Clinical Hypertension临床高血压
Clinical Hypertension(英文缩写 CLIN HYPERTENS),ISSN 2056-5909,eISSN 2056-5909,中文译名:临床高血压 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-11-01 至 2026-10-31，按本站收录文献的发表日期统计。
期刊介绍
Clinical Hypertension 最新收录文献
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1. Deep learning-based retinal risk stratification for 10-year atherosclerotic cardiovascular mortality in patients with hypertension and diabetes: a retrospective cohort study.
1. 基于深度学习的视网膜风险分层用于高血压和糖尿病患者10年动脉粥样硬化性心血管死亡风险的预测：一项回顾性队列研究PMID:日期:2026-09-01Cardiovascular risk stratification in patients with hypertension and diabetes remains suboptimal. We evaluated the prognostic and incremental value of Dr. Noon CVD, a deep learning (DL)-based retinal biomarker, for 10-year atherosclerotic cardiovascular (ASCVD) mortality. This retrospective, single-center, primary prevention cohort study included 7,832 Korean patients with hypertension or diabetes diagnosed on or before retinal fundus photography (2005 to 2022). Patients with prior cardiovascular disease were excluded. The primary outcome of 10-year ASCVD mortality and a sensitivity analysis of 5-year mortality were stratified using 4-tier and 3-tier Dr. Noon CVD systems, respectively. Multivariable Cox proportional hazards models were adjusted for traditional risk factors and chronic kidney disease (CKD), and incremental predictive value was assessed using the change in the C-index (ΔC-index) and net reclassification improvement (NRI). In the overall population, the Dr. Noon CVD score was independently associated with 10-year ASCVD mortality (hazard ratio [HR] trend, 1.49; 95% confidence interval [CI], 1.21 to 1.85; < 0.001) after full adjustment for traditional factors and CKD. Adding Dr. Noon CVD to the clinical model significantly improved discrimination (ΔC-index, 0.030; = 0.001) and risk reclassification (NRI, 0.484; 95% CI, 0.233 to 0.666; < 0.001). This independent prognostic value was consistent in both hypertension (10-year HR trend, 1.48; = 0.006) and diabetes (10-year HR trend, 1.42; = 0.003) subgroups. The reclassification improvement was greater in the diabetes than the hypertension subgroup (10-year NRI, 0.481 vs. 0.413). The score's prognostic value was independent of diabetic retinopathy status. DL-based retinal imaging provides prognostic value for 10-year ASCVD mortality independent of the available clinical risk factors (age, sex, hypertension, diabetes, and CKD) and consistent under adjustment for available laboratory measures, supporting its role as an accessible opportunistic screening tool for long-term primary prevention in cardiometabolic clinics.
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2. Recent update on renal denervation: where do we stand now?
2. 肾去交感神经术的最新进展：我们目前处于什么阶段？PMID:日期:2026-09-01Renal denervation (RDN) has re-emerged as a potential adjunctive therapy for hypertension following advances in device technology, trial design, and patient selection. Early enthusiasm for RDN declined after neutral findings from initial sham-controlled trials; however, subsequent randomized studies have consistently demonstrated modest but significant reductions in blood pressure (BP) across a range of clinical settings. Contemporary sham-controlled trials using radiofrequency-, ultrasound-, and alcohol-mediated approaches have shown that RDN lowers office and ambulatory BP both in the presence and absence of background antihypertensive therapy. Long-term follow-up data extending up to 3 years suggest that BP-lowering effects can be sustained, with no consistent signal of late-emerging safety concerns. Recent meta-analyses further support these findings, reporting modest but consistent reductions in systolic BP compared with sham procedures. Despite these advances, several limitations remain. The magnitude of BP reduction is modest, treatment response is heterogeneous, and definitive evidence for cardiovascular outcome benefit is lacking. Current international guidelines therefore position RDN as an adjunctive, rather than replacement, therapy for carefully selected patients with uncontrolled or resistant hypertension. This review summarizes the mechanistic rationale, key clinical trial evidence, long-term durability, safety considerations, and current guideline recommendations for RDN, and discusses future directions to better define its role in hypertension management.
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3. Associations of weekend warrior and regular physical activity patterns with prevalence of hypertension by socioeconomic status in Korean adults.
