Hipertension y Riesgo Vascular最新文献_第3页

Cardiovascular risk markers in apparently healthy young adults: Evaluation according to optimal or non-optimal office blood pressure 在表面健康的年轻人心血管危险标志物：根据最佳或非最佳办公室血压评估。

IF 1.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Hipertension y Riesgo Vascular

Pub Date : 2025-07-01 DOI: 10.1016/j.hipert.2024.11.006

W. Espeche , O.A. Pinilla , G. Cerri , N. Stavile , J. Minetto , M.R. Salazar , I.L. Ennis

Background

Blood pressure (BP) is linearly related to the incidence of cardiovascular disease from values as low as 115/75 mmHg, even at young ages. A particularly concerning issue is the decrease representation of optimal BP among children and youth. The mechanisms by which minimal elevations in BP increase cardiovascular risk are not defined. The limitations of office BP measurements could be a possible explanation since 24-h ambulatory measurements (ABPM) better detect the risk of future cardiovascular events. Therefore, we aimed to compare healthy normotensive undergraduate students with optimal vs. non-optimal BP: ABPM, the cardiometabolic risk profile, and echocardiographic characteristics.

Methods

Medical students from La Plata voluntarily completed a survey to collect personal and family data on cardiovascular risk factors. Subsequently, anthropometric, BP (office and ABPM), and echocardiography determinations were recorded. Cholesterol, triglycerides, and glucose were measured in fasting blood samples. Statistical analyses were performed blinded, using SPSS software.

Results

Data from 135 students were analyzed (76% female, age 22.5 ± 3.5 years). Mean office BP was 114.5 ± 10.4 and 73.7 ± 7.5 mmHg. Forty percent of students had non-optimal BP (61% females) showing significantly higher BP values in all ABPM periods and higher left ventricular mass index, cardiac wall thicknesses, fasting glucose, TyG index, TG/HDL-c ratio. Seven students met diagnostic criteria for nocturnal hypertension, six of whom were in the non-optimal BP group (11.1% vs 1.2%).

Conclusions

Therefore, our study shows that apparently healthy young individuals with non-optimal BP, even if not hypertensive, exhibit differences in several cardiovascular risk markers compared to those with optimal BP.

背景：血压（BP）与心血管疾病的发病率线性相关，低至115/75mmHg，即使在年轻时也是如此。一个特别值得关注的问题是儿童和青少年中最佳血压的代表性下降。最小血压升高增加心血管风险的机制尚未明确。办公室血压测量的局限性可能是一个可能的解释，因为24小时动态测量（ABPM）可以更好地检测未来心血管事件的风险。因此，我们的目的是比较健康的正常血压的大学生最佳与非最佳的血压：ABPM，心脏代谢风险概况和超声心动图特征。方法：拉普拉塔市医科学生自愿完成一项调查，收集个人和家庭的心血管危险因素资料。随后，记录人体测量、血压（办公室和ABPM）和超声心动图测定。在空腹血液样本中测量胆固醇、甘油三酯和葡萄糖。采用SPSS软件进行盲法统计分析。结果：分析了135名学生的资料（76%为女性，年龄22.5±3.5岁）。平均办公室血压分别为114.5±10.4和73.7±7.5mmHg。40%的学生有非最佳血压（61%为女性），在所有ABPM期间的血压值明显较高，左心室质量指数、心壁厚度、空腹血糖、TyG指数、TG/HDL-c比值较高。7名学生符合夜间高血压诊断标准，其中6人属于非最佳血压组（11.1% vs 1.2%）。结论：因此，我们的研究表明，表面健康的非最佳血压的年轻人，即使不是高血压，与最佳血压的人相比，在一些心血管危险指标上表现出差异。

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引用次数: 0

Prevalence of prehypertension and high normal blood pressure in Latin America: A systematic review with meta-analysis 拉丁美洲高血压前期和高正常血压的患病率：系统回顾与荟萃分析。

IF 1.3 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Hipertension y Riesgo Vascular

Pub Date : 2025-07-01 DOI: 10.1016/j.hipert.2025.02.001

V.J. Vera-Ponce , J.A. Loayza-Castro , F.E. Zuzunaga-Montoya , L.E.M. Vásquez-Romero , N.M. Sanchez-Tamay , J.C. Bustamante-Rodríguez , E. Vigil-Ventura , I.G. De Carrillo

Introduction

Prehypertension and high normal blood pressure (HNBP) are important risk factors for the development of hypertension and cardiovascular diseases. However, their prevalence in Latin America has not been systematically evaluated.

