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In remembrance: the life and legacy of George L. Bakris (1952-2024). 纪念:乔治-L-巴克里斯(1952-2024 年)的生平与遗产。
IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-10-03 DOI: 10.1097/HJH.0000000000003847
Pantelis A Sarafidis, Kostas Tsioufis, Michel Burnier, Bryan Williams, Giuseppe Mancia, Thomas Weber, George S Stergiou

George L. Bakris passed away on June 15, 2024 at the age of 72 years. This obituary aims at honoring his life and career by describing the stages in his personal and professional pathway, presenting some of his many remarkable accomplishments, and highlighting his exceptional clinical skills, mentorship, and friendship.

乔治-L-巴克里斯于 2024 年 6 月 15 日去世,享年 72 岁。这篇讣告旨在通过描述他个人和职业道路上的各个阶段,介绍他的许多杰出成就,强调他卓越的临床技能、指导和友谊,来纪念他的一生和事业。
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引用次数: 0
Advanced progress of the relationship between renin-angiotensin-aldosterone system inhibitors and cancers. 肾素-血管紧张素-醛固酮系统抑制剂与癌症之间关系的最新进展。
IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-08-07 DOI: 10.1097/HJH.0000000000003836
Ruixing Zhang, Hongtao Yin, Mengdi Yang, Jinjin Liu, Donghu Zhen, Zheng Zhang

Hypertension and cancers are the most common causes of death in humans, as well as common co-diseases among elderly population. Studies have shown that hypertension is associated with carcinogenesis. The renin-angiotensin-aldosterone system (RAAS) is a crucial regulatory system of blood pressure, fluid, and electrolyte homeostasis, which plays an essential role in the pathogenesis of hypertension, whose mechanism is relatively clear. Studies have indicated that RAAS also widely exists in cancer tissues of different systems, which can affect the risk of cancers by stimulating cancer angiogenesis, participating in cancer-related oxidative stress, and regulating cancer-related immunity. Therefore, inhibiting RAAS activity seems beneficial to decreasing the risk of cancers. As one of the most commonly used antihypertensive drugs, RAAS inhibitors have been widely used in clinical practice. However, the conclusions of clinical studies on the relationship between RAAS inhibitors and cancers are not entirely consistent, which has been widely concerned by clinicians. The latest findings suggest that while RAAS inhibitors may reduce the risk of digestive cancers, respiratory cancers, urological cancers, gynecological cancers, and skin cancers, ACEIs may increase the risk of lung cancer, endometrial cancer, basal cell carcinoma, and squamous cell carcinoma. This article comprehensively reviews animal experiments, clinical studies, and meta-analyses on the relationship between RAAS inhibitors and cancers, to provide references for related studies in the future.

高血压和癌症是人类最常见的死因,也是老年人常见的并发症。研究表明,高血压与致癌有关。肾素-血管紧张素-醛固酮系统(RAAS)是血压、体液和电解质平衡的重要调节系统,在高血压的发病机制中起着至关重要的作用,其机制已相对明确。研究表明,RAAS 还广泛存在于不同系统的癌症组织中,可通过刺激癌症血管生成、参与癌症相关氧化应激和调节癌症相关免疫等方式影响癌症风险。因此,抑制 RAAS 的活性似乎有利于降低癌症风险。作为最常用的降压药之一,RAAS 抑制剂已广泛应用于临床。然而,关于 RAAS 抑制剂与癌症关系的临床研究结论并不完全一致,这引起了临床医生的广泛关注。最新研究结果表明,RAAS 抑制剂可降低消化系统癌症、呼吸系统癌症、泌尿系统癌症、妇科癌症和皮肤癌的发病风险,而 ACEIs 则可能增加肺癌、子宫内膜癌、基底细胞癌和鳞状细胞癌的发病风险。本文全面回顾了 RAAS 抑制剂与癌症关系的动物实验、临床研究和荟萃分析,为今后的相关研究提供参考。
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引用次数: 0
CD8 + T-cell deficiency protects mice from abdominal aortic aneurysm formation in response to calcium chloride 2. CD8+ T 细胞缺乏可保护小鼠免受氯化钙作用下腹主动脉瘤的形成2。
IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-08-13 DOI: 10.1097/HJH.0000000000003823
Zhuo Lin, Mantong Zhao, Xian Zhang, Jinshun Piao, Xintong Zheng, Shangzhi Shu, Longguo Zhao, Meiping Zhang, Guo-Ping Shi, Yanna Lei, Rihua Cui, Xueling Yue, Xian Wu Cheng

