Blood Pressure[JOURNAL]
Sun
200 papers
Diagnostic and therapeutic approach to acute blood pressure elevations: results of an international survey among excellence centres of the European society of hypertension.
Buso G, Weber T, Fragoulis C … +8 more , Grassi G, Agabiti-Rosei C, Delles C, Doumas M, Salvetti M, Kreutz R, Tsioufis K, Muiesan ML
Blood Press · 2025 Dec · PMID 40705847 · Publisher ↗
BACKGROUND: Acute blood pressure (BP) elevations are common in emergency settings and are traditionally classified into hypertensive urgencies (HU) and hypertensive emergencies (HE). Malignant hypertension (MHT) represen...
BACKGROUND: Acute blood pressure (BP) elevations are common in emergency settings and are traditionally classified into hypertensive urgencies (HU) and hypertensive emergencies (HE). Malignant hypertension (MHT) represents a severe form of HE characterised by small vessel damage. Although international guidelines provide clear definitions and treatment strategies, real-world data have shown persistent fragmentation and heterogeneity in the diagnosis and management of these patients. METHODS: A web-based, anonymous survey promoted by the European Society of Hypertension (ESH) was distributed among physicians from 18 European and 4 non-European countries. The questionnaire assessed definitions, diagnostic work-up, BP measurement practices, and therapeutic strategies for HU, HE, and MHT. RESULTS: Sixty-four participants in 56 centres completed the survey. HU was correctly defined as a severe BP elevation without acute clinically symptomatic hypertension-mediated organ damage (A-HMOD) by 45.3% of respondents. Small cuffs were available to 79.7% and extra-large cuffs to 70.3% of respondents.. Intravenous antihypertensive therapy was used for HE by 88.7% of participants, while 20.6% also used intravenous drugs for HU. Parenteral clonidine and sublingual nifedipine were prescribed by 29.7% and 26.6% of respondents, respectively. Definitions and therapeutic approaches for MHT varied substantially, with 62.9% adopting proposed definition involving at least three target organ damages in patients with BP >200/120 mmHg. CONCLUSIONS: This international survey highlights considerable variability in the definition, diagnostic work-up, and therapeutic management of acute BP elevations, emphasising the need for harmonised protocols and further education.
Association between smartphone screen time and exaggerated blood pressure response during treadmill exercise testing: a cross-sectional study.
Geneş M, Barçin C
Blood Press · 2025 Dec · PMID 40667696 · Publisher ↗
OBJECTIVE: This study aimed to investigate the relationship between exaggerated hypertensive response to exercise (EHRE), mobile phone screen time and daily physical activity levels, with a focus on potential lifestyle-r...
OBJECTIVE: This study aimed to investigate the relationship between exaggerated hypertensive response to exercise (EHRE), mobile phone screen time and daily physical activity levels, with a focus on potential lifestyle-related factors that contribute to cardiovascular risk. METHODS: This observational case-control study enrolled 85 participants, who were categorised into an Exaggerated Hypertensive Response to Exercise (EHRE) group ( = 33) and a normotensive control group ( = 52). Participants underwent a standardised treadmill exercise test to identify EHRE. Objective data on daily mobile phone screen time and step counts were collected directly from the smartphones' native tracking applications. RESULTS: Compared to controls, participants with EHRE exhibited significantly higher daily mobile phone screen time (6.1 ± 1.2 h/day vs. 4.7 ± 0.9 h/day; < .001), greater weekly screen time in dim-light conditions (e.g. in bed at night) (14.5 ± 3.4 h/week vs. 7.0 ± 2.1 h/week; < .001), a longer duration of mobile phone usage (19.7 ± 1.9 years vs. 17.7 ± 1.5 years; = .002) and notably lower daily step counts (4120 ± 950 steps/day vs. 6830 ± 1120 steps/day; < .001). CONCLUSION: Increased mobile phone screen time and reduced physical activity levels were significantly associated with EHRE, suggesting that these factors are relevant as modifiable behavioural risk factors. These findings support the integration of digital behavioural metrics into preventive cardiovascular risk management strategies.
Evaluation of race-free eGFR equations in individuals of different ethnicity.
An DW, Mokwatsi GG, Zhang DY … +15 more , Martens DS, Yu YL, Chori BS, Odili AN, Kruger R, Gafane-Matemane LF, Siwy J, Latosinska A, Mischak H, Mels CM, Schutte AE, M'Buyamba-Kabangu JR, Nawrot TS, Li Y, Staessen JA
Blood Press · 2025 Dec · PMID 40662731 · Full text
BACKGROUND: Glomerular filtration rate (eGFR) derived from serum creatinine (eGFR), cystatin C (eGFR), or both (eGFR) by race-free equations are recommended staging chronic kidney disease (CKD). The current study aimed t...
