Chronic Diseases and Translational Medicine最新文献

In the article titled, “Effects of long-term blood pressure variability on renal function in community population” published in pages 149–152, vol. 10 of Chronic Diseases and Translational Medicine,¹ the order of the first author's name is incorrect. The first author's name should be Feng Zhao.

High blood pressure is a major public health issue and a leading risk factor for death worldwide, with the number of attributable deaths increased from 6.8 million in 1990 to 10.8 million in 2019.^{1, 2} According to the World Health Organization, the age-standardized prevalence of hypertension was estimated to be 33%, affecting approximately 1.3 billion adults aged 30–79 years in 2019 worldwide, doubling from 1990.³ In addition to the heavy disease burden, the economic burden associated with hypertension is also substantial, accounting for approximately 10% of the global healthcare expenditure.⁴ Furthermore, despite improvements in diagnostic and treatment capacities, the status of hypertension care remains suboptimal, especially in low- and middle-income countries. For instance, in China, in 2019, the awareness, treatment, and control rates of hypertension were 38.3%, 34.6%, and 12.0%, respectively.⁵ Accumulating evidence calls for more comprehensive and effective prevention and management of hypertension.

Multiple risk factors for hypertension have been well established, including genetic background, high sodium intake, smoking, physical inactivity, obesity, and alcohol intake.^{6, 7} Other potential risk factors (e.g., air pollution, psychological disorders, sleep habits, and noise exposure) have received increasing attention in recent years.⁴ To enhance the efficacy of prevention, identifying the potential risk factors for hypertension within specific populations and developing advanced tools to improve adherence to interventions remain imperative. In addition to lifestyle modifications, pharmacological treatment is essential for managing hypertension. Moreover, hypertension may cause other diseases such as cardiovascular disease, chronic kidney disease, and dementia.^{8, 9} Additionally, hypertension during pregnancy is associated with adverse consequences for offspring, including preterm birth, vascular dysfunction, and cognitive impairment.^{10, 11} Therefore, it is important to systematically understand the current research status of hypertension and related diseases.

In this special issue, authors from the United States, United Kingdom, China, India, and Pakistan report the latest research findings on hypertension and related diseases. The issue comprises eight publications, including four original articles, two brief reports, one study protocol, and one correspondence. In summary, the aforementioned studies employed different epidemiological designs to assess the risk factors for hypertension, identify molecular biomarkers for pre-eclampsia (PE), depict the adverse impact of blood pressure on various outcomes, and provide potential evidence for hypertension management and treatment.

Zhang et al.¹² offered valuable

High blood pressure is a significant contributor to premature mortality, resulting in nearly 10 million deaths and over 200 million disabilities worldwide.¹ In recent years, hypertension treatment has shifted focus not only to average blood pressure but also to blood pressure variability (BPV), categorized into very short-term, short-term, and long-term BPV based on the time period of occurrence.^{2, 3} Long-term BPV has emerged as clinically significant, with studies demonstrating its superiority in predicting long-term cardiovascular events, stroke, and mortality compared to short-term variability. Given its association with pre-renal function decline, reducing blood pressure fluctuations is imperative.

Chronic kidney disease (CKD) poses a global public health challenge, with its incidence rising alongside aging populations and increasing rates of conditions like diabetes and hypertension. Hypertension and kidney disease are closely intertwined, with hypertension exacerbating renal damage. At present, the management of hypertension mainly focuses on average blood pressure, but the average blood level does not accurately reflect the long-term control status of blood pressure. Notably, some patients with ostensibly controlled average blood pressure still experience renal function deterioration within 5–10 years, potentially due to blood pressure fluctuations. Emerging evidence suggests a link between cardiovascular events, renal injury, and BPV, independent of average blood pressure.^{4, 5} However, the precise relationship between BPV and renal function remains elusive. This study aimed to explore the association between fluctuating blood pressure and rapid renal function decline in a prospective community health checkup-based cohort.

A total of 7153 patients aged ≥18 years who received at least twice regular physical examinations at the Community Health Service Centre in Beijing, between 2015 and 2021, were recruited consecutively in this study. Exclusion criteria included CKD stage 4–5, acute stroke, myocardial infarction, and heart failure (<3 months). Finally, 7130 patients were enrolled in the analysis (Figure S1).

Sociodemographic information, comorbidities, and lifestyle habits were obtained through questionnaires. Blood pressure was measured twice during each visit, and BPV indices were calculated based on measurements across all visits. Additionally, blood samples were collected after an 8-h fast for biochemical analyses. We calculated several indicators as measures of BPV based on data from all visits, including standard deviation (SD), coefficient of variation (CV), variation independent of the mean (VIM), and average successive variability (ASV). The measures have been used in previous studies.^{6, 7}

Baseline data for this study were derived from the results of the initial annual health checkup, while endpoint data we