Objective: Abdominal aortic aneurysm (AAA) is an aneurysm-like dilated and highly fatal cardiovascular disease. CD8 + T cells have been shown to be critical for vascular pathological processes, but the contribution of these lymphocytes to vascular diseases remains elusive.

Methods and results: Eight-week-old male wildtype (CD8 +/+ ) and Cd8a knockout (CD8 -/- ) mice were used in a calcium chloride 2 (CaCl 2 )-induced experimental AAA model. At 6 weeks after surgery, CD8 + T-cell deletion prevented the formation of AAA, accompanied by reductions of the levels of inflammatory (interferon-γ [IFN-γ], interleukin-1β, monocyte chemoattractant protein-1, intracellular adhesion molecule-1, vascular cell adhesion molecule-1, NOD-like receptor protein 3, caspase-1), oxidative stress [NADPH oxidase and gp91 phox ], and proteolysis (cathepsin S, cathepsin K, matrix metalloproteinase-2 [MMP-2] and MMP-9) proteins and/or genes in plasma and/or AAA tissues. Immunoreactivities of MMP-2 and MMP-9 were observed in macrophages. An injection of IFN-γ and adoptive transfer of CD8 + T cells of IFN-γ +/+ mice diminished CD8 -/- -mediated vasculoprotective actions in the AAA mice. In vitro, IFN-γ enhanced MMP-2 and MMP-9 gelatinolytic activities in macrophage and/or vascular smooth muscle cells.

Conclusion: The vasculoprotective effects of CD8 + T-cell deletion in a mouse CaCl 2 -induced AAA model were likely attributable to, at least in part, the attenuation of IFN-γ-dependent inflammation action, oxidative stress production, and proteolysis, suggesting a novel therapeutic target for AAA formation by regulating CD8 + T-cell-derived IFN-γ secretion.

目的:腹主动脉瘤(AAA)是一种动脉瘤样扩张和高度致命的心血管疾病。CD8+ T细胞已被证明对血管病理过程至关重要,但这些淋巴细胞对血管疾病的贡献仍难以确定:在氯化钙2(CaCl2)诱导的实验性 AAA 模型中使用了 8 周大的雄性野生型(CD8+/+)和 Cd8a 基因敲除(CD8-/-)小鼠。术后 6 周,CD8+ T 细胞缺失阻止了 AAA 的形成,同时降低了炎症(干扰素-γ [IFN-γ]、白细胞介素-1β、单核细胞趋化蛋白-1、细胞内粘附分子-1、血管细胞粘附分子-1)的水平、血管细胞粘附分子-1、NOD 样受体蛋白 3、caspase-1)、氧化应激[NADPH 氧化酶和 gp91phox]以及血浆和/或 AAA 组织中的蛋白水解(cathepsin S、cathepsin K、基质金属蛋白酶-2 [MMP-2] 和 MMP-9)蛋白和/或基因。在巨噬细胞中观察到了 MMP-2 和 MMP-9 的免疫活性。注射IFN-γ和收养性转移IFN-γ+/+小鼠的CD8+ T细胞会削弱CD8-/-介导的AAA小鼠血管保护作用。在体外,IFN-γ增强了巨噬细胞和/或血管平滑肌细胞中MMP-2和MMP-9的凝胶溶解活性:结论:CD8+T细胞缺失在小鼠CaCl2诱导的AAA模型中的血管保护作用可能至少部分归因于IFN-γ依赖性炎症作用、氧化应激产生和蛋白分解的减弱,这表明通过调节CD8+T细胞衍生的IFN-γ分泌,AAA的形成有了新的治疗靶点。
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引用次数: 0
The contribution of cumulative blood pressure load to dementia, cognitive function and mortality in older adults. 累积血压负荷对老年人痴呆症、认知功能和死亡率的影响。
IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-07-11 DOI: 10.1097/HJH.0000000000003808
Xiaoyue Xu, Vibeke S Catts, Katie Harris, Nelson Wang, Katya Numbers, Julian Trollor, Henry Brodaty, Perminder S Sachdev, Aletta E Schutte

