Tseng CH, Huang WM, Lin LY
… +5 more, Yu WC, Shih CC, Chiang CE, Chen CH, Sung SH
Hypertens Res
· 2026 May · PMID 41912670
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Endovascular aortic repair (EVAR) treatment was associated with increase in arterial stiffness following the procedure abdominal aortic aneurysm (AAA). This study aims to investigate the impact of different stent-graft m...Endovascular aortic repair (EVAR) treatment was associated with increase in arterial stiffness following the procedure abdominal aortic aneurysm (AAA). This study aims to investigate the impact of different stent-graft materials on arterial stiffness measurements and the outcomes of AAA patients undergoing EVAR. Patients with AAA undergoing EVAR were eligible for this study. Pulsatile hemodynamic parameters, including carotid-femoral pulse wave velocity (cf-PWV), carotid augmentation index (cAI), and backward pressure amplitude (Pb), were measured before and 1 month after the EVAR procedure. All-cause mortality up to 2 years post-discharge was determined by linking the study population to the National Death Registry. Among a total of 265 study participants (age 75.1 ± 11.7 years, 88.3% men), the length and diameter of the aneurysm were 7.95 ± 2.61 cm and 5.88 ± 2.08 cm, respectively. One month after EVAR, cf-PWV significantly increased, and only cf-PWV showed a significant between-group difference among stainless-steel and nitinol stent group after adjusting for MBP. At the 2-year follow-up, mortality was significantly higher in the nitinol vs. stainless-steel group and the Dacron vs. PTFE group. Furthermore, changing of cf-PWV following EVAR was an independent predictor of mortality [hazard ratio (HR) per 1-SD and 95% confidence interval (CI): 4.011 (1.154-13.950), p = 0.029] after accounting for confounding factors. The stent materials and fabric may influence the change of pulsatile hemodynamics after EVAR. Higher mortality rates were observed in those treated with Dacron fabric and nitinol stents, and Δcf-PWV was an independent predictor of mortality. In AAA patient underwent EVAR, nitinol stent was associated with a significant increase in cf-PWV after EVAR. Higher mortality rates were observed in nitinol stents, and changes in cf-PWV was an independent predictor of mortality.
Kyriakoulis KG, Vakka A, Iliakis P
… +13 more, Tatakis F, Papadomarkaki K, Stamataki N, Tsioufis P, Manta E, Soulaidopoulos S, Fragkoulis C, Kasiakogias A, Konstantinidis D, Dimitriadis K, Hettrick DA, Schmieder RE, Tsioufis K
Hypertens Res
· 2026 May · PMID 41882328
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Renal denervation (RDN) is recommended for the management of arterial hypertension. The aim of this study was to assess the cost-effectiveness of RDN. A systematic review/meta-analysis was conducted to identify RDN cost-...Renal denervation (RDN) is recommended for the management of arterial hypertension. The aim of this study was to assess the cost-effectiveness of RDN. A systematic review/meta-analysis was conducted to identify RDN cost-effectiveness studies. The Incremental Cost-Effectiveness Ratio (ICER) per one Quality-Adjusted Life Year (QALY) gained (the extra cost needed for one additional year of good quality life) was compared to the respective country-specific Willingness to Pay (WTP) Thresholds (the maximum ICER/QALY gained that is considered acceptable by a healthcare system or organization for an intervention to be deemed cost-effective). Nineteen studies (16 countries) were included, all in favor of RDN cost-effectiveness. Most studies (n = 12/19, 63%) were conducted after 2024, half in the context of European economic/healthcare systems. All studies implemented decision-analytic Markov models and compared RDN (mainly radiofrequency) plus standard of care (SoC) vs SoC alone. Meta-analysis of 7 studies indicated a pooled ICER/QALY gained 22209 €, compared to WTP Threshold 50000 €, thereby indicating the cost-effectiveness of RDN. Meta-analysis of 19 studies indicated a pooled ICER/QALY gained to WTP Threshold ratio of 0.31 (0.20, 0.44). In sensitivity analyses RDN was shown to be cost-effective in both resistant and uncontrolled hypertensive patients, especially in those with high cardiovascular risk and considering longer time horizons. Most studies were deemed to have a low risk of bias. In line with guidelines recommendations, RDN appears to be a cost-effective intervention across a variety of clinical scenarios, both for patients with resistant or uncontrolled hypertension and especially in young and/or high cardiovascular risk patients.Prospero Registration ID: CRD420251133996.