BACKGROUND: Glomerular filtration rate (eGFR) derived from serum creatinine (eGFR), cystatin C (eGFR), or both (eGFR) by race-free equations are recommended staging chronic kidney disease (CKD). The current study aimed to compare these race-free eGFR equations for screening for low-grade CKD in Blacks and non-Blacks and to evaluate their association with mortality. METHODS: Race-free eGFR equations were evaluated in four studies with specific inclusion criteria based on the original research goals: African-PREDICT (341/380 healthy Black/White South Africans), FLEMENGHO (709 White community-dwelling Flemish), NHANES (1760/7931 Black and non-Black adult Americans), and 401 Black African patients hospitalised in Mbuji Mayi, Democratic Republic of Congo. The intraclass correlation coefficient and Bland and Altman statistics were used to assess consistency between eGFR equations and multivariable logistic or Cox regression to evaluate their association with mortality. RESULTS: Intraindividual discordance between eGFRs was larger in Black than non-Black NHANES and African-PREDICT participants. In NHANES, eGFR was greater than eGFR, but smaller than eGFR, and replacing eGFR by eGFR moved 25% Blacks and 15% non-Blacks to a higher (worse) eGFR KDIGO stage. In African-PREDICT and FLEMENGO, half of the measured creatinine clearance to eGFR ratios fell outside the expected 1.1-1.2 band. In NHANES, multivariable hazard ratios for total and cardiovascular mortality in relation to CKD grade were all lower than unity for grade-1 CKD and greater than unity for grade ≥3 ( < 0.0001) without any racial difference (0.11≤ ≤ 0.98). These NHANES findings were consistent, if CKD stage was replaced by eGFR and in subgroup analyses. Whereas eGFR and eGFR refined models, eGFR did not. CONCLUSIONS: The NHANES mortality outcomes support the use of eGFR and eGFR. However, large intraindividual variability between eGFR estimates may lead to KDIGO eGFR stage misclassification and calls for caution in the opportunistic or systematic screening for CKD in asymptomatic individuals with prevention as objective.
Effects of Dan Shen () on blood pressure management in hypertensive patients: a randomized controlled trial.
Li P, Jiang Z, Dong L … +3 more , Wang S, Qi J, Zhu L
Blood Press · 2025 Dec · PMID 40658027 · Publisher ↗
OBJECTIVE: This randomised, double-blind, placebo-controlled trial aimed to evaluate the efficacy and safety of (Dan Shen) in the management of primary hypertension. METHODS: From April 2023 to September 2024, 320 patie...
OBJECTIVE: This randomised, double-blind, placebo-controlled trial aimed to evaluate the efficacy and safety of (Dan Shen) in the management of primary hypertension. METHODS: From April 2023 to September 2024, 320 patients aged 30-75 years with diagnosed primary hypertension were enrolled at Ganzhou Hospital of Southern Medical University (Ganzhou People's Hospital). Patients were randomised to receive either intravenous (20 mL diluted in 200 mL of 5% glucose daily for 12 weeks) or a placebo with identical appearance and administration. Primary outcomes included changes in blood pressure measured by 24-h ambulatory blood pressure monitoring (ABPM). Secondary outcomes included symptom scores, lipid and glucose profiles and health-related quality of life (QoL) assessed using validated laboratory measures and the SF-36 questionnaire. RESULTS: A significant reduction in systolic and diastolic blood pressure (DBP) was observed in the intervention group from week 4, reaching 136.78 ± 10.28 and 85.36 ± 8.37 mmHg by week 12, respectively - both significantly lower than in the control group ( < 0.01). Symptom scores for headache, dizziness and fatigue decreased by 1.2, 1.1 and 1.2 points ( < 0.01), with no significant changes in the control group. Lipid profiles improved notably: total cholesterol (TC), LDL-C and triglycerides (TGs) declined by 9.8%, 10.7% and 17.1%, respectively, while HDL-C increased by 17.0% (all < 0.05). Fasting glucose levels fell by 4.3% ( < 0.05). QoL, assessed SF-36, improved significantly, particularly in vitality (+20.9) and physical functioning (+18.6). Adverse events (AEs) were mild to moderate, mainly gastrointestinal discomfort and dizziness, and did not result in dropout. Treatment adherence was high, with 94.2% of participants completing at least 80% of the protocol. CONCLUSION: Dan Shen significantly reduced both systolic and DBP, alleviated hypertension-related symptoms, improved lipid and glucose metabolism, and enhanced QoL in patients with primary hypertension.
Clarifying the definition of 'elevated' blood pressure in the 2024 European Society of Cardiology hypertension guidelines.
Mancia G, Grassi G, Kjeldsen SE
Blood Press · 2025 Dec · PMID 40567196 · Publisher ↗
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The inverse and non-linear association between central augmentation index and heart rate variability in a cohort of male British combat personnel- findings from the ADVANCE study.
Maqsood R, Schofield S, Bennett AN … +5 more , Khattab A, Bull AMJ, Fear NT, Cullinan P, Boos CJ
Blood Press · 2025 Dec · PMID 40549417 · Publisher ↗
PURPOSE: The central augmentation index (cAIx) is an indirect measure of arterial stiffness. The influence of heart rate variability (HRV) on cAIx remains unexplored in a military cohort and was the aim of this analysis....
