Pub Date : 2025-12-02DOI: 10.1038/s41371-025-01099-1
Julian Minetto, Walter Espeche, Gustavo Cerri, Lautaro Reitovich, Juan Ignacio Perez Duhalde, Jeremias Altuna Ruiz, Carlos Leiva Sisnieguez, Martin Salazar
Nocturnal blood pressure (BP) is associated with cardiovascular events independently of daytime BP. Isolated nocturnal hypertension (INH), defined by elevated nocturnal BP with normal daytime BP, increases cardiovascular risk. However, its underlying; mechanisms remain unclear. This study aims to assess the association between nocturnal BP and INH with sleep quality and duration. This cross-sectional study analyzed 2297 individuals (57% women, 49.5 ± 15 years) using ambulatory blood pressure monitoring (ABPM) to evaluate the relationship between INH and sleep quality. Individuals with secondary hypertension and sleep disorders were excluded. Sleep quality and duration were primarily assessed using the Pittsburgh Sleep Quality Index (PSQI) and the STOP-BANG score. Results showed that 64% had poor sleep quality (PSQI > 5), and 18.7% slept less than 6 h. No significant differences in sleep quality were found among hypertensive phenotypes. INH was associated with older age, diabetes, and waist circumference; however, sleep quality and duration were not independent factors in its development. Nonetheless, nocturnal BP exhibited a slight association with sleep quality and disturbances of mild clinical significance.
{"title":"Isolated nocturnal hypertension and its association with sleep duration and quality","authors":"Julian Minetto, Walter Espeche, Gustavo Cerri, Lautaro Reitovich, Juan Ignacio Perez Duhalde, Jeremias Altuna Ruiz, Carlos Leiva Sisnieguez, Martin Salazar","doi":"10.1038/s41371-025-01099-1","DOIUrl":"10.1038/s41371-025-01099-1","url":null,"abstract":"Nocturnal blood pressure (BP) is associated with cardiovascular events independently of daytime BP. Isolated nocturnal hypertension (INH), defined by elevated nocturnal BP with normal daytime BP, increases cardiovascular risk. However, its underlying; mechanisms remain unclear. This study aims to assess the association between nocturnal BP and INH with sleep quality and duration. This cross-sectional study analyzed 2297 individuals (57% women, 49.5 ± 15 years) using ambulatory blood pressure monitoring (ABPM) to evaluate the relationship between INH and sleep quality. Individuals with secondary hypertension and sleep disorders were excluded. Sleep quality and duration were primarily assessed using the Pittsburgh Sleep Quality Index (PSQI) and the STOP-BANG score. Results showed that 64% had poor sleep quality (PSQI > 5), and 18.7% slept less than 6 h. No significant differences in sleep quality were found among hypertensive phenotypes. INH was associated with older age, diabetes, and waist circumference; however, sleep quality and duration were not independent factors in its development. Nonetheless, nocturnal BP exhibited a slight association with sleep quality and disturbances of mild clinical significance.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"40 2","pages":"96-102"},"PeriodicalIF":3.4,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41371-025-01099-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660945","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}
Elevated blood pressure (BP) ≥ 180/110 mmHg is a frequent cause of attendance to the Emergency Department (ED). Current hypertension guidelines clearly define a diagnostic and management approach for hypertensive urgencies (HUs) and emergencies (HEs). The aim of this study was to report on physicians’ routine clinical practice regarding diagnosis and treatment of HUs and HEs. This observational cross-sectional study was conducted in tertiary hospitals of Thessaloniki, Greece. A specifically designed questionnaire was distributed to physicians working in the ED, who were actively implicated in the management of patients with HUs/HEs. Among 146 responders, only 54.1% correctly reported that HUs and HEs are characterized by an increase in BP ≥ 180/110 mmHg. Less than half (48.6%) stated that they routinely check for compliance with antihypertensive treatment. The vast majority routinely order an electrocardiogram (91.8%) and laboratory tests (79.5%) in patients attending the ED with BP ≥ 180/110 mmHg, but this percentage dropped to 61.0% for urinalysis. Only 21.2% routinely order a fundoscopic examination. Calcium channel blockers would be the first drug to administer by 63.0% of study participants to HUs, whereas only 40.4% would choose intravenous labetalol as the first-line antihypertensive medication for malignant hypertension. Subgroup analysis revealed significant differences according to the most prevalent ED specialties of Internal Medicine, General Practice and Cardiology. The diagnostic approach and therapeutic management of HUs or HEs may deviate significantly in real-life clinical practice compared to current recommendations by international hypertension guidelines. More efforts are warranted to educate physicians on this important clinical issue.