Styczynski G, Kalinowski P, Cienszkowska K
… +3 more, Ludwiczak M, Strzelczyk J, Szmigielski C
Hypertens Res
· 2026 May · PMID 41882327
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Early blood pressure (BP) reduction following bariatric surgery can be observed early, yet the mechanisms remain incompletely understood. Our study evaluated short-term changes in BP and cardiac hemodynamics following sl...Early blood pressure (BP) reduction following bariatric surgery can be observed early, yet the mechanisms remain incompletely understood. Our study evaluated short-term changes in BP and cardiac hemodynamics following sleeve gastrectomy. Bedside BP, 24-h ambulatory blood pressure monitoring (ABPM), and echocardiography were performed one-week [1 W] and one-month [1 M] post-surgery in 40 patients (pts) (mean age 44.8 years, body mass index (BMI) 42.2 kg/m, 58% females). We found that the mean decrease in bedside SBP was 5.2 mmHg (p < 0.05)[1 W] and 10.4 mmHg (p < 0.05) [1 M] and in ABPM SBP 6.5 mmHg (p < 0.05)[1 W] and 10.5 mmHg (p < 0.05)[1 M]. Mean change in bedside and ABPM heart rate (HR)[1 W] was (-3.2) and an increase of 0.2 bpm (ns) and (-8.4 bpm) and (-6.5 bpm) (p < 0.05)[1 M], respectively. Mean stroke volume (SV) and cardiac output (CO) change at [1 W] was (-6.6 ml) and (-0.88 l/min) (both p < 0.05) and [1 M] ( + 1.4 ml) (ns), and (-0.94 l/min) (p < 0.05). Mitral valve velocity time integral (MV VTI) and early diastolic mitral inflow (E) velocity significantly decreased at [1 W] and returned to baseline at [1 M] (MV VTI 20.62 ± 4.0, 18.8 ± 3.3, p < 0.05 and 21.5 ± 3.7 cm ns, E 77.7 ± 16.8, 65.9 ± 14.2, p < 0.05, and 75.4 ± 11.6 cm/s, ns). Our results indicate that early postoperative BP reduction is accompanied by a transient decrease in CO, associated with reduced SV and echocardiographic changes suggestive of decreased preload. However, individual changes in CO did not independently predict the magnitude of BP reduction, indicating that the precise mechanisms underlying early postoperative BP reduction remain to be established and are multifactorial.
Yasuda H, Yokota K, Katabami T
… +18 more, Nakamura T, Izawa S, Nozato Y, Wada N, Okamoto R, Kakutani M, Yoneda T, Murakami M, Ichijo T, Takahashi K, Kobayashi H, Okamura S, Watanabe M, Taura D, Tamura K, Hayashi K, Naruse M, Sone M
Hypertens Res
· 2026 May · PMID 41876803
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Primary aldosteronism (PA) causes biochemical abnormalities such as hypokalemia and metabolic alkalosis. This study aimed to compare the effects of aldosterone on serum potassium and corrected bicarbonate (cHCO, defined...Primary aldosteronism (PA) causes biochemical abnormalities such as hypokalemia and metabolic alkalosis. This study aimed to compare the effects of aldosterone on serum potassium and corrected bicarbonate (cHCO, defined as Na - Cl - 12) between PA and non-PA and between unilateral and bilateral PA (uPA and bPA, respectively). A total of 463 patients from the Japan Primary Aldosteronism Study II, who had been enrolled as of January 2024, were analyzed. Correlations between plasma aldosterone concentration (PAC) and serum potassium, as well as cHCO, were evaluated in PA vs. non-PA and in uPA vs. bPA. In the PA group, PAC was significantly correlated with both serum potassium (r = -0.449, P < 0.05) and cHCO (r = 0.439, P < 0.05), whereas no significant correlations were observed in the non-PA group. Among PA subtypes, uPA showed significant correlations between PAC and serum potassium (r = -0.299, P < 0.05) and cHCO (r = 0.420, P < 0.05). Conversely, in bPA, PAC showed a weaker correlation with serum potassium (r = -0.178, P < 0.05) and no significant correlation with cHCO. Even in the analysis with matched PAC between uPA and bPA, a significant correlation between PAC and cHCO was observed only in uPA (r = 0.415, P < 0.05), whereas no such correlation was found in bPA, with a significant difference between the two groups (P < 0.05). uPA was observed in 96.7% of patients with PA who had PAC ≥ 150 pg/mL and cHCO ≥ 28 mmol/L. In conclusion, PAC is significantly correlated with cHCO in uPA, but not in non-PA or bPA. cHCO is potentially useful for evaluating disease activity in uPA and detecting uPA.