Background: Few studies evaluated the contribution of long-term elevated blood pressure (BP) towards dementia and deaths. We examined the association between cumulative BP (cBP) load and dementia, cognitive decline, all-cause and cardiovascular deaths in older Australians. We also explored whether seated versus standing BP were associated with these outcomes.

Methods: The Sydney Memory and Aging Study included 1037 community-dwelling individuals aged 70-90 years, recruited from Sydney, Australia. Baseline data was collected in 2005-2007 and the cohort was followed for seven waves until 2021. cSBP load was calculated as the area under the curve (AUC) for SBP ≥140 mmHg divided by the AUC for all SBP values. Cumulative diastolic BP (cDBP) and pulse pressure (cPP) load were calculated using thresholds of 90 mmHg and 60 mmHg. Cox and mixed linear models were used to assess associations.

Results: Of 527 participants with both seated and standing BP data (47.7% men, median age 77), 152 (28.8%) developed dementia over a mean follow-up of 10.5 years. Higher cPP load was associated with a higher risk of all-cause deaths, and cSBP load was associated with a higher risk of cardiovascular deaths in multivariate models ( P for trend < 0.05). Associations between cPP load, dementia and cognitive decline lost statistical significance after adjustment for age. Differences between sitting and standing BP load were not associated with the outcomes.

Conclusion: Long-term cPP load was associated with a higher risk of all-cause deaths and cSBP load associated with a higher risk of cardiovascular deaths in older Australians.

背景:很少有研究评估长期血压升高对痴呆症和死亡的影响。我们研究了澳大利亚老年人的累积血压(cBP)负荷与痴呆、认知能力下降、全因和心血管死亡之间的关系。我们还探讨了坐姿血压与站姿血压是否与这些结果有关:悉尼记忆与衰老研究包括从澳大利亚悉尼招募的 1037 名 70-90 岁的社区居民。cSBP 负荷以 SBP≥140 mmHg 的曲线下面积(AUC)除以所有 SBP 值的曲线下面积(AUC)计算。累积舒张压(cDBP)和脉压(cPP)负荷分别以 90 mmHg 和 60 mmHg 为阈值计算。采用 Cox 和混合线性模型评估相关性:在527名有坐位和站立血压数据的参与者(47.7%为男性,中位年龄为77岁)中,有152人(28.8%)在平均10.5年的随访期间患上了痴呆症。在多变量模型中,较高的 cPP 负荷与较高的全因死亡风险相关,而 cSBP 负荷与较高的心血管死亡风险相关(趋势 P < 0.05)。在对年龄进行调整后,cPP负荷与痴呆症和认知能力下降之间的关系失去了统计学意义。坐姿和站姿血压负荷之间的差异与结果无关:结论:在澳大利亚老年人中,长期 cPP 负荷与较高的全因死亡风险有关,而 cSBP 负荷与较高的心血管死亡风险有关。
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引用次数: 0
Associations of ultra long-term visit-to-visit blood pressure variability, since childhood with vascular aging in midlife: a 30-year prospective cohort study. 自童年开始的超长期就诊血压变化与中年血管老化的关系:一项为期 30 年的前瞻性队列研究。
IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-09-12 DOI: 10.1097/HJH.0000000000003819
Guan-Ji Wu, Ai-Ma Si, Yang Wang, Chao Chu, Ming-Fei Du, Dan Wang, Hao Jia, Gui-Lin Hu, Ze-Jiaxin Niu, Xi Zhang, Yue Sun, Ming-Ke Chang, Teng Zhang, Zi-Yue Man, Xia Wang, Jie Ren, Fang-Yao Chen, Jian-Jun Mu

Objective: Vascular aging, as assessed by structural and functional arterial properties, is an independent predictor of cardiovascular outcomes. In this study, we aimed to investigate the associations of ultra long-term blood pressure (BP) variability from childhood to midlife with vascular aging in midlife.