Objectives

To determine the prevalence of prehypertension and HNBP in Latin America through a systematic review and meta-analysis.

Methods

A systematic search was conducted in electronic databases until September 24, 2024. Observational studies with probabilistic sampling that reported the prevalence of prehypertension or HNBP in adult Latin American populations were included. Random-effects models were used for the meta-analysis, and subgroup analyses and meta-regression were performed.

Results

A total of 17 studies (n = 227,741) from 7 countries were included. The pooled prevalence of prehypertension was 27.98% (95% CI: 21.17–35.34%), with significant heterogeneity (I² = 100%, p < 0.01). The prevalence of HNBP was 19.23% (95% CI: 11.43–28.49%). Considerable variations were observed between countries, with prehypertension prevalence ranging from 3.55% in Cuba to 46.10% in Puerto Rico. Meta-regression analyses identified a slight decreasing trend in prehypertension prevalence over time and with increasing sample size.

Conclusion

This study reveals a high prevalence of prehypertension and HNBP in Latin America, with significant variations between countries. These findings underscore the need for tailored public health strategies to prevent and manage these prehypertensive states early in the region.

前言：高血压前期和高正常血压（HNBP）是高血压和心血管疾病发展的重要危险因素。然而，它们在拉丁美洲的流行情况尚未得到系统评估。目的：通过系统回顾和荟萃分析，确定拉丁美洲高血压前期和HNBP的患病率。方法：系统检索电子数据库至2024年9月24日。采用概率抽样的观察性研究报告了拉丁美洲成年人群中高血压前期或HNBP的患病率。采用随机效应模型进行meta分析，并进行亚组分析和meta回归。结果：共纳入来自7个国家的17项研究（n=227,741）。高血压前期总患病率为27.98% (95% CI: 21.17-35.34%)，具有显著的异质性（I2=100%）。结论：本研究揭示了拉丁美洲高血压前期和HNBP的高患病率，且各国之间存在显著差异。这些发现强调有必要制定有针对性的公共卫生战略，在该地区早期预防和管理这些高血压前期状态。

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引用次数: 0

Real-world efficacy and safety of baroreceptor activation therapy in a series of patients with refractory arterial hypertension [压力感受器激活疗法在一系列难治性高血压患者中的实际疗效和安全性]。

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Hipertension y Riesgo Vascular

Pub Date : 2025-04-01 DOI: 10.1016/j.hipert.2024.10.004

A. Bustos-Merlo , D. Rico-López , F. Jaén-Águila , C. López-Espada , M.I. Rodríguez-Macías , J.D. Mediavilla-García

The number of patients suffering from refractory hypertension and advanced-stage chronic heart failure (CHF) is progressively increasing. In recent years, device-mediated therapies have been developed as an alternative or adjunct to conventional medical treatment. Our primary objective is to describe the clinical experience in a series of patients with refractory hypertension following the implantation of baroreceptor activation therapy (BAT). We analyzed five patients with refractory hypertension, one of whom also had CHF, treated in a specialized cardiovascular risk clinic. After the implantation of the Barostim device with an average activation of 3.64 mA (ranging from 2.80 to 5.4), there was a mean reduction of 30 ± 7.68 mmHg (p = 0.001) and 13.40 ± 9.07 mmHg (p = 0.03) in systolic and diastolic blood pressure, respectively, as measured by ambulatory blood pressure monitoring (ABPM), along with a heart rate reduction of 25 ± 9.13 bpm (p = 0.004). A reduction in the number of antihypertensive medications required for blood pressure control was observed, with an average of 5.2 medications, as well as an improvement in functional class. No adverse events were recorded in our patient series. Currently, BAT is considered a compassionate-use alternative for blood pressure control in patients with refractory hypertension and failure of pharmacological treatment and other invasive techniques, such as renal denervation.