Sekizuka H, Kabutoya T, Hoshide S
… +1 more, Kario K
Hypertens Res
· 2026 May · PMID 41876802
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The impacts of lipid abnormalities on the development of cardiovascular events (CVEs) in relation to the cardio-ankle vascular index (CAVI) have not been fully elucidated. We sought to determine whether the association b...The impacts of lipid abnormalities on the development of cardiovascular events (CVEs) in relation to the cardio-ankle vascular index (CAVI) have not been fully elucidated. We sought to determine whether the association between high-density lipoprotein cholesterol (HDL-C) levels and cardiovascular outcomes varies depending on the CAVI status in patients at risk for cardiovascular disease (CVD). Of 5109 patients enrolled in the multicenter, prospective COUPLING study (CardiOvascUlar Prognostic coupLING Study in Japan), the present analyses included 4,569 patients (51% male; mean age 68.5 ± 11.4years) who had both CAVI and serum HDL-C measured at baseline and whose clinical outcomes could be followed. The primary outcome was a composite of major CVEs. We stratified the subjects into two groups based on their CAVI values: CAVI < 9 (n = 2501) and CAVI ≥ 9 (n = 2068). The incidence of CVEs was compared between these groups and further analyzed by HDL-C levels. During a median follow-up of 5.0 years, 220 CVEs occurred. In the CAVI < 9 subgroup, low HDL-C ( < 40 mg/dL) was also associated with an increased CVEs risk (hazard ratio [HR] 1.79, 95% confidence interval [CI] 1.02-3.14, p = 0.044). In the group with CAVI > 9, the risk of CVEs in patients with HDL-C < 40 mg/dL was not significantly different from that in those with HDL-C > 40 mg/dL (HR 0.64, 95% CI 0.33-1.24, p = 0.640). Low HDL-C ( < 40 mg/dL) was associated with an increased risk of CVEs in patients with normal-to-borderline arterial stiffness (CAVI < 9). Among the subjects at risk for CVD, the combination of CAVI < 9 and HDL-C < 40 mg/dL identified those with a residual risk of CVEs.
Kawasoe S, Kubozono T, Akasaki Y
… +9 more, Tokutake D, Shinchi S, Ojima S, Yamaguchi S, Mukai S, Miyahara H, Tokushige K, Miyata M, Ohishi M
Hypertens Res
· 2026 May · PMID 41876801
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Full text
The combined effects of aging, sex, and body mass index (BMI) on blood pressure trajectories remain incompletely characterized in large-scale populations. The aim was to describe age-related blood pressure trajectories a...The combined effects of aging, sex, and body mass index (BMI) on blood pressure trajectories remain incompletely characterized in large-scale populations. The aim was to describe age-related blood pressure trajectories according to sex and BMI, as understanding these patterns is essential to improve risk stratification and develop preventive strategies for hypertension and cardiovascular diseases. This study included individuals who underwent annual physical examinations at Kagoshima Kouseiren Hospital in 2007-2019 (n = 213058). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, and BMI measurements were retrospectively analyzed, and age-related changes were visualized using locally weighted scatterplot smoothing (LOWESS). Analyses were stratified by sex and BMI category (underweight, normal weight, class 1 obesity, and class 2 obesity or higher). Higher BMI levels were consistently accompanied by higher SBP, DBP, pulse pressure, and heart rate in both sexes. The LOWESS curves revealed that SBP increased steadily with age, particularly in individuals with obesity, whereas DBP increased until middle age before plateauing or declining. Consequently, the pulse pressure widened with age, especially in men with obesity. Heart rates remained stable but were consistently higher in women and obese participants. The age-related divergence between SBP and DBP was more pronounced in men and in individuals with a higher BMI. Ultimately, distinct age-related blood pressure and pulse pressure changes varied by sex and BMI category, and obesity was associated with accelerated SBP and pulse pressure trajectories, suggesting features consistent with earlier vascular aging. Adopting sex- and BMI-specific approaches may help inform blood pressure monitoring and prevention.
