Pub Date : 2025-06-05DOI: 10.1038/s41371-025-01034-4
Wenlang Zhao, Mingdan Wang, Pan Zhou, Ziyu Wang, Xuan Deng, Jiangtao Li, Na Yang, Lizhen Han, Zhao Yang, Yue Qi, Jing Liu
The multidimensional echocardiographic features associated with BP level are unclear. This study aimed to identify the multidimensional echocardiographic features associated with BP. In total, 2 092 adult participants (aged ≥18 years) with hypertension who underwent echocardiography in Beijing between July 2017 and January 2020 as part of the Multi-provincial Cohort for Hypertension study were enrolled. The associations between BP levels and echocardiographic features were investigated by multivariate regression analysis. After multivariable adjustment, a 1 SD (15.4 mmHg) increase in systolic BP was associated with a 0.21-mm increment (95% CI 0.06–0.35) in left atrial diameter, a 2.17-g/m2 increment (95% CI 1.46–2.88) in LV mass index, a 0.25-mm increment (95% CI 0.11–0.39) in ascending aorta diameter and a 0.03 decrement (95% CI −0.04, −0.01) in the E/A ratio. A 1 SD (10.1 mmHg) increase in diastolic BP was associated with a 1.51-g/m2 increment (95% CI 0.80–2.21) in LV mass index, a 0.46-mm increment (95% CI 0.31–0.61) in aortic root diameter, a 0.77-mm increment (95% CI 0.63–0.91) in ascending aorta diameter, and a 0.05 decrement (95% CI −0.07, −0.04) in E/A ratio. In conclusion, specific echocardiographic features were associated with the BP level. LV structure, ascending aorta diameter, and the E/A ratio were associated with systolic and diastolic BP. Left atrial diameter was positively associated only with systolic BP, and aortic root diameter was positively associated only with diastolic BP. These echocardiographic features may be valuable for early identification of target organ damage caused by elevated BP.
与血压水平相关的多维超声心动图特征尚不清楚。本研究旨在确定与BP相关的多维超声心动图特征。作为多省高血压队列研究的一部分，2017年7月至2020年1月期间在北京接受超声心动图检查的2092名成年高血压患者（年龄≥18岁）共入组。通过多元回归分析探讨血压水平与超声心动图特征之间的关系。多变量校正后，收缩压每升高1 SD (15.4 mmHg)，左房内径增加0.21 mm (95% CI 0.06-0.35)，左室质量指数增加2.17 g/m2 (95% CI 1.46-2.88)，升主动脉内径增加0.25 mm (95% CI 0.11-0.39)， E/ a比减少0.03 （95% CI -0.04, -0.01）。舒张压升高1 SD (10.1 mmHg)，左室质量指数增加1.51 g/m2 (95% CI 0.80-2.21)，主动脉根直径增加0.46 mm (95% CI 0.31-0.61)，升主动脉直径增加0.77 mm (95% CI 0.63-0.91)， E/A比减少0.05 （95% CI -0.07, -0.04）。总之，特定的超声心动图特征与血压水平相关。左室结构、升主动脉直径和E/A比值与收缩压和舒张压相关。左心房内径仅与收缩压呈正相关，主动脉根内径仅与舒张压呈正相关。这些超声心动图特征可能对早期识别血压升高引起的靶器官损害有价值。
{"title":"Profiles of echocardiographic features associated with blood pressure in patients with hypertension","authors":"Wenlang Zhao, Mingdan Wang, Pan Zhou, Ziyu Wang, Xuan Deng, Jiangtao Li, Na Yang, Lizhen Han, Zhao Yang, Yue Qi, Jing Liu","doi":"10.1038/s41371-025-01034-4","DOIUrl":"10.1038/s41371-025-01034-4","url":null,"abstract":"The multidimensional echocardiographic features associated with BP level are unclear. This study aimed to identify the multidimensional echocardiographic features associated with BP. In total, 2 092 adult participants (aged ≥18 years) with hypertension who underwent echocardiography in Beijing between July 2017 and January 2020 as part of the Multi-provincial Cohort for Hypertension study were enrolled. The associations between BP levels and echocardiographic features were investigated by multivariate regression analysis. After multivariable adjustment, a 1 SD (15.4 mmHg) increase in systolic BP was associated with a 0.21-mm increment (95% CI 0.06–0.35) in left