{"title":"Deviations in the diagnostic and management approach of hypertensive urgencies and emergencies in routine clinical practice as compared to the guidelines: a survey of physicians in tertiary hospitals","authors":"Panagiota Anyfanti, Christina Antza, Eleni Karlafti, Eleni Chovarda, Konstantinos Triantafyllou, Georgios Styliadis, Eugenia Gkaliagkousi, Vasilios Kotsis","doi":"10.1038/s41371-025-01101-w","DOIUrl":"10.1038/s41371-025-01101-w","url":null,"abstract":"Elevated blood pressure (BP) ≥ 180/110 mmHg is a frequent cause of attendance to the Emergency Department (ED). Current hypertension guidelines clearly define a diagnostic and management approach for hypertensive urgencies (HUs) and emergencies (HEs). The aim of this study was to report on physicians’ routine clinical practice regarding diagnosis and treatment of HUs and HEs. This observational cross-sectional study was conducted in tertiary hospitals of Thessaloniki, Greece. A specifically designed questionnaire was distributed to physicians working in the ED, who were actively implicated in the management of patients with HUs/HEs. Among 146 responders, only 54.1% correctly reported that HUs and HEs are characterized by an increase in BP ≥ 180/110 mmHg. Less than half (48.6%) stated that they routinely check for compliance with antihypertensive treatment. The vast majority routinely order an electrocardiogram (91.8%) and laboratory tests (79.5%) in patients attending the ED with BP ≥ 180/110 mmHg, but this percentage dropped to 61.0% for urinalysis. Only 21.2% routinely order a fundoscopic examination. Calcium channel blockers would be the first drug to administer by 63.0% of study participants to HUs, whereas only 40.4% would choose intravenous labetalol as the first-line antihypertensive medication for malignant hypertension. Subgroup analysis revealed significant differences according to the most prevalent ED specialties of Internal Medicine, General Practice and Cardiology. The diagnostic approach and therapeutic management of HUs or HEs may deviate significantly in real-life clinical practice compared to current recommendations by international hypertension guidelines. More efforts are warranted to educate physicians on this important clinical issue.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"40 2","pages":"88-95"},"PeriodicalIF":3.4,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145634467","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 : 2025-11-27DOI: 10.1038/s41371-025-01098-2
Katrina R. Kissock, Nadine Ghammachi, Annet C. Hoek, James D. Bullen, Jacqui Webster, Simone Pettigrew, Nitika Garg, Bruce Neal, Kathy Trieu
Despite consistent evidence of the cardioprotective benefits of reduced-sodium salt, it remains an underutilised intervention. Understanding how reduced-sodium salt is perceived is required to scale-up its use. This review summarises end user and healthcare professional knowledge, attitudes, and behaviours about reduced-sodium salt. We systematically searched four databases (inception to February 2024) and identified studies reporting knowledge, attitudes and behaviours towards reduced-sodium salt. Twenty-nine studies from 11 countries were included, 18 of which were intervention studies involving reduced-sodium salt and 11 were descriptive studies examining perceptions among the general community and healthcare professionals. Among intervention studies, there was high overall acceptability but mixed findings on taste. Outcomes related to use or willingness to use were mostly positive especially following cost-subsidisation. Among descriptive studies, there was low awareness (ranging from 0–32%) and reported use (10–16%) of reduced-sodium salt among the general community. Barriers to use included low availability and higher costs compared to regular salt. Awareness was higher among healthcare professionals (71%). Overall, most studies found high acceptability and willingness to use following exposure to reduced-sodium salt, despite some detecting taste differences. Greater awareness coupled with strategies to improve availability and affordability are important to scale-up the use of reduced-sodium salt.
{"title":"Knowledge, attitudes, and behaviours related to reduced-sodium salt: a systematic review","authors":"Katrina R. Kissock, Nadine Ghammachi, Annet C. Hoek, James D. Bullen, Jacqui Webster, Simone Pettigrew, Nitika Garg, Bruce Neal, Kathy Trieu","doi":"10.1038/s41371-025-01098-2","DOIUrl":"10.1038/s41371-025-01098-2","url":null,"abstract":"Despite consistent evidence of the cardioprotective benefits of reduced-sodium salt, it remains an underutilised intervention. Understanding how reduced-sodium salt is perceived is required to scale-up its use. This review summarises end user and healthcare professional knowledge, attitudes, and behaviours about reduced-sodium salt. We systematically searched four databases (inception to February 2024) and identified studies reporting knowledge, attitudes and behaviours towards reduced-sodium salt. Twenty-nine studies from 11 countries were included, 18 of which were intervention studies involving reduced-sodium salt and 11 were descriptive studies examining perceptions among the general community and healthcare professionals. Among intervention studies, there was high overall acceptability but mixed findings on taste. Outcomes related to use or willingness to use were mostly positive especially following cost-subsidisation. Among descriptive studies, there was low awareness (ranging from 0–32%) and reported use (10–16%) of reduced-sodium salt among the general community. Barriers to use included low availability and higher costs compared to regular salt. Awareness was higher among healthcare professionals (71%). Overall, most studies found high acceptability and willingness to use following exposure to reduced-sodium salt, despite some detecting taste differences. Greater awareness coupled with strategies to improve availability and affordability are important to scale-up the use of reduced-sodium salt.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"40 1","pages":"1-9"},"PeriodicalIF":3.4,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41371-025-01098-2.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145634464","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}