难治性高血压和晚期慢性心力衰竭（CHF）患者的数量正在逐渐增加。近年来，装置介导疗法已发展成为传统医学治疗的替代或辅助疗法。我们的主要目的是描述一系列顽固性高血压患者在植入压力受体激活疗法（BAT）后的临床经验。我们分析了5例难治性高血压患者，其中1例同时患有CHF，在专门的心血管风险诊所接受治疗。植入平均激活3.64mA（2.80 ~ 5.4）的Barostim装置后，动态血压监测（ABPM）测量的收缩压和舒张压分别平均降低30±7.68mmHg （P=0.001）和13.40±9.07mmHg (P=0.03)，心率降低25±9.13 bpm （P=0.004）。观察到血压控制所需的降压药物数量减少，平均为5.2种药物，功能等级也有所改善。在我们的患者系列中没有记录到不良事件。目前，BAT被认为是难治性高血压和药物治疗和其他侵入性技术（如肾去神经）失败的患者控制血压的替代选择。

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引用次数: 0

Comparison of the effectiveness of aliskiren and ramipril for the management of hypertension: A systematic review and meta-analysis 阿利克伦和雷米普利治疗高血压的疗效比较：一项系统回顾和荟萃分析。

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Hipertension y Riesgo Vascular

Pub Date : 2025-04-01 DOI: 10.1016/j.hipert.2024.11.002

T. Alam , M. Asif Ansari

Objective

Ramipril is an important option in the management of hypertension, while the role of aliskiren is still up for debate. We aim to meta-analyse and compare the effect of aliskiren with ramipril by measuring mean difference in systolic blood pressure (mdSBP) and mean difference in diastolic blood pressure (mdDBP).

Methods

The search was conducted using the PubMed and Cochrane databases for eligible randomized clinical trials (RCTs) to perform a meta-analysis from January 2000 to May 2024. RCTs that included hypertensive patients who were under either aliskiren or ramipril treatment were included in the analysis. The risk of bias was evaluated using RoB 2.0. This study is registered with PROSPERO: CRD42024577105.

Results

Four studies were included: two studies were carried out for 2 months, and two were carried out for 6 months, including 693 and 329 patients, respectively, with mild to moderate hypertension and a mean age of 55.2 years. After 2 months, mdDBP was found to be significant (mdDBP = 0.85 mmHg, 95% CI: 0.73–0.97, I² = 0%), but mdSBP was found to be non-significant (mdSBP = 0.0 mmHg, 95% CI: −0.17–0.17, I² = 0%). There was a significant difference in the mdSBP (mdSBP = 3.15 mmHg, 95% CI: 2.13–4.17, I² = 84%) and mdDBP (mdDBP = 1.2 mmHg, 95% CI: 1.09–1.31, I² = 0%) at 6 months.

Conclusion

Aliskiren provides, in the short term, a slight improvement in BP in non-elderly hypertensive patients without diabetes or previous cardio-cerebrovascular disease.

目的：雷米普利是治疗高血压的重要选择，而阿利克伦的作用仍存在争议。我们的目的是通过测量收缩压（mdSBP）和舒张压（mdDBP）的平均差值，对阿利克伦和雷米普利的疗效进行荟萃分析和比较。方法：使用PubMed和Cochrane数据库检索2000年1月至2024年5月的符合条件的随机临床试验（rct）进行meta分析。纳入阿利克伦或雷米普利治疗的高血压患者的随机对照试验被纳入分析。偏倚风险采用rob2.0进行评估。本研究已注册为PROSPERO: CRD42024577105。结果：纳入4项研究，2项研究2个月，2项研究6个月，分别纳入693例和329例患者，轻至中度高血压，平均年龄55.2岁。2个月后，mdDBP显著（mdDBP=0.85mmHg, 95% CI: 0.73-0.97, I2=0%）， mdSBP无显著性（mdSBP=0.0mmHg, 95% CI: -0.17-0.17, I2=0%）。6个月时mdSBP （mdSBP=3.15mmHg, 95% CI: 2.13-4.17, I2=84%）和mdDBP （mdDBP=1.2mmHg, 95% CI: 1.09-1.31, I2=0%）差异有统计学意义。结论：Aliskiren可在短期内轻微改善无糖尿病或既往心脑血管疾病的非老年高血压患者的血压。