atrial diameter, a 2.17-g/m2 increment (95% CI 1.46–2.88) in LV mass index, a 0.25-mm increment (95% CI 0.11–0.39) in ascending aorta diameter and a 0.03 decrement (95% CI −0.04, −0.01) in the E/A ratio. A 1 SD (10.1 mmHg) increase in diastolic BP was associated with a 1.51-g/m2 increment (95% CI 0.80–2.21) in LV mass index, a 0.46-mm increment (95% CI 0.31–0.61) in aortic root diameter, a 0.77-mm increment (95% CI 0.63–0.91) in ascending aorta diameter, and a 0.05 decrement (95% CI −0.07, −0.04) in E/A ratio. In conclusion, specific echocardiographic features were associated with the BP level. LV structure, ascending aorta diameter, and the E/A ratio were associated with systolic and diastolic BP. Left atrial diameter was positively associated only with systolic BP, and aortic root diameter was positively associated only with diastolic BP. These echocardiographic features may be valuable for early identification of target organ damage caused by elevated BP.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 7","pages":"515-522"},"PeriodicalIF":3.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-04DOI: 10.1038/s41371-025-01032-6
Yaqiong Zhou, Sen Liu, Guo Ji, Changqiang Yang, Lingling Zhang, Tao Luo, Fei Huang, Zongling Chen, Jixin Hou, Peijian Wang
Although unilateral adrenal artery embolization (AAE) has emerged as an alternative treatment for patients with primary aldosteronism (PA), it may be insufficient for treating patients with idiopathic hyperaldosteronism (IHA) due to the bilateral nature of their condition. This study aimed to investigate the safety and efficacy of alcohol-mediated bilateral adrenal artery embolization (Bi-AAE) in patients with idiopathic hyperaldosteronism (IHA). A total of 72 patients were randomly assigned in a (1:1) ratio to receive either Bi-AAE or spironolactone (20–60 mg/day). The primary endpoint was the change in office systolic blood pressure (SBP) from baseline to 6 months. Key secondary endpoints included changes in 24 h blood pressure, aldosterone levels, aldosterone-to-renin ratio (ARR), and serum potassium. At 6 months, Bi-AAE significantly reduced office SBP compared to spironolactone (−18.9 ± 16.4 mmHg vs. −11.6 ± 9.3 mmHg; treatment difference: −7.4 mmHg; P = 0.03), with a greater proportion of Bi-AAE patients achieving target SBP (<140 mmHg; 77.1% vs. 51.5%; P = 0.027). Bi-AAE also resulted in significantly greater reductions in 24 h and home SBP at 1, 3, and 6 months (all P < 0.05). Furthermore, Bi-AAE was more effective in correcting biochemical abnormalities, including hyperaldosteronism and renin suppression (all P < 0.05). Importantly, Bi-AAE preserved zona fasciculata function, as evidenced by normal morning serum cortisol levels and intact responses to ACTH stimulation post-procedure. No serious adverse events occurred during the perioperative or 6-month follow-up period. These findings support Bi-AAE as a safe, minimally invasive, and highly effective alternative to medical therapy for managing IHA. Although the findings support Bi-AAE as a safe, minimally invasive, and highly effective alternative to medical therapy for managing IHA, the need for long-term data before drawing definitive conclusions is emphasized. Future studies with extended follow-up are necessary to confirm its long-term benefits and risks. Trial registration: The trial has been registered at ClinicalTrials.gov (NCT05262660).