Accurately estimating childhood hypertension prevalence is challenging due to blood pressure variability and the need for confirmation across multiple measurements. This study assessed prevalence of hypertension status, stages, and phenotypes among Chinese children on three visits and explored their associations with healthy lifestyles. A school-based cross-sectional survey conducted in Pinghu, Zhejiang province, in September 2022 included 2538 children aged 8–14 years. Elevated blood pressure was defined as blood pressure ≥95th percentile for age, sex, and height in a single measurement, while hypertension required confirmation across three occasions. A healthy lifestyle score was developed based on normal weight, ≥60 min/day of moderate-to-vigorous physical activity, <2 h/day of screen time, adequate sleep, dietary diversity. Multivariable logistic regression assessed associations between healthy lifestyles and hypertension status, stages (stage 1 and stage 2) and phenotypes (isolated systolic hypertension [ISH], isolated diastolic hypertension [IDH], systolic diastolic hypertension [SDH]). Elevated blood pressure prevalence decreased from 16.9% to 4.4% across visits. Prevalence rates were 3.2% for stage 1 hypertension, 1.2% for stage 2 hypertension, 2.5% for ISH, 0.4% for IDH, and 1.4% for SDH. Each 1-point increase in healthy lifestyle score, the odds of children being hypertension, stage1 hypertension, stage 2 hypertension, ISH, IDH and SDH decreased by 43% (odds ratio 0.57, 95% confidence interval 0.46–0.70), 44% (0.56, 0.44–0.71), 40% (0.60, 0.41–0.86), 39% (0.61, 0.47–0.80), 49% (0.51, 0.27–0.98) and 48% (0.52, 0.36–0.74), respectively. Prevalence of childhood hypertension among those aged 8–14 years in Pinghu was 4.4%. Adherence to multiple healthy lifestyles was associated with hypertension status, stages, and phenotypes.
{"title":"Hypertension in Chinese children: prevalence, phenotypes, stages, and associations with healthy lifestyles from a multi-visit study","authors":"Bing Zhu, Shuting Li, Jiali Zhou, Zeyu Luo, Denan Jiang, Longzhu Zhu, Weidi Sun, Shiyi Shan, Ronghua Zhang, Peige Song","doi":"10.1038/s41371-025-01096-4","DOIUrl":"10.1038/s41371-025-01096-4","url":null,"abstract":"Accurately estimating childhood hypertension prevalence is challenging due to blood pressure variability and the need for confirmation across multiple measurements. This study assessed prevalence of hypertension status, stages, and phenotypes among Chinese children on three visits and explored their associations with healthy lifestyles. A school-based cross-sectional survey conducted in Pinghu, Zhejiang province, in September 2022 included 2538 children aged 8–14 years. Elevated blood pressure was defined as blood pressure ≥95th percentile for age, sex, and height in a single measurement, while hypertension required confirmation across three occasions. A healthy lifestyle score was developed based on normal weight, ≥60 min/day of moderate-to-vigorous physical activity, <2 h/day of screen time, adequate sleep, dietary diversity. Multivariable logistic regression assessed associations between healthy lifestyles and hypertension status, stages (stage 1 and stage 2) and phenotypes (isolated systolic hypertension [ISH], isolated diastolic hypertension [IDH], systolic diastolic hypertension [SDH]). Elevated blood pressure prevalence decreased from 16.9% to 4.4% across visits. Prevalence rates were 3.2% for stage 1 hypertension, 1.2% for stage 2 hypertension, 2.5% for ISH, 0.4% for IDH, and 1.4% for SDH. Each 1-point increase in healthy lifestyle score, the odds of children being hypertension, stage1 hypertension, stage 2 hypertension, ISH, IDH and SDH decreased by 43% (odds ratio 0.57, 95% confidence interval 0.46–0.70), 44% (0.56, 0.44–0.71), 40% (0.60, 0.41–0.86), 39% (0.61, 0.47–0.80), 49% (0.51, 0.27–0.98) and 48% (0.52, 0.36–0.74), respectively. Prevalence of childhood hypertension among those aged 8–14 years in Pinghu was 4.4%. Adherence to multiple healthy lifestyles was associated with hypertension status, stages, and phenotypes.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"40 2","pages":"80-87"},"PeriodicalIF":3.4,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145604377","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 : 2025-11-21DOI: 10.1038/s41371-025-01095-5
Martin R Salazar, Walter G Espeche, Ricardo D Olano, Betty C Leiva Sisnieguez, Gustavo Cerri, Julián Minetto, Carlos E Leiva Sisnieguez, Patricia Carrera Ramos, Horacio A Carbajal
We conducted a prospective study in consecutive high-risk pregnant women with 8 to 34 weeks of gestation to evaluate the relationship between PWV and the subsequent development of early- and late- onset preeclampsia (PE). The cohort was divided in high PWV (defined by the top tertile) and normal PWV (the remaining two tertiles). PE were classified as late-onset PE and early- onset PE using a cut-point of 34 weeks of gestation. The risk of women with high PWV for early- and late-onset PE was compared with women with normal PWV using multinomial regression. Two hundred and sixty-three high-risk pregnant women (mean age 30 ± 7 years, with 26 ± 7 weeks of gestation at the evaluation) were included in the study; 7.4%, 22.6%, 1.2%, 3.1% and 0.8% had antecedents of diabetes, chronic hypertension, chronic renal disease, collagen diseases and antiphospholipid syndrome, respectively. In previous pregnancies, 11.3% had had gestational diabetes and 22,6% hypertensive disorders of pregnancy. Forty-six pregnant women (17.9%) developed PE, of which 31 (12.1%) were late-onset and 15 (5.8%) early-onset. Women with high PWV more frequently developed early-onset than late-onset PE (14.0% vs 11.8% p = 0.509). Unadjusted and adjusted OR for early-onset PE were 9.61 (95%CI 2.62-35.25) and 7.13 (1.89-26.71), respectively. In conclusion, in high-risk pregnant women, a high PWV value was related with ~7 times more risk for development of early-onset PE.