PURPOSE: The central augmentation index (cAIx) is an indirect measure of arterial stiffness. The influence of heart rate variability (HRV) on cAIx remains unexplored in a military cohort and was the aim of this analysis. METHOD: The first follow-up data from the ArmeD serVices trAuma rehabilitatioN outComE (ADVANCE) study were analysed. Participants were male British servicemen who served in Afghanistan (2003-2014) and were divided into two groups at recruitment: injured (who sustained severe combat injury) and uninjured. The uninjured were frequency-matched to the injured by age, rank, role-in-theatre and deployment. HRV was reported as root-mean-square-of-successive-differences (RMSSD) using a five-minute single-lead electrocardiogram. The cAIx was measured using pulse waveform analysis and was adjusted for heart rate at 60 beats/minute (cAIx@60). Effect modification by injury was assessed interaction analysis. Linear models reported the association between RMSSD (HRV) and cAIx@60 adjusting for a priori confounders. RESULTS: 1052 participants (injured = 526; uninjured 526; median age at follow-up 37.4 years) were examined. Effect modification by injury was not statistically significant; therefore, was adjusted for along with other confounders. RMSSD and cAIx@60 exhibited a moderate inverse correlation (-0.40; < 0.001). The association between natural log-transformed RMSSD (LnRMSSD) and cAIx@60 was non-linear and statistically significant, suggesting that a 10% decrease in LnRMSSD would be associated with 0.30% increase in cAIx@60. CONCLUSION: Lower RMSSD (HRV) is associated with an increase in cAIx@60, independent of injury status and other traditional cardiovascular risk factors. The efficacy of positive HRV modification on cardiovascular risk in military populations needs to be examined.
Associations of short-term blood pressure variability with presence and progression of organ damage over five years in ischaemic stroke survivors: the Norwegian Stroke in the Young Study.
Eilertsen RK, Midtbø H, Nawaz B … +3 more , Fromm A, Waje-Andreassen U, Gerdts E
Blood Press · 2025 Dec · PMID 40524445 · Publisher ↗
BACKGROUND/AIM: Higher blood pressure (BP) variability (BPV) has been associated with cardiovascular organ damage in cross-sectional studies. Less is known about short-term BPV and organ damage during long-term managemen...
BACKGROUND/AIM: Higher blood pressure (BP) variability (BPV) has been associated with cardiovascular organ damage in cross-sectional studies. Less is known about short-term BPV and organ damage during long-term management of young ischaemic stroke survivors. METHODS: Short-term weighted systolic BPV was assessed from ambulatory 24-hour BP recordings three months after the index stroke in 283 ischaemic stroke survivors aged 15-60 years in the prospective Norwegian Stroke in the young study (NOR-SYS). Organ damage was identified as carotid-femoral pulse wave velocity > 10 m/s, carotid intima-media thickness (cIMT) > 0.9 mm, carotid plaque, and abnormal left ventricular (LV) geometry (LV hypertrophy or concentric LV remodelling). Associations of systolic BPV with organ damage at baseline and after five years were identified in logistic regression analyses. RESULTS: Weighted systolic BPV was associated with all types of organ damage both at baseline and at 5-year follow-up in univariable analyses. When adjusted for other cardiovascular risk factors, weighted systolic BPV at baseline remained associated with presence of cIMT > 0.9 mm at follow-up ( = 0.03), independent of BP, body mass index and tobacco smoking at follow-up. Associations with all other organ damage outcomes were lost when adjusted for BP in multivariable analysis. In contrast, systolic BP remained associated with all types of organ damage both at baseline and follow-up (all < 0.05). CONCLUSIONS: In NOR-SYS, the association of higher weighted systolic BPV with cardiac and arterial organ damage was mostly explained by higher systolic BP both at baseline and at 5-year follow-up.
Effect of green tea supplementation on blood pressure in adults: a GRADE-assessed systematic review and dose-response meta-analysis of randomised controlled trials.
Rezaei M, Akhavan N, Fathi F … +4 more , Alavi SM, Fadaii M, Dehzad MJ, Askarpour M
Blood Press · 2025 Dec · PMID 40497293 · Publisher ↗
BACKGROUND: Hypertension (HTN) is a leading contributor to cardiovascular disease (CVD). Green tea has been proposed as a natural intervention for blood pressure (BP) management due to its antioxidant content. This study...