虽然单侧肾上腺动脉栓塞（AAE）已成为原发性醛固酮增多症（PA）患者的替代治疗方法，但由于其双侧性，它可能不足以治疗特发性高醛固酮增多症（IHA）患者。本研究旨在探讨酒精介导的双侧肾上腺动脉栓塞（Bi-AAE）治疗特发性高醛固酮增多症（IHA）患者的安全性和有效性。共有72例患者按1:1的比例随机分配接受双aae或螺内酯（20-60 mg/天）治疗。主要终点是从基线到6个月的办公室收缩压（SBP）变化。关键次要终点包括24小时血压、醛固酮水平、醛固酮与肾素比值（ARR）和血清钾的变化。6个月时，与螺内酯相比，Bi-AAE显著降低办公室收缩压(-18.9±16.4 mmHg vs -11.6±9.3 mmHg；治疗差异：-7.4 mmHg；P = 0.03)， Bi-AAE患者达到目标收缩压的比例更高(
{"title":"Safety and efficacy of alcohol-mediated bilateral adrenal artery embolization in patients with idiopathic hyperaldosteronism: a 6-month follow-up of a randomized controlled trial","authors":"Yaqiong Zhou, Sen Liu, Guo Ji, Changqiang Yang, Lingling Zhang, Tao Luo, Fei Huang, Zongling Chen, Jixin Hou, Peijian Wang","doi":"10.1038/s41371-025-01032-6","DOIUrl":"10.1038/s41371-025-01032-6","url":null,"abstract":"Although unilateral adrenal artery embolization (AAE) has emerged as an alternative treatment for patients with primary aldosteronism (PA), it may be insufficient for treating patients with idiopathic hyperaldosteronism (IHA) due to the bilateral nature of their condition. This study aimed to investigate the safety and efficacy of alcohol-mediated bilateral adrenal artery embolization (Bi-AAE) in patients with idiopathic hyperaldosteronism (IHA). A total of 72 patients were randomly assigned in a (1:1) ratio to receive either Bi-AAE or spironolactone (20–60 mg/day). The primary endpoint was the change in office systolic blood pressure (SBP) from baseline to 6 months. Key secondary endpoints included changes in 24 h blood pressure, aldosterone levels, aldosterone-to-renin ratio (ARR), and serum potassium. At 6 months, Bi-AAE significantly reduced office SBP compared to spironolactone (−18.9 ± 16.4 mmHg vs. −11.6 ± 9.3 mmHg; treatment difference: −7.4 mmHg; P = 0.03), with a greater proportion of Bi-AAE patients achieving target SBP (<140 mmHg; 77.1% vs. 51.5%; P = 0.027). Bi-AAE also resulted in significantly greater reductions in 24 h and home SBP at 1, 3, and 6 months (all P < 0.05). Furthermore, Bi-AAE was more effective in correcting biochemical abnormalities, including hyperaldosteronism and renin suppression (all P < 0.05). Importantly, Bi-AAE preserved zona fasciculata function, as evidenced by normal morning serum cortisol levels and intact responses to ACTH stimulation post-procedure. No serious adverse events occurred during the perioperative or 6-month follow-up period. These findings support Bi-AAE as a safe, minimally invasive, and highly effective alternative to medical therapy for managing IHA. Although the findings support Bi-AAE as a safe, minimally invasive, and highly effective alternative to medical therapy for managing IHA, the need for long-term data before drawing definitive conclusions is emphasized. Future studies with extended follow-up are necessary to confirm its long-term benefits and risks. Trial registration: The trial has been registered at ClinicalTrials.gov (NCT05262660).","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 7","pages":"489-499"},"PeriodicalIF":3.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-30DOI: 10.1038/s41371-025-01031-7
Megan Bach, Joseph Kassab, Ahmed Mohamed Hassan, Nandan Kodur, Luke J. Laffin
The utility of ambulatory blood pressure monitoring (ABPM) among patients with various forms of autonomic dysfunction (AD) is unknown. Twenty-four-hour ABPM among patients with postural orthostatic tachycardia syndrome (POTS), AD without POTS, and control patients without AD were compared. Patients with AD without POTS had high rates of uncontrolled blood pressure (76%), whereas 19% of patients with POTS had uncontrolled blood pressure, suggesting ABPM may provide less value among patients with POTS.