我们对妊娠8 ~ 34周的连续高危孕妇进行了一项前瞻性研究，以评估PWV与早期和晚发型先兆子痫（PE）的后续发展之间的关系。该队列被分为高PWV（由前五分位数定义）和正常PWV（其余两分位数）。PE分为晚发性PE和早发性PE，以妊娠34周为切入点。采用多项回归法比较PWV高的女性与PWV正常的女性发生早、晚发性PE的风险。263例高危孕妇（平均年龄30±7岁，评估时妊娠26±7周）纳入研究；糖尿病、慢性高血压、慢性肾病、胶原蛋白疾病和抗磷脂综合征的既往病史分别为7.4%、22.6%、1.2%、3.1%和0.8%。在以前的妊娠中，11.3%患有妊娠糖尿病，22.6%患有妊娠高血压疾病。46例（17.9%）孕妇发生PE，其中迟发性31例（12.1%），早发性15例（5.8%）。高PWV的女性发生早发性PE的频率高于晚发性PE （14.0% vs 11.8% p = 0.509）。早发性PE的未校正OR和校正OR分别为9.61 （95%CI 2.62-35.25）和7.13（1.89-26.71）。综上所述，在高危孕妇中，高PWV值与发生早发性PE的风险增加约7倍相关。
{"title":"Pulse wave velocity in high-risk pregnant women who subsequently developed early- and late-onset preeclampsia.","authors":"Martin R Salazar, Walter G Espeche, Ricardo D Olano, Betty C Leiva Sisnieguez, Gustavo Cerri, Julián Minetto, Carlos E Leiva Sisnieguez, Patricia Carrera Ramos, Horacio A Carbajal","doi":"10.1038/s41371-025-01095-5","DOIUrl":"https://doi.org/10.1038/s41371-025-01095-5","url":null,"abstract":"<p><p>We conducted a prospective study in consecutive high-risk pregnant women with 8 to 34 weeks of gestation to evaluate the relationship between PWV and the subsequent development of early- and late- onset preeclampsia (PE). The cohort was divided in high PWV (defined by the top tertile) and normal PWV (the remaining two tertiles). PE were classified as late-onset PE and early- onset PE using a cut-point of 34 weeks of gestation. The risk of women with high PWV for early- and late-onset PE was compared with women with normal PWV using multinomial regression. Two hundred and sixty-three high-risk pregnant women (mean age 30 ± 7 years, with 26 ± 7 weeks of gestation at the evaluation) were included in the study; 7.4%, 22.6%, 1.2%, 3.1% and 0.8% had antecedents of diabetes, chronic hypertension, chronic renal disease, collagen diseases and antiphospholipid syndrome, respectively. In previous pregnancies, 11.3% had had gestational diabetes and 22,6% hypertensive disorders of pregnancy. Forty-six pregnant women (17.9%) developed PE, of which 31 (12.1%) were late-onset and 15 (5.8%) early-onset. Women with high PWV more frequently developed early-onset than late-onset PE (14.0% vs 11.8% p = 0.509). Unadjusted and adjusted OR for early-onset PE were 9.61 (95%CI 2.62-35.25) and 7.13 (1.89-26.71), respectively. In conclusion, in high-risk pregnant women, a high PWV value was related with ~7 times more risk for development of early-onset PE.</p>","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573814","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 : 2025-11-15DOI: 10.1038/s41371-025-01094-6
Jose P. Lopez-Lopez, Yuri Sanchez-Martinez, Yesica Giraldo-Castrillon, Daniel Martinez-Bello, Alvaro Castañeda, Claudia Garcia, Marianne Lopez-Cabrera, Johanna Otero, Patricio Lopez-Jaramillo
In Latin America, hypertension prevalence varies widely, and control rates remain low, particularly in low-income communities, despite the proven efficacy of recommended interventions. We aimed to describe baseline characteristics and identify individual factors associated with uncontrolled hypertension in participants of the RE-HOPE study in Santander, Colombia. A cross-sectional analysis was conducted including participants ≥18 years old with hypertension, defined by self-reported history, antihypertensive use, or systolic BP ≥ 140 and/or diastolic BP ≥ 90 mmHg. Descriptive statistics were used for baseline characteristics. Mixed-effects logistic regression models stratified by sex were applied to identify factors associated with uncontrolled hypertension, adjusting for age, diabetes, obesity, medication intake, physical activity, and smoking. A total of 3 481 participants were included, with a mean age of 60.2 years (SD 13.7); 62% were female. Mean systolic and diastolic BP were 144 ± 16 mmHg and 86 ± 10 mmHg, respectively. Despite high levels of awareness (81%) and medication use (76%), only 26% of participants had controlled hypertension ( < 140/90 mmHg), and 9.6% met the target below 130/80 mmHg. Control rates were higher in the capital city compared to peripheral and rural provinces. Being female was inversely associated with uncontrolled hypertension (OR = 0.62; 95% CI: 0.52–0.75). In contrast, age ≥ 60 years (OR = 2.19; 95% CI: 1.84–2.61) and current smoking (OR = 2.48; 95% CI: 1.54–4.00) were positively associated with poor control. This study highlights significant challenges in hypertension management, particularly early diagnosis and the identification of priority groups, and emphasizes the need for targeted public health initiatives and policy actions to enhance hypertension control.