Methods: Using data from the longitudinal cohort of Hanzhong Adolescent Hypertension Study, 2065 participants aged 6-18 years were enrolled and followed up with seven visits over 30 years. Ultra long-term BP variability (BPV) was defined as the standard deviation (SD) and average real variability (ARV) of BP over 30 years (seven visits). Vascular aging included arterial stiffness, carotid hypertrophy, and carotid plaque.

Results: After adjusting for demographic variables, clinical characteristics and mean BP over 30 years, higher SD SBP , ARV SBP , SD DBP and ARV DBP since childhood were significantly associated with arterial stiffness in midlife. Additionally, higher SD DBP and ARV DBP were significantly associated with carotid hypertrophy and the presence of carotid plaque in midlife. When we used cumulative exposure to BP from childhood to midlife instead of mean BP as adjustment factors, results were similar. Furthermore, we found a significant association between long-term BPV from childhood to adolescence and the presence of carotid plaque, whereas long-term BPV from youth to adulthood is associated with arterial stiffness.

Conclusion: Higher BPV from childhood to adulthood was associated with vascular aging in midlife independently of mean BP or cumulative BP exposure. Therefore, long-term BPV from an early age may serve as a predictor of cardiovascular diseases (CVDs) in later life.

目的:根据动脉结构和功能特性评估的血管老化是心血管预后的独立预测因素。本研究旨在探讨儿童期至中年期超长期血压变化与中年期血管老化的关系:方法:利用汉中青少年高血压研究的纵向队列数据,对 2065 名 6-18 岁的参与者进行了登记,并在 30 年内进行了 7 次随访。超长期血压变异性(BPV)定义为 30 年(7 次随访)内血压的标准差(SD)和平均实际变异性(ARV)。血管老化包括动脉僵化、颈动脉肥厚和颈动脉斑块:结果:在对人口统计学变量、临床特征和 30 年平均血压进行调整后,自童年起较高的 SDSBP、ARVSBP、SDDBP 和 ARVDBP 与中年动脉僵化显著相关。此外,较高的 SDDBP 和 ARVDBP 与中年时颈动脉肥厚和颈动脉斑块的存在也有显著关联。当我们使用从童年到中年的累积血压暴露而非平均血压作为调整因素时,结果与之相似。此外,我们还发现,儿童期至青少年期的长期血压值与颈动脉斑块的存在有显著关联,而青年期至成年期的长期血压值则与动脉僵化有关:结论:儿童期至成年期较高的血压值与中年期血管老化有关,而与平均血压或累积血压暴露无关。因此,从幼年开始的长期血压变异值可作为晚年心血管疾病(CVDs)的预测因子。
{"title":"Associations of ultra long-term visit-to-visit blood pressure variability, since childhood with vascular aging in midlife: a 30-year prospective cohort study.","authors":"Guan-Ji Wu, Ai-Ma Si, Yang Wang, Chao Chu, Ming-Fei Du, Dan Wang, Hao Jia, Gui-Lin Hu, Ze-Jiaxin Niu, Xi Zhang, Yue Sun, Ming-Ke Chang, Teng Zhang, Zi-Yue Man, Xia Wang, Jie Ren, Fang-Yao Chen, Jian-Jun Mu","doi":"10.1097/HJH.0000000000003819","DOIUrl":"10.1097/HJH.0000000000003819","url":null,"abstract":"<p><strong>Objective: </strong>Vascular aging, as assessed by structural and functional arterial properties, is an independent predictor of cardiovascular outcomes. In this study, we aimed to investigate the associations of ultra long-term blood pressure (BP) variability from childhood to midlife with vascular aging in midlife.</p><p><strong>Methods: </strong>Using data from the longitudinal cohort of Hanzhong Adolescent Hypertension Study, 2065 participants aged 6-18 years were enrolled and followed up with seven visits over 30 years. Ultra long-term BP variability (BPV) was defined as the standard deviation (SD) and average real variability (ARV) of BP over 30 years (seven visits). Vascular aging included arterial stiffness, carotid hypertrophy, and carotid plaque.