BACKGROUND: Hypertension (HTN) is a leading contributor to cardiovascular disease (CVD). Green tea has been proposed as a natural intervention for blood pressure (BP) management due to its antioxidant content. This study aimed to systematically evaluate the effect of green tea supplementation on systolic (SBP) and diastolic blood pressure (DBP) using a meta-analysis of randomised controlled trials (RCTs). METHODS: Eligibility criteria were defined using the PICOS framework. PubMed, Scopus, and Web of Science were searched through January 2024 for randomised controlled trials in adults (≥18 years) comparing green tea supplementation with control or placebo, reporting pre- and post-intervention systolic and diastolic blood pressure (SBP and DBP). Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were pooled using random-effects models. Subgroup analyses and dose-response analyses were performed. RESULTS: A total of 36 RCTs were included. Green tea reduced SBP (WMD: -1.08 mmHg; 95% CI: -1.98, -0.18; I = 85.0%) and DBP (WMD: -1.09 mmHg; 95% CI: -1.67, -0.50; I = 74.0%). Subgroup analyses showed stronger effects in participants with elevated baseline BP (SBP ≥120 mmHg), those consuming <500 mg/day green tea, studies ≤8 weeks, Asian populations, and women. No clear association was found between BP changes and tea dose or intervention duration. CONCLUSION: Green tea supplementation is associated with modest reductions in SBP and DBP. Given the heterogeneity and lack of clear dose-duration effects, green tea is better considered a complementary approach for managing blood pressure.
Comparison between an adapted protocol for home and ambulatory measurement for evaluating night-time blood pressure behaviour.
Costa Borges T, Valverde de Oliveira Vitorino P, Inuzuka S … +6 more , Lima Sousa AL, Martins de Oliveira M, Augusto Pícoli de Andrade C, Bezerra R, Magalhães Feitosa AD, Barroso WKS
Blood Press · 2025 Dec · PMID 40488361 · Publisher ↗
BACKGROUND: The diagnosis and treatment of hypertension rely on the accuracy of blood pressure (BP) measurements obtained both in and out of the office during awake and sleep periods. OBJECTIVE: To evaluate whether a hom...
BACKGROUND: The diagnosis and treatment of hypertension rely on the accuracy of blood pressure (BP) measurements obtained both in and out of the office during awake and sleep periods. OBJECTIVE: To evaluate whether a home blood pressure monitoring (HBPM) protocol incorporating morning, afternoon, and evening measurements supports the assessment of blood pressure behaviour during sleep and enhances the diagnosis of hypertension. METHODS: This cross-sectional study included 40 patients (73% women; age = 62.0 ± 13.2 years) who underwent 24-h ambulatory blood pressure monitoring (ABPM) and (five-day HBPM) with measurements taken across three time periods. The association between the sleep-wake dip recorded by ABPM and the night-day difference measured by HBPM was examined. Additionally, the sensitivity, specificity, predictive values, concordance index, Kappa coefficient, and area under the ROC curve (AUC) of mean BP values obtained from HBPM were compared with those from ABPM. RESULTS: Mean BP values obtained from HBPM were 126.2 ± 13.3/79.2 ± 9.1 mmHg, (daytime), 125.9 ± 16.4/78.7 ± 10.5 mmHg (evening), and 126.1 ± 14.3/78.9 ± 9.6 mmHg (total). For ABPM, mean values were 120.3 ± 12.5/74.5 ± 8.9 mmHg (awake), 116.5 ± 10.9/69.3 ± 8.0 mmHg (asleep), and 119.4 ± 11.4/73.4 ± 8.0 mmHg (total). Total HBPM outperformed daytime and evening HBPM in detecting abnormalities on ABPM (daytime, night-time, and 24 h), with higher sensitivity, negative predictive value (NPV), AUC, concordance index, and Kappa coefficient. The correlation between the day-night dip in ABPM and the night-day difference in HBPM was weak. CONCLUSION: Including night-time measurements in the HBPM protocol improves the accuracy of hypertension diagnosis when compared to ABPM. However, the night-day BP difference captured by HBPM does not correspond to the day-night dip measured by ABPM.
Impact of amlodipine-based therapy on blood pressure time in target range in Chinese adults with primary hypertension: a retrospective study.
Wang H, Zhang Y, Lin J … +7 more , Shu Y, Bu P, Wang Z, Song W, Zhang Y, Yu W, Sun N
Blood Press · 2025 Dec · PMID 40456693 · Publisher ↗
BACKGROUND: Recently, both international and Chinese guidelines have mentioned for the first time that blood pressure (BP) target range is more reasonable and workable than BP target in clinical practice, and time in tar...
BACKGROUND: Recently, both international and Chinese guidelines have mentioned for the first time that blood pressure (BP) target range is more reasonable and workable than BP target in clinical practice, and time in target range (TTR) could become a potential evaluation indicator for long-term blood pressure management. Until now, there was no research on the long-term effects of antihypertensive treatment on systolic BP (SBP) TTR. The objective, therefore, is to observe the impact of long-acting calcium channel blockers (CCBs) on BP TTR in Chinese patients with hypertension (HTN). METHODS: A retrospective observational study was conducted using data from the China Cardiovascular Association Hypertension Centre, including 36,153 adult patients diagnosed with primary HTN and treated with amlodipine-based antihypertensive therapy between 1 January 2018 and 31 December 2022. The primary endpoint was the SBP TTR. Other endpoints included the annual trend of SBP TTR, factors influencing SBP TTR, etc. RESULTS: Results showed an overall SBP TTR was 80.42 ± 21.97%. The SBP TTR at 1, 2 and 3 years of follow-up was 79.49 ± 26.16%, 81.86 ± 25.10% and 82.79 ± 25.77%, respectively, showing a significant difference ( < 0.001). Seven factors were positively correlated with SBP TTR, while three factors were negatively correlated with SBP TTR including heart failure, high baseline SBP level, and high LDL-C level. CONCLUSION: Long-term and continuous use of amlodipine-based antihypertensive therapy could improve SBP TTR. This finding may relate to the characteristic of amlodipine which is a long-acting drug due to pharmacokinetic properties. TRIAL REGISTRATION: Chinese Clinical Trial Registry Identifier: ChiCTR2400090150.