{"title":"Comparison of ambulatory blood pressure monitoring among patients with postural orthostatic tachycardia syndrome, autonomic dysfunction, and controls","authors":"Megan Bach, Joseph Kassab, Ahmed Mohamed Hassan, Nandan Kodur, Luke J. Laffin","doi":"10.1038/s41371-025-01031-7","DOIUrl":"10.1038/s41371-025-01031-7","url":null,"abstract":"The utility of ambulatory blood pressure monitoring (ABPM) among patients with various forms of autonomic dysfunction (AD) is unknown. Twenty-four-hour ABPM among patients with postural orthostatic tachycardia syndrome (POTS), AD without POTS, and control patients without AD were compared. Patients with AD without POTS had high rates of uncontrolled blood pressure (76%), whereas 19% of patients with POTS had uncontrolled blood pressure, suggesting ABPM may provide less value among patients with POTS.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 7","pages":"534-536"},"PeriodicalIF":3.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41371-025-01031-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-28DOI: 10.1038/s41371-025-01030-8
Ana Cristina Tenório da Costa Fernandes, João Carlos Moreno Azevedo, Elizabeth Silaid Muxfeldt, Fabio de Souza
Continuous Positive Airway Pressure (CPAP) is the gold standard treatment for Obstructive Sleep Apnea (OSA). Its long-term effects on Resistant Hypertension (RHT) have not yet been fully established. We conducted a prospective intervention study to evaluate the impact of long-term CPAP therapy on office and ambulatory blood pressure (BP) in patients with RHT and moderate to severe OSA. Patients who used CPAP for a minimum of 12 months were included in the CPAP group and compared with those who declined to use CPAP despite clinical indications (control group). All participants underwent 24-h ambulatory blood pressure monitoring (ABPM) at baseline and at the end of the study. Intergroup comparisons of BP changes were performed using a general linear model, including two per-protocol analyses for patients with optimal CPAP adherence (at least 4 h/night) and those with refractory hypertension. A total of 124 individuals were included (65 in the CPAP group and 59 controls), with a mean age of 60.7 ± 7.8 years. The intention-to-treat analysis found no significant differences in overall BP changes between groups. The per-protocol analyses (50 CPAP users with optimal adherence and 28 with refractory hypertension) showed significant reductions in nighttime systolic BP (−8.1 mmHg (95% CI −14.7 to −1.5) and −25.6 mmHg (95% CI −40.1 – −10.5), respectively) and in nighttime diastolic BP (−5.3 mmHg (95% CI −9.6 to −1.1) and −13.9 mmHg (95% CI −22.5 – −5.3), respectively). These findings suggest that while CPAP benefits adherent patients and refractory hypertensives, its overall long-term effects on resistant hypertension require further investigation.
{"title":"Long-term effect of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea","authors":"Ana Cristina Tenório da Costa Fernandes, João Carlos Moreno Azevedo, Elizabeth Silaid Muxfeldt, Fabio de Souza","doi":"10.1038/s41371-025-01030-8","DOIUrl":"10.1038/s41371-025-01030-8","url":null,"abstract":"Continuous Positive Airway Pressure (CPAP) is the gold standard treatment for Obstructive Sleep Apnea (OSA). Its long-term effects on Resistant Hypertension (RHT) have not yet been fully established. We conducted a prospective intervention study to evaluate the impact of long-term CPAP therapy on office and ambulatory blood pressure (BP) in patients with RHT and moderate to severe OSA. Patients who used CPAP for a minimum of 12 months were included in the CPAP group and compared with those who declined to use CPAP despite clinical indications (control group). All participants underwent 24-h ambulatory blood pressure monitoring (ABPM) at baseline and at the end of the study. Intergroup comparisons of BP changes were performed using a general linear model, including two per-protocol analyses for patients with optimal CPAP adherence (at least 4 h/night) and those with refractory hypertension. A total of 124 individuals were included (65 in the CPAP group and 59 controls), with a mean age of 60.7 ± 7.8 years. The intention-to-treat analysis found no significant differences in overall BP changes between groups. The per-protocol analyses (50 CPAP users with optimal adherence and 28 with refractory hypertension) showed significant reductions in nighttime systolic BP (−8.1 mmHg (95% CI −14.7 to −1.5) and −25.6 mmHg (95% CI −40.1 – −10.5), respectively) and in nighttime diastolic BP (−5.3 mmHg (95% CI −9.6 to −1.1) and −13.9 mmHg (95% CI −22.5 – −5.3), respectively). These findings suggest that while CPAP benefits adherent patients and refractory hypertensives, its overall long-term effects on resistant hypertension require further investigation.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 7","pages":"475-482"},"PeriodicalIF":3.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41371-025-01030-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-28DOI: 10.1038/s41371-025-01029-1
Aletta S. Uys, Wayne Smith, Annemarie Wentzel, Catharina MC Mels, Ruan Kruger
In children reduced baroreceptor sensitivity (BRS) has been linked to obesity but not blood pressure (BP). Offspring of hypertensive parents have reduced BRS, with possibly increasing risk for hypertension development and kidney dysfunction. This study aimed to explore the relationships between BRS, kidney function, familial cardiovascular-and lifestyle risk in prepubescent boys with varying BP levels. We included 40 Black and 41 White boys (aged 6–8 years). Anthropometric measurements included calculated body mass index (BMI) and sex-and-age specific BMI z-scores (BMIz). Demographic data was collected with questionnaires and included information on familial cardiovascular-and lifestyle risk. Cardiovascular measures were resting BP and Finometer monitoring for BRS calculation. Kidney function was assessed using urinary albumin-to-creatinine ratio (uACR). Stratification was based on normal or elevated BP status. The elevated BP group had more Black boys (n = 37; 65.5%; p = 0.003). Notably, BRS (p = 0.56) and uACR (p = 0.92) were comparable between normal and elevated BP groups. In the normal BP group, single, partial and fully adjusted models revealed an inverse association between BRS and uACR (β = −0.38; p = 0.009). In the elevated BP group, BRS associated with familial risk (β = −0.52; p = 0.002), BMIz (β = 0.36; p = 0.020) and Black ethnicity (β = −0.37; p = 0.024), yet no association was evident between BRS and uACR. A cardioprotective relationship exists between BRS and kidney function in boys with normal BP. In boys with elevated BP, a positive familial cardiovascular-and lifestyle risk, adiposity and Black ethnicity seems to contribute to cardiovascular disease risk via a relationship with lower BRS.