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引用次数: 0

Hypertension and uric acid, uric acid and hypertension: Is hyperuricaemia a new vascular risk factor to take into account? 高血压与尿酸，尿酸与高血压：高尿酸血症是需要考虑的新血管风险因素吗？

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Hipertension y Riesgo Vascular

Pub Date : 2025-04-01 DOI: 10.1016/j.hipert.2024.12.001

M. Benitez Camps

引用次数: 0

Association of different domains of sedentary behavior and cardiovascular risk factors in adolescents: Cross-sectional study 青少年不同领域的久坐行为与心血管风险因素的关系：横断面研究

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Hipertension y Riesgo Vascular

Pub Date : 2025-04-01 DOI: 10.1016/j.hipert.2024.10.002

E.P. Antunes , W.R. Tebar , G.G. Cucato , C.C.M. Silva , I. Leoci , A.B. dos Santos , G. Ferrari , D.G.D. Christofaro

Background

Sedentary behavior (SB) has been related to cardiovascular risk factors (CVRF) such as high BMI, waist circumference (WC) and blood pressure (BP), including pediatric populations. However, it is still unclear whether the association between SB and CVRF could be domain dependent. Therefore, this study aimed to analyze the relationship between sedentary at different domains (time spent in TV, videogames, computer, smartphone) with CVRF in adolescents.

Methods

A sample of 1011 adolescents (10–17 years old; 55.1% girls) was assessed. The different BS domains were obtained through a questionnaire, as well as socioeconomic status, habitual physical activity, smoking and alcohol consumption. BMI was calculated by objectively measured height and body mass, WC was assessed at middle point between the last rib and iliac crest, and BP was assessed by a digital oscillometric device. The relationship between SB and CVRF was determined by quantile regression, adjusted for sex, age, socioeconomic status, physical activity, smoking and alcohol consumption.

Results

Elevated time in smartphone use was associated with higher median values of WC (β = 1.88; 95%CI: (0.27; 3.49) and SBP (β = 2.70; 95%CI: 0.35; 5.05). High total time spent in SB was associated with higher median values of BMI (β = 0.68; 95%CI = (0.02; 1.35), WC (β = 1.95; 95% = 0.47; 3.42) and SBP (β = 2.52; 95%CI: 0.37; 4.68).

Conclusions

Smartphone use and total SB time were related to higher CVRF in adolescents. Cardiovascular health promotion strategies should focus on reducing SB in pediatric populations, especially smartphone use.

背景：久坐行为（SB）与心血管风险因素（CVRF）有关，如高体重指数（BMI）、腰围（WC）和血压（BP），包括儿童人群。然而，SB 与 CVRF 之间的关系是否与领域有关仍不清楚。因此，本研究旨在分析青少年在不同领域（花在电视、电子游戏、电脑、智能手机上的时间）的久坐与 CVRF 之间的关系：对 1011 名青少年（10-17 岁，55.1% 为女孩）进行了抽样评估。通过问卷调查了解了不同的 BS 领域，以及社会经济状况、习惯性体育活动、吸烟和饮酒情况。体重指数（BMI）通过客观测量身高和体重计算得出，腹围（WC）在最后一根肋骨和髂嵴之间的中点进行评估，血压（BP）通过数字示波仪进行评估。SB和CVRF之间的关系是通过量回归确定的，并对性别、年龄、社会经济地位、体力活动、吸烟和饮酒进行了调整：智能手机使用时间的增加与较高的 WC（β=1.88；95%CI：（0.27；3.49））和 SBP（β=2.70；95%CI：0.35；5.05）中值有关。SB总时间长与BMI（β=0.68；95%CI=（0.02；1.35））、WC（β=1.95；95%=0.47；3.42）和SBP（β=2.52；95%CI：0.37；4.68）的中位值较高有关：结论：智能手机的使用和总SB时间与青少年较高的CVRF有关。心血管健康促进策略应侧重于减少儿科人群的SB，尤其是智能手机的使用。