Patient perceptions, motivations and barriers to treatment adherence in hypertension: results of a questionnaire-based survey in five European countries.
Burnier M, Azizi M, Magne J … +13 more , Prejbisz A, Cunha V, Gupta P, Vaclavik J, Versmissen J, Cornelissen V, Dorobantu M, Desideri G, Persu A, Kjeldsen SE, Kreutz R, Weber T, Working group on Lifestyle, Cardiovascular Pharmacotherapy and Adherence of the European Society of Hypertension
Blood Press · 2025 Dec · PMID 40445169 · Publisher ↗
AIMS: To assess perceptions, motivations and barriers to treatment adherence depending on emotional, lifestyle, medical and non-adherence risk profiles in hypertensive patients. METHODS AND RESULTS: Cross-sectional data...
AIMS: To assess perceptions, motivations and barriers to treatment adherence depending on emotional, lifestyle, medical and non-adherence risk profiles in hypertensive patients. METHODS AND RESULTS: Cross-sectional data were obtained using an online anonymous survey. Four distinct global risk scores (medical, lifestyle, emotional and quality of life (QoL) and non-adherence risk scores) were calculated based on the responses to specific groups of questions. A total of 2615 treated hypertensive patients (≥18 years of age) from 5 European countries completed the questionnaire. Mean (SD) age was 69.6 years (5.8); 54% males. Overall, antihypertensive therapy represented a low burden in patients' daily life (2.9/10 in the Likert scale). Perfect self-reported adherence was claimed by 59.8% of participants. Reporting of non-adherence episodes to physicians was low (13% always/often). Participants with a high non-adherence risk score had a greater number of associated diseases (obesity, sleep disturbances, depression and cardiac complications), a higher treatment-associated burden on daily life, a greater stress level and more antihypertensive pills per day ( < 0.001 for all). No correlation was found between the clinical and lifestyle risk scores and the risk of non-adherence. The emotional score correlated significantly with the non-adherence risk score ( < 0.001). Comparing patients with a low/middle risk to those with a high risk of non-adherence, female gender and age >65 years were associated with a lower odd ratio of non-adherence whereas depression, stress, family hardships, negative information on drugs and poor information were associated with higher odds of non-adherence. CONCLUSIONS: This large survey reveals several underestimated issues regarding patients' perspective in hypertension. It highlights the impact of emotions, exposure to family hardships, and stress on the risk of non-adherence. Non-adherence is underreported by patients; hence it remains mostly unrecognised.
'It does not end with delivery?' Pregnancy-associated thrombotic microangiopathy in the setting of postpartum preeclampsia/eclampsia - case report.
Ivanko I, Dika Ž, Ćelap I … +3 more , Vukosav V, Gaćina P, Josipović J
Blood Press · 2025 Dec · PMID 40408307 · Publisher ↗
INTRODUCTION: Pregnancy-associated thrombotic microangiopathy (TMA) is potentially life-threatening disorder which refers to endothelial injury as the main culprit. Our case demonstrates true severity of pregnancy-associ...
INTRODUCTION: Pregnancy-associated thrombotic microangiopathy (TMA) is potentially life-threatening disorder which refers to endothelial injury as the main culprit. Our case demonstrates true severity of pregnancy-associated TMA in postpartum period and diagnostic challenges in obtaining correct diagnosis. CASE PRESENTATION: The 32-year-old woman, with no previous record of gestational hypertension, underwent C-section in 30 week of 1 pregnancy due to preeclampsia. Postpartum period was complicated with TMA and continuous need for antihypertensive therapy. Due to suspicion of thrombotic thrombocytopenic purpura (TTP), plasmapheresis was started. After dismissing TTP diagnosis, plasmapheresis was continued while perusing other possible pregnancy-associated TMAs. After a period of stabilisation, anaemia and thrombocytopenia worsened with signs of renal impairment and the patient experienced hypertensive crisis, culminating with grand mal epileptic seizure. She was sedated and treated with intravenous antihypertensive therapy in the Intensive care unit setting. Anti-complement therapy was obtained due to high suspicion of atypical haemolytic uraemic syndrome (aHUS) but ultimately was not delivered due to the rapid improvement in clinical and laboratory findings. No high-risk polymorphism for aHUS were detected, rather multiple common risk variants for complement mediated TMA. The patient experienced full clinical recovery with minimal residual renal impairment. CONCLUSION: this case is an example of pregnancy-associated TMA in the setting of preeclampsia in postpartum period which progressed to eclampsia due to the uncontrolled arterial hypertension. Upon vigorous blood pressure management, signs of TMA fully subsided.