3. 周末战士与规律身体活动模式与韩国成年人高血压患病率在社会经济地位上的关联PMID:日期:2026-08-01[中文摘要] 有证据表明，“周末战士”型身体活动（PA）模式（每周1-2天）与较低的高血压风险相关，但该关联是否因社会经济地位（SES）而异尚不清楚。本研究旨在探讨在韩国成年人中，“周末战士”型PA模式与高血压患病率之间的关联是否因SES而异。我们分析了2018-2023年韩国国家健康与营养调查中的28,039名成年人（年龄≥19岁）。PA模式被分为不活动、活动不足、周末战士或规律活动。受教育程度（高中及以下 vs. 大学及以上）和家庭收入（Q1-Q2 vs. Q3-Q4）被用作SES的替代指标。高血压定义为收缩压≥140 mmHg、舒张压≥90 mmHg、医生诊断或使用降压药物。多变量logistic回归按受教育程度和家庭收入水平分层，估计各PA模式下高血压患病的比值比（OR）和95%置信区间（CI）。在28,039名成年人中，8,842名（31.5%）患有高血压。在多变量校正模型中，与不活动参与者相比，活动不足（OR，0.85；95% CI，0.77-0.93）、周末战士（OR，0.74；95% CI，0.59-0.92）和规律活动（OR，0.84；95% CI，0.77-0.91）PA模式均与较低的高血压患病比值相关。受教育程度与周末战士之间对高血压患病的交互作用不显著（交互作用P = 0.349），而观察到家庭收入与周末战士之间存在显著交互作用（交互作用P = 0.049），在低收入成年人中反向关联更为明显。包括周末战士模式在内的PA模式与韩国成年人较低的高血压患病比值相关。周末战士模式与高血压之间的反向关联似乎因家庭收入水平而异，在低收入成年人中反向关联更为明显。需要在大型纵向队列中开展进一步研究以证实这些发现。
[英文摘要] Evidence shows that the weekend warrior physical activity (PA) pattern (1-2 days/week) is associated with a lower risk of hypertension, but it is unclear whether this association differs by socioeconomic status (SES). This study aimed to examine whether the association between the weekend warrior PA pattern and prevalent hypertension differs according to SES in Korean adults. We analyzed 28,039 adults (aged ≥ 19 years) from the 2018-2023 Korea National Health and Nutrition Examination Survey. PA patterns were categorized as inactive, insufficiently active, weekend warrior, or regularly active. Educational attainment (high school or less vs. college or higher) and household income (Q1-Q2 vs. Q3-Q4) were used as proxies of SES. Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, a physician diagnosis, or use of antihypertensive medication. Multivariable logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs) for prevalent hypertension across PA patterns, stratified by educational attainment and household income level. Among 28,039 adults, 8,842 (31.5%) had hypertension. In multivariable-adjusted models, compared with inactive participants, insufficiently active (OR, 0.85; 95% CI, 0.77-0.93), weekend warrior (OR, 0.74; 95% CI, 0.59-0.92), and regularly active (OR, 0.84; 95% CI, 0.77-0.91) PA patterns were each associated with lower odds of prevalent hypertension. There was no significant educational attainment-by-weekend warrior interaction for prevalent hypertension ( for interaction = 0.349), whereas a significant household income-by- weekend warrior interaction was observed ( for interaction = 0.049), with a more pronounced inverse association among lower-income adults. PA patterns, including the weekend warrior pattern, were associated with lower odds of prevalent hypertension among Korean adults. The inverse association between the weekend warrior pattern and hypertension appeared to differ by household income level, with a more pronounced inverse association among lower-income adults. Further studies in large longitudinal cohorts are warranted to confirm these findings.
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4. Prevalence of adherence to antihypertensive treatment: a comparison of drug biochemical analysis and the self-report scale.