{"title":"Baroreceptor sensitivity, kidney function and cardiovascular risk in prepubescent boys with normal versus elevated blood pressure","authors":"Aletta S. Uys, Wayne Smith, Annemarie Wentzel, Catharina MC Mels, Ruan Kruger","doi":"10.1038/s41371-025-01029-1","DOIUrl":"10.1038/s41371-025-01029-1","url":null,"abstract":"In children reduced baroreceptor sensitivity (BRS) has been linked to obesity but not blood pressure (BP). Offspring of hypertensive parents have reduced BRS, with possibly increasing risk for hypertension development and kidney dysfunction. This study aimed to explore the relationships between BRS, kidney function, familial cardiovascular-and lifestyle risk in prepubescent boys with varying BP levels. We included 40 Black and 41 White boys (aged 6–8 years). Anthropometric measurements included calculated body mass index (BMI) and sex-and-age specific BMI z-scores (BMIz). Demographic data was collected with questionnaires and included information on familial cardiovascular-and lifestyle risk. Cardiovascular measures were resting BP and Finometer monitoring for BRS calculation. Kidney function was assessed using urinary albumin-to-creatinine ratio (uACR). Stratification was based on normal or elevated BP status. The elevated BP group had more Black boys (n = 37; 65.5%; p = 0.003). Notably, BRS (p = 0.56) and uACR (p = 0.92) were comparable between normal and elevated BP groups. In the normal BP group, single, partial and fully adjusted models revealed an inverse association between BRS and uACR (β = −0.38; p = 0.009). In the elevated BP group, BRS associated with familial risk (β = −0.52; p = 0.002), BMIz (β = 0.36; p = 0.020) and Black ethnicity (β = −0.37; p = 0.024), yet no association was evident between BRS and uACR. A cardioprotective relationship exists between BRS and kidney function in boys with normal BP. In boys with elevated BP, a positive familial cardiovascular-and lifestyle risk, adiposity and Black ethnicity seems to contribute to cardiovascular disease risk via a relationship with lower BRS.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 7","pages":"483-488"},"PeriodicalIF":3.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41371-025-01029-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-23DOI: 10.1038/s41371-025-01028-2
Tatiane de Azevedo Rubio, Moacir Fernandes de Godoy, Jéssica Roma Rodrigues Uyemura, José E. Tanus-Santos, Tatiana Palotta Minari, José Fernando Vilela-Martin, Juan Carlos Yugar-Toledo, Heitor Moreno Junior
Resistant arterial hypertension (RHTN) has been associated with sympathetic hyperactivity, which represents a significant challenge in the management and treatment of arterial hypertension. In the present study, autonomic modulation was analysed in hypertensive, resistant hypertensive, and refractory hypertensive patients, compared to a group of apparently healthy normotensive individuals. Participants with resistant hypertension were included only after the exclusion of secondary hypertension and pseudo-resistance diagnoses. Heart rate variability (HRV) analysis included parameters from the time domain, frequency domain, and nonlinear methods, providing a comprehensive assessment of global autonomic modulation. The results demonstrated a significant reduction in global HRV across all three hypertensive groups, evidenced by decreases in parameters from the time domain, frequency domain and nonlinear methods. Furthermore, a concomitant reduction in the low- and high-frequency components was observed, with the decrease in the high-frequency component being more pronounced. These findings challenge the traditional view of isolated sympathetic hyperactivity in hypertension. Instead, the results reveal a relative predominance of sympathetic function due to the more marked attenuation of parasympathetic activity. These results underscore the need to reinterpret autonomic dysfunction in arterial hypertension, particularly in its more severe forms, as a global loss of autonomic modulation.