{"title":"Association of different domains of sedentary behavior and cardiovascular risk factors in adolescents: Cross-sectional study","authors":"E.P. Antunes , W.R. Tebar , G.G. Cucato , C.C.M. Silva , I. Leoci , A.B. dos Santos , G. Ferrari , D.G.D. Christofaro","doi":"10.1016/j.hipert.2024.10.002","DOIUrl":"10.1016/j.hipert.2024.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Sedentary behavior (SB) has been related to cardiovascular risk factors (CVRF) such as high BMI, waist circumference (WC) and blood pressure (BP), including pediatric populations. However, it is still unclear whether the association between SB and CVRF could be domain dependent. Therefore, this study aimed to analyze the relationship between sedentary at different domains (time spent in TV, videogames, computer, smartphone) with CVRF in adolescents.</div></div><div><h3>Methods</h3><div>A sample of 1011 adolescents (10–17 years old; 55.1% girls) was assessed. The different BS domains were obtained through a questionnaire, as well as socioeconomic status, habitual physical activity, smoking and alcohol consumption. BMI was calculated by objectively measured height and body mass, WC was assessed at middle point between the last rib and iliac crest, and BP was assessed by a digital oscillometric device. The relationship between SB and CVRF was determined by quantile regression, adjusted for sex, age, socioeconomic status, physical activity, smoking and alcohol consumption.</div></div><div><h3>Results</h3><div>Elevated time in smartphone use was associated with higher median values of WC (<em>β</em>  =2.70; 95%CI: 0.35; 5.05). High total time spent in SB was associated with higher median values of BMI (<em>β</em>    =1.95; 95%=0.47; 3.42) and SBP (<em>β</em>  <!-->2.52; 95%CI: 0.37; 4.68).</div></div><div><h3>Conclusions</h3><div>Smartphone use and total SB time were related to higher CVRF in adolescents. Cardiovascular health promotion strategies should focus on reducing SB in pediatric populations, especially smartphone use.</div></div>","PeriodicalId":39403,"journal":{"name":"Hipertension y Riesgo Vascular","volume":"42 2","pages":"Pages 72-78"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Refractory arterial hypertension. What can we offer these patients? 难治性动脉高血压。我们能为这些病人提供什么？

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Hipertension y Riesgo Vascular

Pub Date : 2025-04-01 DOI: 10.1016/j.hipert.2024.12.004

J. Segura , P. Armario

引用次数: 0

The complex interplay: How lifestyle and psychosocial factors contribute to hypertension in myocardial infarction patients—An integrated model 复杂的相互作用：生活方式和社会心理因素如何导致心肌梗死患者的高血压--一个综合模型。

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Hipertension y Riesgo Vascular

Pub Date : 2025-04-01 DOI: 10.1016/j.hipert.2024.11.001

H. Roohafza , M. Mansourian , F. Zarimeidani , R. Rahmati , N. Shakibaei , H. Marateb , F. Noohi , A. Salari , M. Sadeghi

Introduction

A significant proportion of acute myocardial infarction (MI) patients also suffer from hypertension (HTN), underscoring the need for effective HTN prevention and management strategies in this group. This study aims to elucidate the complex web of direct and indirect factors contributing to HTN in the context of MI.

Material and methods

The study utilized longitudinal data from patients aged 18–75 experiencing their first ST-segment elevation MI from five major provinces of Iran, including Tehran, Isfahan, Yazd, Gilan, and Hormozgan. HTN was the primary endpoint, with contributing factors including lifestyle, psychological factors, socioeconomic status, and comorbidities. We applied Bayesian structural equation modeling to analyze the interplay among 14 key variables influencing HTN in MI patients.

Results

Among the 1699 participants, 424 men (69.9%) and 181 women (30.1%) were identified as having HTN. Our multi-dimensional analysis revealed that increased comorbidities directly escalate blood pressure levels. Furthermore, the adoption of a healthier lifestyle characterized by sufficient physical activity, quality sleep, sexual satisfaction, non-smoking status, and a favorable dietary score, along with the enhancement of psychosocial factors such as stress management and the modification of type D personality traits and socioeconomic status can curb HTN directly and indirectly.