{"title":"Factors associated with uncontrolled hypertension in Santander, Colombia: baseline findings from the RE-HOPE study","authors":"Jose P. Lopez-Lopez, Yuri Sanchez-Martinez, Yesica Giraldo-Castrillon, Daniel Martinez-Bello, Alvaro Castañeda, Claudia Garcia, Marianne Lopez-Cabrera, Johanna Otero, Patricio Lopez-Jaramillo","doi":"10.1038/s41371-025-01094-6","DOIUrl":"10.1038/s41371-025-01094-6","url":null,"abstract":"In Latin America, hypertension prevalence varies widely, and control rates remain low, particularly in low-income communities, despite the proven efficacy of recommended interventions. We aimed to describe baseline characteristics and identify individual factors associated with uncontrolled hypertension in participants of the RE-HOPE study in Santander, Colombia. A cross-sectional analysis was conducted including participants ≥18 years old with hypertension, defined by self-reported history, antihypertensive use, or systolic BP ≥ 140 and/or diastolic BP ≥ 90 mmHg. Descriptive statistics were used for baseline characteristics. Mixed-effects logistic regression models stratified by sex were applied to identify factors associated with uncontrolled hypertension, adjusting for age, diabetes, obesity, medication intake, physical activity, and smoking. A total of 3 481 participants were included, with a mean age of 60.2 years (SD 13.7); 62% were female. Mean systolic and diastolic BP were 144 ± 16 mmHg and 86 ± 10 mmHg, respectively. Despite high levels of awareness (81%) and medication use (76%), only 26% of participants had controlled hypertension ( < 140/90 mmHg), and 9.6% met the target below 130/80 mmHg. Control rates were higher in the capital city compared to peripheral and rural provinces. Being female was inversely associated with uncontrolled hypertension (OR = 0.62; 95% CI: 0.52–0.75). In contrast, age ≥ 60 years (OR = 2.19; 95% CI: 1.84–2.61) and current smoking (OR = 2.48; 95% CI: 1.54–4.00) were positively associated with poor control. This study highlights significant challenges in hypertension management, particularly early diagnosis and the identification of priority groups, and emphasizes the need for targeted public health initiatives and policy actions to enhance hypertension control.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"40 1","pages":"53-59"},"PeriodicalIF":3.4,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523555","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 : 2025-11-15DOI: 10.1038/s41371-025-01092-8
Bruno Bavaresco Gambassi, Thiago Matheus da Silva Sousa, Luíz Filipe Costa Chaves, Samir Seguins Sotão, Roberto Bianco, Paulo Adriano Schwingel, Cristiano Teixeira Mostarda
This pilot study investigated the effects of dynamic power training (PT) with elastic bands (EB) on arterial stiffness and hemodynamic parameters in older adults. Twenty-six older adults were randomly assigned to the control group and the intervention group (IG). IG participants performed PT with EB twice a week for 12 weeks. Pulse wave velocity (PWV), pulse pressure (PP), central pulse pressure, systolic blood pressure (SBP), diastolic blood pressure (DBP), central SBP, and central DBP were assessed before and after 12 weeks. PWV, PP, and SBP significantly improved after 12 weeks of intervention (p < 0.05). These findings indicate that 12 weeks of PT with EB reduces AS and significantly improves systolic blood pressure in older adults. Given the pilot nature of this work, larger randomized controlled trials are essential to confirm these benefits and further establish the safety of the protocol.