Association between 24-hour blood pressure variability and mortality in acute ischemic stroke patients admitted in intensive care units: a MIMIC-IV study.
Yuan Z, Zeng Y, Shi Z … +4 more , Chen A, Hou Y, Li G, Cheng J
Blood Press · 2025 Dec · PMID 40391852 · Publisher ↗
INTRODUCTION: Acute ischaemic stroke (AIS) patients in the intensive care unit (ICU) face high mortality. This study examined the association between systolic blood pressure variability (SBPV), specifically average real...
INTRODUCTION: Acute ischaemic stroke (AIS) patients in the intensive care unit (ICU) face high mortality. This study examined the association between systolic blood pressure variability (SBPV), specifically average real variability (SBP-ARV), and short-term mortality in critically ill AIS patients. METHODS: We conducted a retrospective cohort study using the MIMIC-IV database. The primary outcomes were 28-day and 90-day all-cause mortality. Cox regression, Kaplan-Meier curves, restricted cubic spline (RCS) models, and subgroup analyses were used to assess associations. RESULTS: A total of 861 AIS patients were included. The 28-day and 90-day mortality rates were 20.9% and 23.3%, respectively. Higher SBP-ARV was independently associated with increased mortality. Compared with the lowest tertile, the highest tertile of SBP-ARV had significantly increased 28-day mortality (HR: 1.53; 95% CI: 1.03-2.27; = 0.035). SBP-ARV as a continuous variable was also significantly associated with 28-day and 90-day mortality. RCS analysis showed that mortality risk increased when SBP-ARV exceeded 11.63. CONCLUSION: Our findings suggest that elevated systolic blood pressure variability, particularly higher SBP-ARV within the first 24 h of ICU admission, is significantly associated with increased 28-day and 90-day mortality in AIS patients. SBP-ARV may serve as a valuable prognostic marker for risk stratification and early clinical intervention in critically ill stroke patients.
Primary aldosteronism in hypertensive patients with obstructive sleep apnea.
Hu Z, Chen X
Blood Press · 2025 Dec · PMID 40381611 · Publisher ↗
OBJECTIVE: To investigate the prevalence and clinical characteristics of primary aldosteronism (PA) in patients with hypertension and obstructive sleep apnoea (OSA) in a newly established cohort, given inconsistencies in...
OBJECTIVE: To investigate the prevalence and clinical characteristics of primary aldosteronism (PA) in patients with hypertension and obstructive sleep apnoea (OSA) in a newly established cohort, given inconsistencies in previous studies and intolerance to drug washout in some cases. DESIGN AND METHOD: A single-centre cross-sectional study enrolled 316 hypertensive patients diagnosed with OSA polysomnography. All participants underwent PA screening, followed by confirmatory testing for positive cases. Patients with confirmed PA underwent further subtype diagnosis and were assigned to the OSA and PA group. Those unable to undergo antihypertensive drug washout but with a high clinical suspicion of PA were categorised into the OSA and suspected PA group. RESULTS: Among 316 patients, 41 (13.0%) were PA. The prevalence was 4.8% in OSA alone, and 50.0% in OSA with hypokalaemia. Compared to the OSA group, the OSA and PA group had a lower proportion of current smokers, a longer duration of hypertension, lower serum triglycerides, lower serum potassium, higher plasma aldosterone concentration, urinary aldosterone excretion, and lower renin. Multivariable logistic regression showed that the diagnosis of PA in OSA patients was positively associated with hypertension duration, and negatively associated with serum potassium levels and smoking. CONCLUSIONS: PA screening may be considered in patients with hypertension and OSA; however, given the relatively low prevalence in those with OSA alone, routine screening may not be cost-effective. In contrast, the presence of hypokalaemia was strongly associated with a higher prevalence of PA, suggesting that targeted screening is warranted in this subgroup.
Diverse trends in antihypertensive medication usage among U.S. Adults with hypertension by socioeconomic status and comorbidities, 1999-2020.
Wang J, Ye Y, Chen X … +2 more , Hu X, Peng Y
Blood Press · 2025 Dec · PMID 40380865 · Publisher ↗
BACKGROUND: Hypertension is a global health concern, and antihypertensive medications are vital for its management. This study examined evolving trends in antihypertensive medication usage among adults with hypertension...