Conclusion

This study integrates diverse factors into a multi-dimensional model and offers insights into new preventive avenues for HTN in MI patients. Our findings can inform strategies to mitigate HTN risk in this vulnerable population by pinpointing both direct and indirect predictors and intervention points.

在急性心肌梗死（MI）患者中，有相当大比例的患者同时患有高血压（HTN），这强调了在这一群体中需要有效的HTN预防和管理策略。本研究旨在阐明在心肌梗死背景下导致HTN的直接和间接因素的复杂网络。材料和方法：本研究利用了来自伊朗五个主要省份（包括德黑兰、伊斯法罕、亚兹德、吉兰和Hormozgan）的18-75岁首次st段抬高心肌梗死患者的纵向数据。HTN是主要终点，影响因素包括生活方式、心理因素、社会经济地位和合并症。我们应用贝叶斯结构方程模型分析了影响心肌梗死患者HTN的14个关键变量之间的相互作用。结果：在1699名参与者中，424名男性（69.9%）和181名女性（30.1%）被确定患有HTN。我们的多维分析显示，合并症的增加直接导致血压水平升高。此外，采用健康的生活方式，包括充足的身体活动、高质量的睡眠、性满意度、不吸烟和良好的饮食评分，以及加强心理社会因素，如压力管理，改变D型人格特征和社会经济地位，可以直接或间接地抑制HTN。结论：本研究将多种因素整合到一个多维模型中，为心肌梗死患者HTN的预防提供了新的途径。我们的研究结果可以通过确定直接和间接的预测因素和干预点，为减轻这一弱势群体HTN风险的策略提供信息。

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引用次数: 0

Physicians’ perception of guideline recommendations for the treatment of resistant hypertension by renal denervation: Resistant Hypertension Working Group, Argentine Hypertension Society 医生对肾去神经支配治疗顽固性高血压的指南建议的看法：阿根廷高血压学会顽固性高血压工作组。

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Hipertension y Riesgo Vascular

Pub Date : 2025-04-01 DOI: 10.1016/j.hipert.2024.10.003

N.F. Renna , L. Brandani , R. Parodi , C. Kotliar , E. Ylarri , G. Lavenia , M. Marin , M. Ruise , R. Sanchez , D. Cianfagna , G. Botvinik , P. Rumi , V. Ferreti , P. Rodríguez

Introduction

This study investigates the perceptions and knowledge of specialized Argentine physicians regarding renal denervation (RDN) as a treatment for resistant hypertension (R-HT).

Method

A survey was conducted among 206 physicians, mainly cardiologists and internists, to assess their awareness and perceptions of RDN. Data were analyzed using descriptive statistics and Spearman's Rho correlation.

Results

The survey revealed that 83% of the responders are aware of RDN. Despite this high awareness, only 60% believe in its safety, while 33.2% are uncertain, and 6.8% consider it unsafe. Significant correlations were found between the awareness of RDN and perceptions of its efficacy and safety.

Conclusions

The study highlights a gap between knowledge and confidence in RDN among specialized Argentine physicians. Continuous education and shared decision-making are crucial to improve the adoption of RDN in clinical practice. Long-term safety and efficacy data support RDN as a valuable tool for managing R-HT. Addressing safety concerns through targeted educational initiatives is essential.

简介：本研究调查了阿根廷专业医生对肾去神经支配（RDN）作为顽固性高血压（R-HT）治疗的认知和知识。方法：对206名内科医生（主要是心脏科医生和内科医生）进行调查，了解他们对RDN的认识和看法。数据分析采用描述性统计和Spearman’s Rho相关。结果：调查显示83%的应答者知道RDN。尽管有很高的认知度，但只有60%的人相信它的安全性，33.2%的人不确定，6.8%的人认为它不安全。对RDN的认知与对其有效性和安全性的认知之间存在显著的相关性。结论：该研究突出了阿根廷专业医生对RDN的知识和信心之间的差距。持续教育和共同决策对于提高临床实践中RDN的采用至关重要。长期安全性和有效性数据支持RDN作为治疗R-HT的宝贵工具。通过有针对性的教育举措解决安全问题至关重要。