{"title":"A new approach to interpreting the LF/HF ratio: a study in hypertensive patients","authors":"Tatiane de Azevedo Rubio, Moacir Fernandes de Godoy, Jéssica Roma Rodrigues Uyemura, José E. Tanus-Santos, Tatiana Palotta Minari, José Fernando Vilela-Martin, Juan Carlos Yugar-Toledo, Heitor Moreno Junior","doi":"10.1038/s41371-025-01028-2","DOIUrl":"10.1038/s41371-025-01028-2","url":null,"abstract":"Resistant arterial hypertension (RHTN) has been associated with sympathetic hyperactivity, which represents a significant challenge in the management and treatment of arterial hypertension. In the present study, autonomic modulation was analysed in hypertensive, resistant hypertensive, and refractory hypertensive patients, compared to a group of apparently healthy normotensive individuals. Participants with resistant hypertension were included only after the exclusion of secondary hypertension and pseudo-resistance diagnoses. Heart rate variability (HRV) analysis included parameters from the time domain, frequency domain, and nonlinear methods, providing a comprehensive assessment of global autonomic modulation. The results demonstrated a significant reduction in global HRV across all three hypertensive groups, evidenced by decreases in parameters from the time domain, frequency domain and nonlinear methods. Furthermore, a concomitant reduction in the low- and high-frequency components was observed, with the decrease in the high-frequency component being more pronounced. These findings challenge the traditional view of isolated sympathetic hyperactivity in hypertension. Instead, the results reveal a relative predominance of sympathetic function due to the more marked attenuation of parasympathetic activity. These results underscore the need to reinterpret autonomic dysfunction in arterial hypertension, particularly in its more severe forms, as a global loss of autonomic modulation.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 7","pages":"467-474"},"PeriodicalIF":3.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41371-025-01028-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-20DOI: 10.1038/s41371-025-01027-3
Sanjana Mishra, Prekshi Garg, Mala Trivedi, Prachi Srivastava
Hypertension is a prevalent disease that substantially elevates the risk of neurological disorders such as dementia, stroke and Parkinson’s disease. MicroRNAs (miRNAs) play a critical role in the regulation of gene expression related to brain function and disorders. Understanding the involvement of miRNAs in these conditions could provide new insights into potential therapeutic targets. The main objective of this study is to target and investigate microRNAs (miRNAs) associated with neurological disorders in patients suffering from hypertension. The genes involved in hypertension were identified from various databases including GeneCard, MalaCard, DisGeNet, OMIM & GEO2R. The key gene for hypertension was identified using a systems biology approach. Also, potent phytochemical for hypertension was determined by computer-aided drug-designing approach. Functional miRNAs were determined for the key target gene using miRNet analytics platform by hypergeometric tests. Further, the gene-miRNA interaction was determined and enrichment analysis was done. RPS27A was identified as a key target gene for hypertension. Naringenin showed effective molecular interaction with RPS27A with a binding energy score (−6.28). Further, a list of miRNAs which were targeting brain disorders was determined from miRNet. A gene-miRNA network was constructed using the PSRR tool for Parkinson’s Disease, Autism Spectrum Disorder, Acute Cerebral Infarction, ACTH-Secreting Pituitary Adenoma, & Ependymoma. Further, miRNA 21 & miRNA 16 were found to be associated with four of the neurological disorders. The study identifies specific miRNAs that may serve as potential biomarkers for brain disorders in hypertensive patients. Targeting these miRNAs could open new avenues for therapeutic strategies aimed at mitigating neurological damage in this patient population.