PMID:日期:2026-08-01Assessing adherence to antihypertensive medication remains a major challenge for healthcare professionals. The objective of this study was to compare the evaluation of adherence to antihypertensive medication between direct and indirect methods, and to identify variables associated with nonadherence. A cross-sectional study was conducted with 253 persons with hypertension followed at a hypertension unit of a tertiary teaching hospital. Participants aged over 18 years and under antihypertensive drug treatment were included. Persons with secondary hypertension, end-stage chronic kidney disease, or pregnancy were excluded. Biopsychosocial, anthropometric, lifestyle, comorbidity, and medication data were collected. Indirect assessment of treatment adherence was performed using the 4-item Morisky-Green Medication Adherence Scale, while direct assessment was based on urine analysis using high-performance liquid chromatography coupled with mass spectrometry. Variables with < 0.20 in the bivariate analysis were included in the multiple logistic regression model. The significance level was set at 5%. Cohen's Kappa coefficient (CKC) was used to assess agreement between the methods. The sample consisted predominantly of women (61.7%), white individuals (63.2%), and married participants (52.8%), with a mean age of 65 ± 13.3 years and median education of 12.0 (7-12) years. Participants were using an average of 3.2 ± 1.3 antihypertensive drugs, and 69.2% had controlled blood pressure (BP). The prevalence of adherence according to the direct method was 32.4%, while 90.1% were adherent according to the indirect method. Agreement between the direct and indirect methods was low (CKC = 0.014). Variables independently associated with nonadherence according to the direct method were regular physical activity (odds ratio [OR], 0.370; 95% confidence interval [CI], 0.158-0.853), proteinuria (OR, 2.406; 95% CI, 1.066-5.751), number of antihypertensive medications (OR, 1.570; 95% CI, 1.127-2.225), and systolic BP (OR, 1.051; 95% CI, 1.010-1.097). Indirect adherence assessment was associated only with the presence of common mental disorders (OR, 1.163; 95% CI, 1.035-1.307). The prevalence of adherence to antihypertensive drug treatment assessed by the indirect method was substantially higher than that observed with the direct method. The results were inconsistent between the 2 approaches. Moreover, the direct method identified a broader range of variables associated with nonadherence.
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5. Dynamic changes in right ventricular free wall strain during hemodialysis identify patients at risk for intradialytic hypotension.
5. 血液透析期间右心室游离壁应变的动态变化可识别有透析中低血压风险的患者PMID:日期:2026-08-01[中文摘要] 透析中低血压（IDH）是血液透析常见的并发症，与不良心血管后果相关。右心室（RV）功能储备对透析期间血流动力学稳定性的贡献尚不清楚。我们研究了右心室应变的动态变化是否与IDH相关。在这项前瞻性单中心研究中，50例接受维持性血液透析的终末期肾病患者在透析前和透析后即刻接受了全面的超声心动图检查及斑点追踪分析。IDH定义为透析前至透析后收缩压（SBP）下降≥20 mmHg。右心室游离壁应变（RVFWS）由一名设盲的专家离线分析。比较了发生与未发生IDH患者之间RVFWS的变化，并评估了SBP变化与RVFWS变化之间的相关性。在纳入分析的33例患者中，15例（45%）发生了IDH。两组间的基线临床特征、超滤量（平均2.9 L）及透析前SBP相当。大多数患者左心室射血分数保留，基线RVFWS无显著差异。然而，IDH组透析后RVFWS的下降幅度显著大于非IDH组（-7.0 ± 7.2% vs. -1.7 ± 4.6%，= 0.017）。此外，SBP下降幅度与RVFWS下降呈中度相关（= 0.50，= 0.003）。受试者工作特征分析提示，透析引起的RVFWS变化对IDH具有中等程度的判别能力（曲线下面积0.74；95%置信区间0.56-0.92）。尽管基线右心室功能相似，IDH仍与透析引起的RVFWS更大下降相关，提示急性容量卸载可能揭示右心室收缩储备受损。这些发现提供了初步证据，表明动态右心室应变评估有助于识别易发生透析中血流动力学不稳定的患者，值得在更大规模的研究中进一步验证。
[英文摘要] Intradialytic hypotension (IDH) is a frequent complication of hemodialysis that is associated with adverse cardiovascular consequences. The contribution of right ventricular (RV) functional reserve to hemodynamic stability during dialysis remains unclear. We investigated whether dynamic changes in RV strain are associated with IDH. In this prospective single-center study, 50 patients with end-stage renal disease undergoing maintenance hemodialysis underwent comprehensive echocardiography with speckle-tracking analysis immediately before and after dialysis. IDH was defined as a decrease in systolic blood pressure (SBP) of ≥ 20 mmHg from pre- to post-dialysis. Right ventricular free wall strain (RVFWS) was analyzed offline by a blinded specialist. Changes in RVFWS were compared between patients with and without IDH, and correlations between SBP change and RVFWS change were assessed. In the analyzed 33 patients, 15 patients (45%) developed IDH. Baseline clinical characteristics, ultrafiltration volume (mean, 2.9 L), and pre-dialysis SBP were comparable between groups. Left ventricular ejection fraction was preserved in most patients, and baseline RVFWS did not differ significantly. However, the IDH group showed a significantly greater post-dialysis reduction in RVFWS than the non-IDH group (-7.0 ± 7.2% vs. -1.7 ± 4.6%, = 0.017). Moreover, the magnitude of SBP decline correlated moderately with the decrease in RVFWS ( = 0.50, = 0.003). Receiver operating characteristic analysis suggested a modest discriminatory ability of dialysis-induced changes in RVFWS for IDH (area under the curve, 0.74; 95% confidence interval, 0.56-0.92). IDH was associated with a greater dialysis-induced decline in RVFWS despite similar baseline RV function, suggesting that acute volume unloading may unmask impaired RV contractile reserve. These findings provide preliminary evidence that dynamic RV strain assessment could help identify patients vulnerable to intradialytic hemodynamic instability, warranting further validation in larger studies.
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6. Metabolic health and cardiovascular outcomes in treated hypertension: a secondary analysis of SPRINT.
PMID:日期:2026-07-01Metabolic abnormalities frequently coexist with hypertension and independently contribute to cardiovascular disease (CVD) risk. Whether metabolic dysfunction predicts incident CVD events and/or modifies the efficacy of intensive blood pressure control in primary prevention remains uncertain. Data from Systolic Blood Pressure Intervention Trial participants without baseline CVD or diabetes were analyzed. Metabolic health was classified based on triglycerides ≥ 150 mg/dL, high-density lipoprotein cholesterol < 40 mg/dL in men or < 50 mg/dL in women, fasting glucose ≥ 100 mg/dL, and body mass index ≥ 30 kg/m. Participants with ≤ 1 abnormality were classified as metabolically healthy (MH) and those with ≥ 2 as metabolically unhealthy (MUH). Cox proportional hazards models assessed the association of metabolic health status with outcomes and tested for effect modification by treatment arm. The primary outcome was a composite of myocardial infarction, acute coronary syndrome, stroke, heart failure, and cardiovascular death. A total of 7,299 participants (mean age, 67.5 years; 37.9% female) were included, of whom 2,852 (39.1%) were classified as MUH. Over a median follow-up of 3.2 years, 440 primary outcome events occurred. The incidence of primary outcome events was higher in the MUH compared with the MH group (6.4% vs. 5.8%). After multivariable adjustment, MUH participants had a significantly higher risk of the primary outcome compared with MH participants (hazard ratio, 1.27; 95% confidence interval, 1.03-1.57; = 0.024). Among hypertensive adults free of diabetes and CVD, MUH status was associated with higher cardiovascular risk; however, intensive systolic blood pressure lowering was protective across levels of metabolic burden.
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7. Feasibility and preliminary effectiveness of mindfulness-based stress reduction program on patients with nocturnal hypertension: a pilot randomized controlled trial.
7. 基于正念的减压计划对夜间高血压患者的可行性和初步有效性：一项试点随机对照试验PMID:日期:2026-07-01Nocturnal blood pressure (BP) during sleep is a stronger predictor of cardiovascular events than daytime BP. This pilot randomized controlled trial (RCT) aimed to assess feasibility and preliminary effectiveness of mindfulness-based stress reduction (MBSR) in managing nocturnal hypertension. Eligible patients were randomized to either a generic MBSR program or usual care (1:1). Primary outcomes included recruitment rate, dropout rate, adherence to ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM), and MBSR participation. Secondary outcomes encompassed BP measurements from ABPM, mood symptoms, sleep quality, mindfulness levels, and safety at 8 weeks, with acceptability evaluated through interviews. All eligible patients were recruited (76/113), with 13 participants recruited monthly and a retention rate of 100%. The 83.3% of MBSR participants attended at least six classes, and they engaged in home practices on 77% of days during the 8-week program. All participants completed ABPM at baseline and 8 weeks; however, only 55.3% reported adequate nocturnal HBPM readings. While MBSR significantly reduced nocturnal systolic BP (121.9 vs. 128.6 mmHg, < 0.001), no significant differences were observed on other outcomes and no adverse events were detected. Patients noted benefits from the MBSR course, although HBPM and ABPM disrupted sleep for a minority. This is the first RCT to investigate the effect of mindfulness on nocturnal BP in a Chinese population. We confirm the feasibility of a definitive RCT regarding patient recruitment and retention, acceptability of the intervention (i.e., MBSR), and data collection (e.g., repeated ABPM). Although MBSR may reduce nocturnal systolic BP by 7 mmHg, this needs to be confirmed in a definitive RCT. ClinicalTrials.gov Identifier: NCT06510907.