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引用次数: 0

Cutting-edge lipid-lowering pharmacological therapies: Improving lipid control beyond statins 尖端降脂药物疗法：改善血脂控制超越他汀类药物

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Hipertension y Riesgo Vascular

Pub Date : 2025-04-01 DOI: 10.1016/j.hipert.2024.12.002

M. Capuozzo , A. Ottaiano , C. Cinque , S. Farace , F. Ferrara

Statins are crucial for both the prevention and management of atherosclerotic cardiovascular disease (ASCVD). However, even with optimized statin therapy, a significant residual risk of ASCVD remains, highlighting the need for innovative approaches to lipid-lowering therapies (LLT) that more effectively target low-density lipoprotein cholesterol (LDL-C) and other atherogenic lipoproteins. Recently, novel pharmacologic agents have been introduced for the management of dyslipidemia. Bempedoic acid, an inhibitor of ATP citrate lyase, has emerged as a promising alternative for patients who exhibit statin intolerance. Moreover, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have transformed the management of hypercholesterolemia by reducing LDL-C levels. PCSK9 is a protein that mediates LDL receptor degradation; its inhibition enhances LDL receptor recycling, facilitating increased LDL-C uptake. New antisense oligonucleotides targeting apolipoprotein C3 (apoC3), ANGPTL3, and lipoprotein(a) have demonstrated significant reductions in these molecules, offering potential therapeutic advantages for certain dyslipidemias. Ongoing research is also evaluating apolipoprotein A1 (apoA1) to leverage the protective effects of high-density lipoprotein cholesterol (HDL-C), though conclusive clinical evidence is still required. This review examines the mechanisms and clinical efficacy of emerging LLT other than statins, focusing on bempedoic acid and PCSK9 inhibitors. Bempedoic acid acts upstream in the cholesterol biosynthesis pathway, offering a potentially safer option for patients intolerant to statins. PCSK9 inhibitors enhance LDL receptor recycling, significantly lowering LDL-C levels and reducing cardiovascular risk. A deeper understanding of these mechanisms is essential for the advancement of therapeutic strategies in dyslipidemia and cardiovascular disease management.

他汀类药物对于预防和治疗动脉粥样硬化性心血管疾病（ASCVD）至关重要。然而，即使采用优化的他汀类药物治疗，ASCVD的残余风险仍然存在，这突出了对更有效地靶向低密度脂蛋白胆固醇（LDL-C）和其他致动脉粥样硬化脂蛋白的降脂治疗（LLT）的创新方法的需求。近年来，一些新的药物被用于治疗血脂异常。苯二甲酸，一种ATP柠檬酸裂解酶抑制剂，已经成为他汀类药物不耐受患者的一种有希望的替代药物。此外，蛋白转化酶枯草杆菌素/酮素9型（PCSK9）抑制剂通过降低LDL-C水平改变了高胆固醇血症的管理。PCSK9是一种介导LDL受体降解的蛋白；其抑制增强LDL受体循环，促进LDL- c摄取增加。新的针对载脂蛋白C3 （apoC3）、ANGPTL3和脂蛋白(a)的反义寡核苷酸已显示出这些分子的显著减少，为某些血脂异常提供了潜在的治疗优势。正在进行的研究也在评估载脂蛋白A1 （apoA1）在利用高密度脂蛋白胆固醇（HDL-C）的保护作用方面的作用，尽管仍需要确凿的临床证据。本综述探讨了他汀类药物以外的新出现的LLT的机制和临床疗效，重点是苯甲多酸和PCSK9抑制剂。苯二甲酸作用于胆固醇生物合成途径的上游，为他汀类药物不耐受的患者提供了一个潜在的更安全的选择。PCSK9抑制剂增强LDL受体循环，显著降低LDL- c水平，降低心血管风险。深入了解这些机制对于推进血脂异常和心血管疾病管理的治疗策略至关重要。

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引用次数: 0