</p><p><strong>Results: </strong>After adjusting for demographic variables, clinical characteristics and mean BP over 30 years, higher SD SBP , ARV SBP , SD DBP and ARV DBP since childhood were significantly associated with arterial stiffness in midlife. Additionally, higher SD DBP and ARV DBP were significantly associated with carotid hypertrophy and the presence of carotid plaque in midlife. When we used cumulative exposure to BP from childhood to midlife instead of mean BP as adjustment factors, results were similar. Furthermore, we found a significant association between long-term BPV from childhood to adolescence and the presence of carotid plaque, whereas long-term BPV from youth to adulthood is associated with arterial stiffness.</p><p><strong>Conclusion: </strong>Higher BPV from childhood to adulthood was associated with vascular aging in midlife independently of mean BP or cumulative BP exposure. Therefore, long-term BPV from an early age may serve as a predictor of cardiovascular diseases (CVDs) in later life.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1948-1957"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Innovations in blood pressure measurement and reporting technology: International Society of Hypertension position paper endorsed by the World Hypertension League, European Society of Hypertension, Asian Pacific Society of Hypertension, and Latin American Society of Hypertension. 血压测量和报告技术的创新:世界高血压联盟、欧洲高血压学会、亚太高血压学会和拉丁美洲高血压学会认可的国际高血压学会立场文件。
IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-09-09 DOI: 10.1097/HJH.0000000000003827
Kazuomi Kario, Bryan Williams, Naoko Tomitani, Richard J McManus, Aletta E Schutte, Alberto Avolio, Daichi Shimbo, Ji-Guang Wang, Nadia A Khan, Dean S Picone, Isabella Tan, Peter H Charlton, Michihiro Satoh, Keneilwe Nkgola Mmopi, Jose P Lopez-Lopez, Tomas L Bothe, Elisabetta Bianchini, Buna Bhandari, Jesús Lopez-Rivera, Fadi J Charchar, Maciej Tomaszewski, George Stergiou

Blood pressure (BP) is a key contributor to the lifetime risk of preclinical organ damage and cardiovascular disease. Traditional clinic-based BP readings are typically measured infrequently and under standardized/resting conditions and therefore do not capture BP values during normal everyday activity. Therefore, current hypertension guidelines emphasize the importance of incorporating out-of-office BP measurement into strategies for hypertension diagnosis and management. However, conventional home and ambulatory BP monitoring devices use the upper-arm cuff oscillometric method and only provide intermittent BP readings under static conditions or in a limited number of situations. New innovations include technologies for BP estimation based on processing of sensor signals supported by artificial intelligence tools, technologies for remote monitoring, reporting and storage of BP data, and technologies for BP data interpretation and patient interaction designed to improve hypertension management ("digital therapeutics"). The number and volume of data relating to new devices/technologies is increasing rapidly and will continue to grow. This International Society of Hypertension position paper describes the new devices/technologies, presents evidence relating to new BP measurement techniques and related indices, highlights standard for the validation of new devices/technologies, discusses the reliability and utility of novel BP monitoring devices, the association of these metrics with clinical outcomes, and the use of digital therapeutics. It also highlights the challenges and evidence gaps that need to be overcome before these new technologies can be considered as a user-friendly and accurate source of novel BP data to inform clinical hypertension management strategies.