{"title":"Multiple system biology approaches reveals the role of the hsa-miR-21 in increasing risk of neurological disorders in patients suffering from hypertension","authors":"Sanjana Mishra, Prekshi Garg, Mala Trivedi, Prachi Srivastava","doi":"10.1038/s41371-025-01027-3","DOIUrl":"10.1038/s41371-025-01027-3","url":null,"abstract":"Hypertension is a prevalent disease that substantially elevates the risk of neurological disorders such as dementia, stroke and Parkinson’s disease. MicroRNAs (miRNAs) play a critical role in the regulation of gene expression related to brain function and disorders. Understanding the involvement of miRNAs in these conditions could provide new insights into potential therapeutic targets. The main objective of this study is to target and investigate microRNAs (miRNAs) associated with neurological disorders in patients suffering from hypertension. The genes involved in hypertension were identified from various databases including GeneCard, MalaCard, DisGeNet, OMIM & GEO2R. The key gene for hypertension was identified using a systems biology approach. Also, potent phytochemical for hypertension was determined by computer-aided drug-designing approach. Functional miRNAs were determined for the key target gene using miRNet analytics platform by hypergeometric tests. Further, the gene-miRNA interaction was determined and enrichment analysis was done. RPS27A was identified as a key target gene for hypertension. Naringenin showed effective molecular interaction with RPS27A with a binding energy score (−6.28). Further, a list of miRNAs which were targeting brain disorders was determined from miRNet. A gene-miRNA network was constructed using the PSRR tool for Parkinson’s Disease, Autism Spectrum Disorder, Acute Cerebral Infarction, ACTH-Secreting Pituitary Adenoma, & Ependymoma. Further, miRNA 21 & miRNA 16 were found to be associated with four of the neurological disorders. The study identifies specific miRNAs that may serve as potential biomarkers for brain disorders in hypertensive patients. Targeting these miRNAs could open new avenues for therapeutic strategies aimed at mitigating neurological damage in this patient population.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 6","pages":"432-441"},"PeriodicalIF":2.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-15DOI: 10.1038/s41371-025-01026-4
Annabel X. Tan, Andrew Y. Chang, Daichi Shimbo, Adam Bress, Mario Sims, Michelle C. Odden
Extreme temperature events related to climate change may impact blood pressure (BP). African American populations are disproportionately affected by temperature extremes due to structural inequities. We examined the association between ambient outdoor temperature and BP among participants in JHS, a cohort of African American adults residing in the tri-county area of Jackson, Mississippi. Our primary hypothesis is that daily higher outdoor ambient temperatures would be associated with lower BP. We used a linear-mixed effects model to determine the relationship between temperature and systolic and diastolic blood pressure (SBP and DBP) at three visits (N = 5296). Participants had BP readings across three visits: Visit 1 (2000–2004), Visit 2 (2005–2008), Visit 3 (2009–2013). Cardiovascular disease (CVD), diabetes, BP medication, sex, age, and visit number were included as adjustment variables. For every 1-degree Celsius higher average temperature from the mean, SBP was 0.11 mm Hg lower (95% CI: −0.14, −0.07, p < 0.001) in adjusted models. Similarly, for every 1-degree Celsius higher average temperature from the mean, DBP was 0.06 mm Hg lower (95% CI: −0.08, −0.04) in adjusted models. The associations were weakly curvilinear (inverted U-shape) with significant quadratic terms. This relationship was not modified by markers of socioeconomic status. This is the first study in the Jackson Heart Study (JHS) to investigate the association between temperature and blood pressure. Further research is needed to explore this relationship in vulnerable populations living in areas prone to extreme temperatures.