BACKGROUND: Hypertension is a global health concern, and antihypertensive medications are vital for its management. This study examined evolving trends in antihypertensive medication usage among adults with hypertension from 1999 to 2020. METHODS: Data from 10 National Health and Nutrition Examination Survey (NHANES) survey cycles were obtained for adults aged 18 years and older with hypertension. The study analysed demographic, drug classification and demographic variables. All statistical analyses, including logistic regression, were used to assess trends. RESULTS: Among 18,221 hypertensive participants, diverse characteristics were observed. The use of angiotensin-converting enzyme inhibitors increased from 26.18% in 1999 to 32.76% in 2020 (linear = 0.001). Angiotensin receptor blocker use rose from 10.36% to 26.57%. Beta blocker usage increased from 28.98% in 1999 to 42.50% in 2010, plateauing at approximately 40% from 2011 to 2020 (quadratic < 0.001). Calcium channel blocker (CCB) utilisation increased from 16.70% in 1999 to 20.46% in 2020 (linear < 0.001). Diuretic (DU) use decreased from 32.70% in 1999 to 26.34% in 2020 (quadratic = 0.009). The use of antihypertensive medications varies across different demographic groups and comorbidities. CONCLUSIONS: ACEI, ARB and CCB usage increased, while DU usage decreased. BB utilisation stabilised at a high rate. Antihypertensive drug use displayed diverse trends across demographic groups and comorbidities.
Prevalence, awareness and therapeutic control of hypertension in Belgium: an opportunistic screening of nearly 6,000 participants during the May Measurement Month campaigns 2017-23.
De Bacquer D, Bayet S, Bondue A … +18 more , Brohée F, Brouwers S, Carlier A, Chabot M, Delmotte P, Falque B, Heuten H, Huart J, Krzesinski JM, Persu A, Robberechts T, Vanassche T, Van Der Beken E, Van de Borne P, Van der Niepen P, Van Nieuwenhuyse B, Vanparys J, De Backer T
Blood Press · 2025 Dec · PMID 40323139 · Publisher ↗
BACKGROUND: The May Measurement Month (MMM) initiative is an annual global screening campaign started in 2017 by the International Society of Hypertension highlighting the importance of regular measurements of blood pres...
BACKGROUND: The May Measurement Month (MMM) initiative is an annual global screening campaign started in 2017 by the International Society of Hypertension highlighting the importance of regular measurements of blood pressure (BP). Here we report on the results of the MMM campaign done in Belgium during the month of May in 2017, 2018, 2019, 2022 and 2023. METHODS: Participants ≥18 years were recruited through opportunistic sampling in 12 sites (mostly hospital entrances) across Belgium. Apart from standardised BP recordings by trained staff, data were collected on demographics, lifestyle factors and comorbidities. Hypertension was defined as raised BP (systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg) and/or taking antihypertensive medication. RESULTS: Data were collected from 5,926 participants aged 51.5 years on average. Mean (SD) systolic and diastolic BP were 125.9 (17.6) mmHg and 79.4 (10.9) mmHg with 25.8% exceeding the 140/90 mmHg threshold. Age-standardised prevalences of hypertension were 45.4% in men and 36.9% in women. Among the 2,468 individuals with hypertension, 78.5% had been previously diagnosed and 1,578 of those with known hypertension, received antihypertensive treatment. Only about half of those being treated (56.3%) did achieve the target of systolic/diastolic BP <140/90 mmHg. Inadequate therapeutic control was independently associated with increasing age and higher body mass index. Untreated hypertension was significantly associated with male sex, age, body mass index and alcohol use. CONCLUSION: Despite the limited representativeness of the sample, these data suggest that the 'rule of halves' for hypertension no longer holds true in Belgium and that therapeutic control of hypertension is still suboptimal.
Higher blood pressure variability during hospitalisation is associated with lower cerebral white matter integrity in COVID-19 patients.
van Lith TJ, Janssen E, van Dalen JW … +11 more , Li H, Koeneman M, Sluis WM, Wijers NT, Wermer MJH, Huisman MV, van der Worp HB, Meijer FJA, Tuladhar AM, Bredie SJH, de Leeuw FE
Blood Press · 2025 Dec · PMID 40241653 · Publisher ↗
BACKGROUND: High blood pressure variability (BPV) is associated with cerebrovascular damage and dementia, but it is unknown whether short-term BPV during hospitalisation is also associated with cerebral white matter (WM)...
BACKGROUND: High blood pressure variability (BPV) is associated with cerebrovascular damage and dementia, but it is unknown whether short-term BPV during hospitalisation is also associated with cerebral white matter (WM) damage. We examined whether BPV, measured in-hospital using continuous monitoring, is associated with WM microstructural integrity in COVID-19 patients. METHODS: We included hospitalised COVID-19 patients from the CORONavirus and Ischemic Stroke (CORONIS) study who underwent continuous vital signs monitoring using a wearable device during hospital admission and had an MRI shortly after discharge. Systolic BPV was calculated as Average Real Variability (ARV) and Coefficient of Variation (CV) with 1-, 5- and 20-minute intervals. We used diffusion tensor imaging to assess fractional anisotropy (FA) and peak width of skeletonised mean diffusivity (PSMD) as markers of WM integrity. Associations between BPV and WM integrity were examined with linear regression adjusted for age, mean systolic blood pressure (BP), number of BP measurements and type of respiratory support. RESULTS: We included 47 COVID-19 patients (mean age: 59.6 years). BP was measured 6306 ± 4343 times per patient (median admission: 11 days (Interquartile Range [IQR] 7.5-15.0). Both higher ARV and CV were associated with lower WM microstructural integrity, reflected by lower FA (ARV: = -0.40, = .010; CV: = -0.33, = 0.026) and higher PSMD (CV: = 0.28, = .038) after adjustment for confounders. Correction for WM hyperintensities did not change these results. CONCLUSIONS: High BPV during hospitalisation is associated with lower WM integrity in COVID-19 patients, although causality needs to be demonstrated. Our findings need validation in hospitalised patients without COVID-19 to examine generalisability.
