies, respectively. Although no statistically significant differences were observed, MD-twin pregnancies tended to have higher odds for both EO- and LO-onset HDP compared with DD-twin pregnancies. In conclusion, both DD- and MD-twin pregnancies are risk factors for the development of EO- and LO-HDP. We showed that both dichorionic diamniotic and monochorionic diamniotic twin pregnancies are risk factors for the development of early-onset and late-onset hypertensive disorders of pregnancy.