血压(BP)是临床前器官损伤和心血管疾病终生风险的关键因素。传统的门诊血压读数通常在标准化/休息状态下测量,测量频率较低,因此无法捕捉到正常日常活动中的血压值。因此,目前的高血压指南强调将诊室外血压测量纳入高血压诊断和管理策略的重要性。然而,传统的家用和非卧床血压监测设备使用的是上臂袖带示波法,只能在静态条件下或有限的几种情况下提供间歇性血压读数。新的创新包括基于人工智能工具支持的传感器信号处理的血压估算技术,远程监测、报告和存储血压数据的技术,以及旨在改善高血压管理的血压数据解读和患者互动技术("数字疗法")。与新设备/技术相关的数据数量和质量正在迅速增加,并将继续增长。这份国际高血压学会立场文件介绍了新设备/技术,提出了与新血压测量技术和相关指数有关的证据,强调了新设备/技术的验证标准,讨论了新型血压监测设备的可靠性和实用性、这些指标与临床结果的关联以及数字疗法的使用。报告还强调了在将这些新技术视为方便用户且准确的新型血压数据来源以指导临床高血压管理策略之前需要克服的挑战和证据差距。
{"title":"Innovations in blood pressure measurement and reporting technology: International Society of Hypertension position paper endorsed by the World Hypertension League, European Society of Hypertension, Asian Pacific Society of Hypertension, and Latin American Society of Hypertension.","authors":"Kazuomi Kario, Bryan Williams, Naoko Tomitani, Richard J McManus, Aletta E Schutte, Alberto Avolio, Daichi Shimbo, Ji-Guang Wang, Nadia A Khan, Dean S Picone, Isabella Tan, Peter H Charlton, Michihiro Satoh, Keneilwe Nkgola Mmopi, Jose P Lopez-Lopez, Tomas L Bothe, Elisabetta Bianchini, Buna Bhandari, Jesús Lopez-Rivera, Fadi J Charchar, Maciej Tomaszewski, George Stergiou","doi":"10.1097/HJH.0000000000003827","DOIUrl":"10.1097/HJH.0000000000003827","url":null,"abstract":"<p><p>Blood pressure (BP) is a key contributor to the lifetime risk of preclinical organ damage and cardiovascular disease. Traditional clinic-based BP readings are typically measured infrequently and under standardized/resting conditions and therefore do not capture BP values during normal everyday activity. Therefore, current hypertension guidelines emphasize the importance of incorporating out-of-office BP measurement into strategies for hypertension diagnosis and management. However, conventional home and ambulatory BP monitoring devices use the upper-arm cuff oscillometric method and only provide intermittent BP readings under static conditions or in a limited number of situations. New innovations include technologies for BP estimation based on processing of sensor signals supported by artificial intelligence tools, technologies for remote monitoring, reporting and storage of BP data, and technologies for BP data interpretation and patient interaction designed to improve hypertension management (\"digital therapeutics\"). The number and volume of data relating to new devices/technologies is increasing rapidly and will continue to grow. This International Society of Hypertension position paper describes the new devices/technologies, presents evidence relating to new BP measurement techniques and related indices, highlights standard for the validation of new devices/technologies, discusses the reliability and utility of novel BP monitoring devices, the association of these metrics with clinical outcomes, and the use of digital therapeutics. It also highlights the challenges and evidence gaps that need to be overcome before these new technologies can be considered as a user-friendly and accurate source of novel BP data to inform clinical hypertension management strategies.</p>","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":" ","pages":"1874-1888"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Juvenile primary hypertension is associated with attenuated macro- and microvascular dilator function independently of body weight. 青少年原发性高血压与大血管和微血管扩张器功能减弱有关,与体重无关。
IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-07-04 DOI: 10.1097/HJH.0000000000003812
Martina Kos, Tihana Nađ, Ana Stupin, Ines Drenjančević, Nikolina Kolobarić, Petar Šušnjara, Zrinka Mihaljević, Mia Damašek, Silvija Pušeljić, Ivana Jukić

Objective: Hypertension has become a global medical and public health issue even in childhood. It is well accepted that hypertension is associated with impaired endothelium-dependent vascular reactivity in adult patients. However, there is a lack of data on hypertension-related endothelial dysfunction in hypertensive children. Thus, present study aimed to evaluate the association of primary hypertension in the pediatric population with macro- and microvascular function, and to assess the potential role of oxidative stress in that connection.