与气候变化相关的极端温度事件可能影响血压（BP）。由于结构性不平等，非洲裔美国人受到极端温度的影响不成比例。我们研究了JHS参与者中室外环境温度和血压之间的关系，JHS是一个居住在密西西比州杰克逊三县地区的非裔美国成年人队列。我们的主要假设是，每天较高的室外环境温度与较低的血压有关。我们使用线性混合效应模型来确定三次就诊时温度与收缩压和舒张压（SBP和DBP）之间的关系（N = 5296）。参与者在三次访问中有血压读数：访问1(2000-2004)，访问2(2005-2008)，访问3（2009-2013）。调整变量包括心血管疾病（CVD）、糖尿病、降压药物、性别、年龄和就诊次数。平均温度每比平均值高1摄氏度，收缩压降低0.11毫米汞柱(95% CI: -0.14, -0.07, p
{"title":"Association of ambient temperature and blood pressure in the Jackson Heart Study","authors":"Annabel X. Tan, Andrew Y. Chang, Daichi Shimbo, Adam Bress, Mario Sims, Michelle C. Odden","doi":"10.1038/s41371-025-01026-4","DOIUrl":"10.1038/s41371-025-01026-4","url":null,"abstract":"Extreme temperature events related to climate change may impact blood pressure (BP). African American populations are disproportionately affected by temperature extremes due to structural inequities. We examined the association between ambient outdoor temperature and BP among participants in JHS, a cohort of African American adults residing in the tri-county area of Jackson, Mississippi. Our primary hypothesis is that daily higher outdoor ambient temperatures would be associated with lower BP. We used a linear-mixed effects model to determine the relationship between temperature and systolic and diastolic blood pressure (SBP and DBP) at three visits (N = 5296). Participants had BP readings across three visits: Visit 1 (2000–2004), Visit 2 (2005–2008), Visit 3 (2009–2013). Cardiovascular disease (CVD), diabetes, BP medication, sex, age, and visit number were included as adjustment variables. For every 1-degree Celsius higher average temperature from the mean, SBP was 0.11 mm Hg lower (95% CI: −0.14, −0.07, p < 0.001) in adjusted models. Similarly, for every 1-degree Celsius higher average temperature from the mean, DBP was 0.06 mm Hg lower (95% CI: −0.08, −0.04) in adjusted models. The associations were weakly curvilinear (inverted U-shape) with significant quadratic terms. This relationship was not modified by markers of socioeconomic status. This is the first study in the Jackson Heart Study (JHS) to investigate the association between temperature and blood pressure. Further research is needed to explore this relationship in vulnerable populations living in areas prone to extreme temperatures.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 6","pages":"415-421"},"PeriodicalIF":2.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-07DOI: 10.1038/s41371-025-01024-6
Constance B. Hilliard
{"title":"The mislaid clue to APOL1 kidney disease prevention in blacks","authors":"Constance B. Hilliard","doi":"10.1038/s41371-025-01024-6","DOIUrl":"10.1038/s41371-025-01024-6","url":null,"abstract":"","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 6","pages":"389-391"},"PeriodicalIF":2.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41371-025-01024-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-06DOI: 10.1038/s41371-025-01025-5
Helen Shi, Allison Stark, Aloke Maity, Abhishek Shah, Joseph Manganelli, Paula Baichoo, Svetlana Korchevsky, Pooja Suthar, Chenshu Zhang, Sharon Rikin
In this implementation science study evaluating the feasibility and effectiveness of a remote patient monitoring program for hypertension, we found that most, but not all of patients received the intended program components of clinical pharmacist outreach and medication titration. Despite feasibility challenges, remote-patient monitoring for hypertension was effective at reducing systolic blood pressure by ≥ 5 mmHg in (64%) and 346 (71%) patients by 3 and 6 months of enrollment respectively. Unexpectedly, chi-square and multivariate logistic regressions analysis showed that the clinical pharmacist outreach, was not associated with blood pressure improvement, but that patient engagement and medication titration were associated with blood pressure improvement. These results suggest that other unmeasured behavioral and lifestyle changes may be a large driver of BP improvement and that while RPM-HTN is a worthwhile intervention, it may not require all ancillary components to deliver meaningful results.
{"title":"Assessment of clinical pharmacist outreach and medication titration in remote patient monitoring program for hypertension","authors":"Helen Shi, Allison Stark, Aloke Maity, Abhishek Shah, Joseph Manganelli, Paula Baichoo, Svetlana Korchevsky, Pooja Suthar, Chenshu Zhang, Sharon Rikin","doi":"10.1038/s41371-025-01025-5","DOIUrl":"10.1038/s41371-025-01025-5","url":null,"abstract":"In this implementation science study evaluating the feasibility and effectiveness of a remote patient monitoring program for hypertension, we found that most, but not all of patients received the intended program components of clinical pharmacist outreach and medication titration. Despite feasibility challenges, remote-patient monitoring for hypertension was effective at reducing systolic blood pressure by ≥ 5 mmHg in (64%) and 346 (71%) patients by 3 and 6 months of enrollment respectively. Unexpectedly, chi-square and multivariate logistic regressions analysis showed that the clinical pharmacist outreach, was not associated with blood pressure improvement, but that patient engagement and medication titration were associated with blood pressure improvement. These results suggest that other unmeasured behavioral and lifestyle changes may be a large driver of BP improvement and that while RPM-HTN is a worthwhile intervention, it may not require all ancillary components to deliver meaningful results.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"39 6","pages":"422-424"},"PeriodicalIF":2.7,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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