An interactive care plan plus remote blood pressure monitoring in a rural primary care clinic: a pilot study.
DeJesus RS, Njeru JW, Beahm MR … +5 more , Gullerud RE, Grimm JA, Copeland BJ, Lunde JJ, Croghan IT
Blood Press · 2025 Dec · PMID 40219656 · Publisher ↗
BACKGROUND: Remote blood pressure monitoring (RBPM), an effective method of enhancing BP control for patients with hypertension, can potentially helpovercome geographic limitations of health care services. We conducted a...
BACKGROUND: Remote blood pressure monitoring (RBPM), an effective method of enhancing BP control for patients with hypertension, can potentially helpovercome geographic limitations of health care services. We conducted a 90-day pilot to explore combining an interactive care plan (ICP) with RBPM. METHOD: The pilot invited fifty adult patients with uncontrolled hypertension (BP ≥140/90 mm Hg) empanelled to a rural primary care practice in midwestern United States. Participants received instructions for downloading an ICP app and were given a wireless BP monitoring device that automatically transmitted readings to their care team. Patients were surveyed after 30 and 90 days about program experience. RESULTS: Thirty-six patients enrolled. Mean participant age was 59.1 years; most were male, married, and White. Mean baseline BP was 153/89 mm Hg. Participants who engaged in the program for at least 75 days ( = 15) had a postintervention mean BP of 135/80 mm Hg. Sixteen participants (44%) had 1 outpatient visit (no multiple outpatient visits): only 4 (11%) had an emergency department visit. Among survey respondents, most strongly agreed or agreed that 1) ICP app was easy to use, 2) BP device was helpful in home care, 3) interacting remotely with care team was smooth, and 4) they were satisfied with functionality of the RBPM device. CONCLUSION: An ICP paired with an RBPM device is a reasonable intervention for managing hypertension in a primary care practice particularly for patients in rural areas. New strategies must be developed to reduce barriers to meaningful engagement, achieve sustainability, and ensure successful widespread adoption.
Letter to editor: validating the accuracy of Omron J760 electronic blood pressure monitor in the general population according to AAMI/ESH/ISO (ISO 81060-2:2018) + AMD1:2020.
Luthfiyah S, Triwiyanto T, Muafiro A
Blood Press · 2025 Dec · PMID 40190263 · Publisher ↗
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Hypertension and burden of myocardial infarction in China: risk factors, gender differences and temporal trends from a National Chronic Disease Surveillance study (2021-2023).
Zhang X, Huang D, Zhao J … +1 more , Wu J
Blood Press · 2025 Dec · PMID 40188379 · Publisher ↗
Myocardial infarction (MI) remains a leading global cause of morbidity and mortality, with rising prevalence in China. Hypertension persists as a predominant modifiable risk factor. This study investigates MI prevalence,...
Myocardial infarction (MI) remains a leading global cause of morbidity and mortality, with rising prevalence in China. Hypertension persists as a predominant modifiable risk factor. This study investigates MI prevalence, trends and risk factors using data from China CDC's Chronic Disease Surveillance program. Data from 258,742 participants (2021-2023) were analysed. Demographic characteristics, risk factors and gender/urban-rural disparities in MI prevalence were assessed. Multivariate logistic regression identified significant risk factors. Hypertension was the leading MI risk factor (64.3%), followed by dyslipidaemia (58.6%) and smoking (42.3%). Men had higher MI prevalence than women (58.2% . 41.8%), and urban residents surpassed rural residents (56.7% 43.3%), with significant lifestyle disparities (e.g. physical inactivity and smoking). Multivariate analysis identified age ≥ 60 years (OR = 2.75, 95% CI: 2.46-3.08), hypertension, dyslipidaemia, smoking and obesity (BMI ≥ 25) as key risk factors. MI incidence increased by 3.14% nationally from 2021 to 2023. China's MI burden is escalating, with notable gender, age and residence disparities. Older adults and individuals with hypertension, dyslipidaemia, smoking or obesity face elevated risks. Hypertension contributes to nearly two-thirds of MI cases, emphasising the urgency for targeted prevention strategies, particularly in high-risk groups (hypertensive individuals, older adults and urban populations).
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