Methods: Fifty-two children were enrolled in this study; 26 normotensive (NT) and 26 with primary hypertension (HT), both sexes, 9-17 years old. In addition to anthropometric, hemodynamic and biochemical measurements, peripheral microvascular responses to occlusion (postocclusive reactive hyperemia, PORH), local heating (local thermal hyperemia, LTH), iontophoretically applied acetylcholine (AChID) and sodium nitroprusside (SNPID) were evaluated by laser Doppler flowmetry (LDF). Furthermore, brachial artery flow-mediated dilation (FMD) was measured and biomarker of oxidative stress was determined.

Results: PORH, AChID and LTH were impaired in hypertensive compared to normotensive children, while SNPID did not differ between groups. FMD was decreased in hypertensive compared to normotensive children. Serum concentration of 8- iso -PGF2α was significantly elevated in hypertensive compared to normotensive children.

Conclusion: Even in childhood, primary hypertension is associated with attenuated endothelial function and reduced endothelium-dependent responses to various physiological stimuli. Juvenile hypertension is related to increased level of vascular oxidative stress. All changes are independent of BMI.

目的:即使在儿童时期,高血压也已成为一个全球性的医疗和公共卫生问题。众所周知,高血压与成人患者血管内皮依赖性反应受损有关。然而,关于高血压儿童与高血压相关的内皮功能障碍的数据却很缺乏。因此,本研究旨在评估儿童原发性高血压与大血管和微血管功能的关系,并评估氧化应激在其中的潜在作用:本研究共招募了 52 名儿童,其中 26 名血压正常(NT),26 名患有原发性高血压(HT),男女不限,年龄均为 9-17 岁。除了人体测量、血液动力学和生化测量外,还通过激光多普勒血流测量仪(LDF)评估了外周微血管对闭塞(闭塞后反应性充血,PORH)、局部加热(局部热充血,LTH)、离子渗透应用乙酰胆碱(AChID)和硝普钠(SNPID)的反应。此外,还测量了肱动脉血流介导的扩张(FMD),并测定了氧化应激的生物标志物:结果:与正常血压儿童相比,高血压儿童的 PORH、AChID 和 LTH 均受损,而 SNPID 在组间无差异。与正常血压儿童相比,高血压儿童的 FMD 有所下降。与正常血压儿童相比,高血压儿童血清中的 8-iso-PGF2α 浓度明显升高:结论:即使在儿童时期,原发性高血压也与内皮功能减弱和内皮对各种生理刺激的依赖性反应降低有关。青少年高血压与血管氧化应激水平升高有关。所有这些变化都与体重指数无关。
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引用次数: 0
Occurrence of hypertension among patients with opioid use disorder in methadone maintenance treatment. 接受美沙酮维持治疗的阿片类药物使用障碍患者中高血压的发生率。
IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-10-03 DOI: 10.1097/HJH.0000000000003833
Einat Peles, Shaul Schreiber
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引用次数: 0
Enhancing analytical approaches for investigating the age-dependent association of central blood pressure: UK biobank cohort study. 加强中心血压与年龄相关性的分析方法:英国生物库队列研究。
IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-10-03 DOI: 10.1097/HJH.0000000000003805
Raj Bhatt, Anahit Stepanyan, Uzayr Wasif, Don D Shamilov, David F Lo
{"title":"Enhancing analytical approaches for investigating the age-dependent association of central blood pressure: UK biobank cohort study.","authors":"Raj Bhatt, Anahit Stepanyan, Uzayr Wasif, Don D Shamilov, David F Lo","doi":"10.1097/HJH.0000000000003805","DOIUrl":"https://doi.org/10.1097/HJH.0000000000003805","url":null,"abstract":"","PeriodicalId":16043,"journal":{"name":"Journal of Hypertension","volume":"42 11","pages":"2018"},"PeriodicalIF":3.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Defining childhood hypertension: is it too complicated? An evaluation of the potential impact of different approaches in an Australian paediatric population. 儿童高血压的定义:是否过于复杂?评估不同方法对澳大利亚儿科人群的潜在影响。
IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-11-01 Epub Date: 2024-07-12 DOI: 10.1097/HJH.0000000000003815
Nicholas G Larkins, Catherine Choong, Markus Schlaich, Catherine Quinlan, Jonathan P Mynard, Siah Kim, Trevor A Mori, Lawrence J Beilin