Hypertens Res
· 2026 May · PMID 41851487
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In a DXA screening cohort, higher mean arterial pressure (MAP) as a continuous exposure was associated with greater odds of DXA-defined osteoporosis (OR 1.15 per +10 mmHg). This supports a blood-pressureburden perspectiv...In a DXA screening cohort, higher mean arterial pressure (MAP) as a continuous exposure was associated with greater odds of DXA-defined osteoporosis (OR 1.15 per +10 mmHg). This supports a blood-pressureburden perspective that complements claims-based hypertension definitions.
Hamada Y, Matsuoka H, Sato T
… +8 more, Hamada K, Shimada T, Kawabata Y, Iwamoto K, Ikeda M, Takaguchi G, Higuchi Y, Takashima H
Hypertens Res
· 2026 May · PMID 41826505
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Although intensive blood pressure (BP) lowering after mechanical thrombectomy (MT) may adversely affect outcomes, the prognostic significance of post-recanalization BP variability remains unclear. This study aimed to eva...Although intensive blood pressure (BP) lowering after mechanical thrombectomy (MT) may adversely affect outcomes, the prognostic significance of post-recanalization BP variability remains unclear. This study aimed to evaluate the association between systolic blood pressure (SBP) variability after successful recanalization and 90-day functional outcomes following MT. Among 342 consecutive patients who underwent MT between May 2014 and June 2025, 280 patients who achieved successful recanalization were included in this retrospective analysis. SBP was recorded from immediately after recanalization up to 72 h thereafter. BP variability indices, including variability independent of the mean (VIM), time rate, and coefficient of variation, were calculated. The primary outcome was defined as a modified Rankin Scale (mRS) score of 4-6 at 90 days. Associations between SBP variability and outcomes were assessed using multivariable logistic regression models. Of the 280 patients, 104 (37.1%) experienced poor functional outcomes. Higher SBP variability was significantly associated with unfavorable outcomes. In time-segmented analyses, only SBP variability during the 24-72-h period remained significantly associated with poor outcomes (aOR per 10-unit increase in VIM [VIM/10], 1.89; 95% CI, 1.20-3.06, p = 0.005). Sensitivity analyses excluding patients who received antihypertensive therapy during 24-72 h and those with symptomatic intracranial hemorrhage confirmed the robustness of the association between 24-72 h VIM and poor outcomes (aOR VIM/10, 1.94; 95% CI, 1.26-3.11, p = 0.003). In conclusion, these findings highlight the clinical importance of stabilizing BP beyond the first 24 h after recanalization.
Notsu T, Kurata Y, Tsuneto M
… +4 more, Kuwabara M, Otani N, Nanba D, Hisatome I
Hypertens Res
· 2026 May · PMID 41826504
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Although elevated soluble uric acid (SUA) levels enhance the production of IL-1β in macrophages stimulated with monosodium urate (MSU) crystals, the underlying mechanism remains unelucidated. The aim of this study was to...Although elevated soluble uric acid (SUA) levels enhance the production of IL-1β in macrophages stimulated with monosodium urate (MSU) crystals, the underlying mechanism remains unelucidated. The aim of this study was to examine the effects of SUA on inflammatory response-related gene expression in lipopolysaccharide-primed and MSU crystal-stimulated macrophages using mouse macrophage-like J774.1 cells. Differential gene expression in SUA-pretreated and untreated group cells was analyzed by RNA sequencing and quantitative reverse transcription-polymerase chain reaction. SUA upregulated the genes related to pro-inflammatory reactions and downregulated those related to anti-inflammatory reactions. SUA also upregulated M1 pro-inflammatory macrophage-related genes and enhanced mRNA expression of CD44 responsible for phagocytosis of MSU crystals. These results suggest that SUA enhances gouty inflammation via promoting the expression of genes related to pro-inflammatory reactions, polarization toward the M1 phenotype, and MSU crystal phagocytosis in macrophages. Enhanced expression of the transcription factor genes Nfkb1 and Stat1 may underlie the SUA-induced M1 polarization and resulting enhancement of inflammasome activation and IL-1β transcription.