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8. Hypertension in chronic kidney disease: where do international guidelines converge and diverge?
PMID:日期:2026-07-01In recent years, major scientific societies have updated their hypertension guidelines, each incorporating specific recommendations for patients with chronic kidney disease (CKD). Across societies, there is strong consensus on standardized office and out-of-office blood pressure (BP) measurement, as well as systematic assessment of estimated glomerular filtration rate and albuminuria, with confirmation of abnormalities and regular monitoring. Moderate-to-severe CKD is universally recognized as a major determinant of cardiovascular (CV) risk and is frequently considered equivalent to established CV disease, thereby supporting earlier and more intensive BP treatment. Although BP thresholds for treatment initiation and on-treatment BP targets remain debated, there is broad agreement on the preferential use of dual-agent combination therapy, including surely renin-angiotensin system inhibitors in patients with albuminuric CKD-together with calcium-channel blockers or diuretics, with diuretic selection largely guided by renal function. Moreover, contemporary guidelines increasingly emphasize disease-modifying strategies, including sodium-glucose cotransporter 2 inhibitors and nonsteroidal mineralocorticoid receptor antagonists in selected patients, to improve cardio-renal outcomes. Despite differences in definitions, targets, and treatment algorithms, all guidelines converge on a patient-centered approach prioritizing cardio-renal protection, adherence, and individualized care. With this review, we summarize and compare key recommendations for patients with CKD from the 2023 European Society of Hypertension (ESH), the 2024 European Society of Cardiology, the 2021 Kidney Disease: Improving Global Outcomes, and the 2025 American Heart Association/American College of Cardiology guidelines, with the aim of supporting clinicians in navigating guideline complexity and optimizing hypertension management in CKD.
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10. Global trends and geographic variations of hypertension in childhood and adolescence 1990-2021: a systematic analysis of the Global Burden of Disease Study 2021.
PMID:日期:2026-06-01Childhood hypertension is strongly associated with the development of cardiovascular diseases in adulthood. Understanding the epidemiological patterns of disease burden is crucial for developing effective prevention strategies. This cross-sectional study utilized data from the Global Burden of Disease Study (GBD) 2021, including 204 countries and territories. The analysis estimated deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) attributable to high systolic blood pressure (sBP) among individuals under the age of 20 within the GBD comparative risk assessment (CRA) framework, covering the period from 1990 to 2021. Trends and regional disparities in disease burden were examined, emphasizing correlations between DALY rates and socio-demographic indices (SDI). In 2021, the global DALY rate was 2.39 (95% uncertainty interval [UI], 1.75 to 2.88) per 100,000 population, representing a 20.11% decrease (95% UI, -35.02 to 10.21) compared to 1990. The YLL rate showed a decrease of 21.06% (95% UI, -36.21 to 9.95), contributing to the decline in the DALY rate, whereas the YLD rate showed an increase of 22.33% (95% UI, 4.16 to 40.74). The DALY rates were negatively correlated with Socio-demographic Index. Among the 21 GBD regions in 2021, Middle East and North Africa (MENA) showed the highest disease burden across all metrics. Western Sub-Saharan Africa (SSA) demonstrated a pronounced gender disparity. High-income North America experienced the largest increase in disease burden. Global DALYs and deaths attributable to high sBP among children and adolescents suggested a declining trend from 1990 to 2021, although the 95% UIs were compatible with no clear change. DALYs showed a negative correlation with SDI, with highest burden in MENA and notable gender disparities in Western SSA. High-income North America showed the largest increase since 1990.