{"title":"Dynamic power training with elastic bands improves arterial stiffness and hemodynamic parameters in older adults? A pilot study","authors":"Bruno Bavaresco Gambassi, Thiago Matheus da Silva Sousa, Luíz Filipe Costa Chaves, Samir Seguins Sotão, Roberto Bianco, Paulo Adriano Schwingel, Cristiano Teixeira Mostarda","doi":"10.1038/s41371-025-01092-8","DOIUrl":"10.1038/s41371-025-01092-8","url":null,"abstract":"This pilot study investigated the effects of dynamic power training (PT) with elastic bands (EB) on arterial stiffness and hemodynamic parameters in older adults. Twenty-six older adults were randomly assigned to the control group and the intervention group (IG). IG participants performed PT with EB twice a week for 12 weeks. Pulse wave velocity (PWV), pulse pressure (PP), central pulse pressure, systolic blood pressure (SBP), diastolic blood pressure (DBP), central SBP, and central DBP were assessed before and after 12 weeks. PWV, PP, and SBP significantly improved after 12 weeks of intervention (p < 0.05). These findings indicate that 12 weeks of PT with EB reduces AS and significantly improves systolic blood pressure in older adults. Given the pilot nature of this work, larger randomized controlled trials are essential to confirm these benefits and further establish the safety of the protocol.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"40 1","pages":"60-66"},"PeriodicalIF":3.4,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530526","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 : 2025-11-14DOI: 10.1038/s41371-025-01090-w
Baozhen zhu, Peng Wu, Zefeng He, Juan Ma, Ning Yan, Yuru Ma, Ru Yan, Tianshui Ma, Rongbin Ma, Guangzhi Cong, Shaobin Jia, Xueping Ma
H-type hypertension, characterized by concomitant hypertension and hyperhomocysteinemia (HHcy), is associated with heightened cardiovascular risk. Despite emerging evidence implicating apolipoprotein A1 (APOA1) in atherosclerotic processes, its prognostic value in acute myocardial infarction (AMI) patients with H-type hypertension remains underexplored.We conducted multivariable-adjusted cox regression analyses to investigate major adverse cardiovascular events (MACES) associations. Non-linear relationships were explored using restricted cubic spline (RCS) and threshold effect analyses. Survival disparities were quantified through Kaplan-Meier estimates. Stratification analyses were used to demonstrate the stability of the relationship between APOA1 and MACES. A total of 581 participants were included, with a median follow-up time of 34.00 ± 1.21 months, and 134 MACES occurred, with higher tertiles of the APOA1 associated with a lower cumulative risk of MACEs (log-rank, P < 0.001). After adjusting for confounders, the fully adjusted HRs (95% CI) for Q3 and Q4 of the APOA1, with the lowest tertile as reference, were 0.46 (0.23,0.92) and 0.42 (0.19,0.93), respectively. RCS analysis showed that APOA1 had a linear relationship with MACES. Subgroup analyses and interaction tests revealed that the association between APOA1 and MACES was negative association at most subgroup (Pinteraction >0.05). However, with the negative association observed in participants with hs-CRP > 3(mg/L), but not in those with hs-CRP ≤ 3(mg/L). In conclusion,emerging evidence demonstrates an inverse association between APOA1 and MACES risk in H-type hypertension with AMI.
伴有高血压和高同型半胱氨酸血症（HHcy）的h型高血压与心血管风险增加有关。尽管越来越多的证据表明载脂蛋白A1 （APOA1）参与动脉粥样硬化过程，但其在急性心肌梗死（AMI）合并h型高血压患者中的预后价值仍未得到充分探讨。我们进行了多变量校正cox回归分析，以调查主要不良心血管事件（mace）的关联。利用限制三次样条（RCS）和阈值效应分析探讨了非线性关系。生存差异通过Kaplan-Meier估计进行量化。分层分析证明APOA1与mace之间关系的稳定性。共纳入581名参与者，中位随访时间为34.00±1.21个月，发生了134例mace， APOA1的高位数与mace的累积风险较低相关（log-rank, P < 0.05）。然而，在hs-CRP水平为bbb3 （mg/L）的参与者中观察到负相关，而在hs-CRP≤3（mg/L）的参与者中则没有。总之，新出现的证据表明APOA1与h型高血压合并AMI的mace风险呈负相关。
{"title":"The association between APOA1 levels and long-term outcomes in H-type hypertension with acute myocardial infarction patients: A retrospective cohort study","authors":"Baozhen zhu, Peng Wu, Zefeng He, Juan Ma, Ning Yan, Yuru Ma, Ru Yan, Tianshui Ma, Rongbin Ma, Guangzhi Cong, Shaobin Jia, Xueping Ma","doi":"10.1038/s41371-025-01090-w","DOIUrl":"10.1038/s41371-025-01090-w","url":null,"abstract":"H-type hypertension, characterized by concomitant hypertension and hyperhomocysteinemia (HHcy), is associated with heightened cardiovascular risk. Despite emerging evidence implicating apolipoprotein A1 (APOA1) in atherosclerotic processes, its prognostic value in acute myocardial infarction (AMI) patients with H-type hypertension remains underexplored.We conducted multivariable-adjusted cox regression analyses to investigate major adverse cardiovascular events (MACES) associations. Non-linear relationships were explored using restricted cubic spline (RCS) and threshold effect analyses. Survival disparities were quantified through Kaplan-Meier estimates. Stratification analyses were used to demonstrate the stability of the relationship between APOA1 and MACES. A total of 581 participants were included, with a median follow-up time of 34.00 ± 1.21 months, and 134 MACES occurred, with