Objectives: Current American Academy of Pediatrics (AAP) and European Society of Hypertension (ESH) thresholds defining hypertension in children use blood pressure (BP) normalised to age, sex and height. However, scare data exists regarding the relative importance of these variables to accurately model the 95th quantile of BP. We hypothesised that height alone may fit the population data equally well compared to more complex definitions. We also compare the potential impact of various thresholds for defining hypertension in an Australian population.

Methods: Longitudinal data from the Raine Study were used, with 2248 participants contributing 7479 valid BP values across the 3/5/10/14/17-year study visits. BP was measured after 5 min rest, ≥3 times at each visit, using a Dinamap device. Quantile regression was used to predict the 95th percentile of BP, with nonlinear modelling of covariates through restricted cubic spline terms.

Results: At a single visit, 6-16% of young children exceeded the ESH threshold and 12-23% the AAP threshold. The transition to fixed thresholds (≥13 years AAP, ≥16 years ESH), increased the number of males (AAP only) and reduced the number of females considered hypertensive. A quantile regression model constructed with Raine Study data using height-only as the explanatory variable better predicted BP than the respective model using age-only (or a combination of the two).

Conclusions: There may be large differences in the prevalence of hypertension according to AAP and ESH criteria, with a marked sex-discrepancy emerging from the point of fixed threshold application in adolescence. It may not be necessary to normalise BP by both age and height, the latter being a better predictor of childhood BP. Simpler methods may be preferable in clinical practice but require validation against clinical outcomes.

目标:美国儿科学会 (AAP) 和欧洲高血压学会 (ESH) 目前定义儿童高血压的阈值使用的是按年龄、性别和身高归一化的血压 (BP)。然而,关于年龄和身高这两个变量对准确建立血压第 95 个量值模型的相对重要性,目前还没有相关数据。我们假设,与更复杂的定义相比,仅身高一项可能同样适合人口数据。我们还比较了在澳大利亚人群中定义高血压的各种阈值的潜在影响:我们使用了雷恩研究的纵向数据,2248 名参与者在 3/5/10/14/17 年的研究访问中提供了 7479 个有效血压值。每次访问使用 Dinamap 设备测量休息 5 分钟后的血压,测量次数≥3 次。使用量子回归预测血压的第 95 百分位数,并通过受限三次样条对协变量进行非线性建模:单次就诊时,6%-16% 的幼儿超过 ESH 临界值,12%-23% 的幼儿超过 AAP 临界值。过渡到固定阈值(≥13 岁 AAP,≥16 岁 ESH)后,被认为患有高血压的男性人数增加(仅 AAP),女性人数减少。利用雷恩研究数据构建的仅以身高为解释变量的量子回归模型比仅以年龄为解释变量的模型(或两者的组合)更能预测血压:结论:根据 AAP 和 ESH 标准,高血压患病率可能存在很大差异,在青春期应用固定阈值时会出现明显的性别差异。也许没有必要同时按年龄和身高对血压进行正常化处理,因为后者能更好地预测儿童血压。在临床实践中,更简单的方法可能更可取,但需要根据临床结果进行验证。
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Journal of Hypertension
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