higher tertiles of the APOA1 associated with a lower cumulative risk of MACEs (log-rank, P < 0.001). After adjusting for confounders, the fully adjusted HRs (95% CI) for Q3 and Q4 of the APOA1, with the lowest tertile as reference, were 0.46 (0.23,0.92) and 0.42 (0.19,0.93), respectively. RCS analysis showed that APOA1 had a linear relationship with MACES. Subgroup analyses and interaction tests revealed that the association between APOA1 and MACES was negative association at most subgroup (Pinteraction >0.05). However, with the negative association observed in participants with hs-CRP > 3(mg/L), but not in those with hs-CRP ≤ 3(mg/L). In conclusion,emerging evidence demonstrates an inverse association between APOA1 and MACES risk in H-type hypertension with AMI.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"40 1","pages":"29-36"},"PeriodicalIF":3.4,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41371-025-01090-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523528","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}
Hypertension (HTN) is a mitochondrial and metabolic disease. However, cause-effect connections between mitochondrial dysfunction and HTN remains uncharted. we focused on mitochondria-related genes, identifying potential causal-genes-relevant blood pressure (BP) using mitochondria-related genome-wide Mendelian randomization (MR). Through the summary statistics from cis-expression quantitative trait loci (cis-eQTL) datasets (human blood and artery), mitochondrial transcription factor A (TFAM), and genome-wide association studies (GWAS) datasets of BP indices (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], and mean arterial pressure [MAP]) and HTN. we conducted a MR analysis to explore the potential causal relationship between mitochondrial-related genes and the BP indices, HTN. Sensitivity analysis and Bayesian colocalization were employed to validate this causal relationship. In aorta, HIBCH expression was negatively associated with SBP; OCIAD1 expression was positively associated with MAP. In tibial artery, HIBCH expression was negatively associated with SBP; OCIAD1 expression was positively associated with SBP, PP, and MAP; SLC25A37 was positively associated with MAP. In blood, LACTB expression was negatively associated with SBP, PP, and MAP; OCIAD1 expression was negatively associated with SBP and PP; and MTX1 expression was negatively associated with MAP. HARS2 expression was positively associated with SBP and PP; RAB24 and PRELID1 expression was positively associated with DBP; and NME6 expression was positively associated with SBP and DBP. In conclusion, the regulation of blood pressure correlates with mitochondria-related genes (HIBCH, SLC25A37 and OCIAD1 in artery; LACTB, OCIAD1, MTX1, HARS2, RAB24, PRELID1 and NME6 in blood). This study provides scientific evidence for specifically regulating BP phenotypes.
{"title":"Identification of potential causal-genes-relevant blood pressure: a mitochondria-related genome-wide Mendelian randomization study","authors":"Hongrui Zhang, Xiaoyang Li, Yichen Liu, Zhuoshuai Liang, Ruofei Li, Wenhui Gao, Bo Wang, Yuchen Zhang, Yuyang Tian, Xinmeng Hu, Huizhen Jin, Shuang Qiu, Yong Li, Yulu Gu, Siyu Liu, Yunkai Liu, Yi Cheng, Jikang Shi, Yawen Liu","doi":"10.1038/s41371-025-01085-7","DOIUrl":"10.1038/s41371-025-01085-7","url":null,"abstract":"Hypertension (HTN) is a mitochondrial and metabolic disease. However, cause-effect connections between mitochondrial dysfunction and HTN remains uncharted. we focused on mitochondria-related genes, identifying potential causal-genes-relevant blood pressure (BP) using mitochondria-related genome-wide Mendelian randomization (MR). Through the summary statistics from cis-expression quantitative trait loci (cis-eQTL) datasets (human blood and artery), mitochondrial transcription factor A (TFAM), and genome-wide association studies (GWAS) datasets of BP indices (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], and mean arterial pressure [MAP]) and HTN. we conducted a MR analysis to explore the potential causal relationship between mitochondrial-related genes and the BP indices, HTN. Sensitivity analysis and Bayesian colocalization were employed to validate this causal relationship. In aorta, HIBCH expression was negatively associated with SBP; OCIAD1 expression was positively associated with MAP. In tibial artery, HIBCH expression was negatively associated with SBP; OCIAD1 expression was positively associated with SBP, PP, and MAP; SLC25A37 was positively associated with MAP. In blood, LACTB expression was negatively associated with SBP, PP, and MAP; OCIAD1 expression was negatively associated with SBP and PP; and MTX1 expression was negatively associated with MAP. HARS2 expression was positively associated with SBP and PP; RAB24 and PRELID1 expression was positively associated with DBP; and NME6 expression was positively associated with SBP and DBP. In conclusion, the regulation of blood pressure correlates with mitochondria-related genes (HIBCH, SLC25A37 and OCIAD1 in artery; LACTB, OCIAD1, MTX1, HARS2, RAB24, PRELID1 and NME6 in blood). This study provides scientific evidence for specifically regulating BP phenotypes.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"40 1","pages":"45-52"},"PeriodicalIF":3.4,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523536","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 : 2025-11-14DOI: 10.1038/s41371-025-01093-7
Nicholas Cauwenberghs, Anna Carlén, Thomas Lindow, Viktor Elmberg, Lars Brudin, Magnus Ekström, Kristofer Hedman
During graded exercise, systolic blood pressure (SBP) is expected to increase linearly, but other responses are observed. To date, a framework for algorithmic assessment of the shape of the SBP response is lacking, making its physiological and clinical relevance poorly understood. We aimed to algorithmically identify distinct SBP response shapes and analyze their association with clinical factors and all-cause mortality. We retrospectively analyzed SBP recordings from a cohort of 5633 patients (mean age, 55.1 years; 43% female) undergoing maximal cycle ergometry, who met strict quality criteria, including ≥30 mmHg increase in SBP during exercise. Per patient, test duration and SBP values were rescaled (0-100%) to retrieve the SBP response shape. Group-based trajectory modelling (GBTM) was used to classify SBP shapes by sex. Associations with clinical factors and all-cause mortality were evaluated using multinomial logistic regression and Cox survival analysis. In both sexes, GBTM identified three SBP response shapes: early, linear and late rise in SBP. Late rise was associated with higher resting SBP, lower peak SBP and smaller increases in SBP during exercise (P < 0.05). A late SBP rise related independently to older age, higher body mass index, beta blocker use and lower exercise capacity. A late SBP rise predicted increased all-cause mortality in men (HRadjusted versus early SBP rise: 1.66, 95% CI: 1.10-2.50; P = 0.015) but not in women (1.06, 0.60-1.90; P = 0.84). In conclusion, a late SBP response was linked to a worse risk profile and independently predicted all-cause mortality in men, suggesting clinical relevance for SBP shape assessment during exercise.
在分级运动中，预期收缩压（SBP）线性增加，但观察到其他反应。迄今为止，还缺乏一个评估收缩压反应形状的算法框架，这使得人们对其生理和临床相关性知之甚少。我们的目的是通过算法识别不同的收缩压反应形状，并分析它们与临床因素和全因死亡率的关系。我们回顾性分析了5633例患者的收缩压记录（平均年龄55.1岁，43%为女性），这些患者接受了最大周期测量术，符合严格的质量标准，包括运动时收缩压升高≥30 mmHg。每位患者，测试时间和收缩压值被重新调整（0-100%），以获取收缩压反应形状。采用基于组的轨迹模型（GBTM）对收缩压形状进行性别分类。使用多项logistic回归和Cox生存分析评估与临床因素和全因死亡率的关系。在两性中，GBTM发现了三种收缩压反应形式：早期、线性和晚期收缩压上升。晚起与运动时静息收缩压升高、收缩压峰值降低和收缩压升高较小相关（P校正后与早期收缩压升高：1.66,95% CI: 1.10-2.50; P = 0.015），但与女性无关（1.06,0.60-1.90;P = 0.84）。总之，较晚的收缩压反应与较差的风险状况有关，并独立预测男性的全因死亡率，提示运动期间收缩压形状评估的临床相关性。
{"title":"The shape of the systolic blood pressure response during graded exercise: methodology, correlates and predictive value","authors":"Nicholas Cauwenberghs, Anna Carlén, Thomas Lindow, Viktor Elmberg, Lars Brudin, Magnus Ekström, Kristofer Hedman","doi":"10.1038/s41371-025-01093-7","DOIUrl":"10.1038/s41371-025-01093-7","url":null,"abstract":"During graded exercise, systolic blood pressure (SBP) is expected to increase linearly, but other responses are observed. To date, a framework for algorithmic assessment of the shape of the SBP response is lacking, making its physiological and clinical relevance poorly understood. We aimed to algorithmically identify distinct SBP response shapes and analyze their association with clinical factors and all-cause mortality. We retrospectively analyzed SBP recordings from a cohort of 5633 patients (mean age, 55.1 years; 43% female) undergoing maximal cycle ergometry, who met strict quality criteria, including ≥30 mmHg increase in SBP during exercise. Per patient, test duration and SBP values were rescaled (0-100%) to retrieve the SBP response shape. Group-based trajectory modelling (GBTM) was used to classify SBP shapes by sex. Associations with clinical factors and all-cause mortality were evaluated using multinomial logistic regression and Cox survival analysis. In both sexes, GBTM identified three SBP response shapes: early, linear and late rise in SBP. Late rise was associated with higher resting SBP, lower peak SBP and smaller increases in SBP during exercise (P < 0.05). A late SBP rise related independently to older age, higher body mass index, beta blocker use and lower exercise capacity. A late SBP rise predicted increased all-cause mortality in men (HRadjusted versus early SBP rise: 1.66, 95% CI: 1.10-2.50; P = 0.015) but not in women (1.06, 0.60-1.90; P = 0.84). In conclusion, a late SBP response was linked to a worse risk profile and independently predicted all-cause mortality in men, suggesting clinical relevance for SBP shape assessment during exercise.","PeriodicalId":16070,"journal":{"name":"Journal of Human Hypertension","volume":"40 1","pages":"37-44"},"PeriodicalIF":3.4,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41371-025-01093-7.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145523558","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}
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