Hypertension has become a major health issue, impacting both health and quality of life. Due to its long course of illness, multiple and complex complications, and lack of a cure or correcting deviation, patients require lengthy and continuous support and medical management. Understanding the long-term journey and influencing factors of medical-help-seeking behaviour in hypertensive patients is crucial for developing targeted and patient-centred prevention and control strategies.

The study aimed to identify and analyze the long-term trajectories of medical-help-seeking behaviour among hypertensive patients who were managed by community health centres of Putuo District in Shanghai City. Using trajectory modeling to determine key behavioral patterns and the influencing factors, the study will inform hypertension prevention and treatment policies.

Continuous clinical records of 8 922 hypertensive patients were retrieved from Resident Electronic Health Record System of Putuo District in Shanghai from 2014 to 2021. The data include histories, encounters, diagnostic, management and follow-up information. The Group-Based Trajectory Model (GBTM) was applied to analyze the patterns of the medical-help-seeking behaviour change, simulate behavioural transitions, and identify the best fitting model. Analysis of variance and chi square test were employed to examine patient characteristics across diflerent behavioural trajectories. The persistently irregular medical-help-seeking behaviour' group served as the reference group for comparing influencing factors among medical-help-seeking behaviour trajectory groups.

A total of 444 126 outpatient records were retrieved. The GBTM analysis revealed flve distinct medicalhelp-seeking behaviour trajectories: sustained regular (39.84%), regular with a slow decline (25.36%), U-shaped (11.43%), regular with slow increase (11.86%), and persistently irregular (14.86%). Statistical diverences were observed between these groups, including gender, age, illness duration, diabetes history, transient ischemic attack (TIA) history, and family history of high blood pressure, regular exercise habits (P<0.05). Female patients and those aged 75 years or older were more likely to transition from irregular to regular medical-help-seeking behaviour. Patients with diabetes or a history of TIA were less likely to follow irregular medical-help-seeking behaviour. Longer duration of hypertensive history and a family history were associated with a less favorable shift in behaviour.

Less than 40% of hypertensive patients consistently follow a regular medical-help-seeking behaviour. However, appropriate management strategies can promote regular medical-help-seeking behaviour, particularly in females, patients aged 75 years or above, and those with diabetes or a history of TIA. Further research is suggested identifying factors that can encourage medical help-behavioral changes in other medicalhelp-seeking behaviour trajectory groups.

Nocturnal hypertension (NH) is a significant contributor to multi-organ damage (cardiovascular, cerebral, and renal) and serves as a predictor of all-cause mortality. Its predictive value surpasses that of daytime blood pressure and office blood pressure. Classified as a form of masked hypertension due to its occult nature during nocturnal sleep, early screening and individualized treatment can mitigate the risk of cardiovascular, cerebral, and renal diseases.

To investigate risk factors associated with NH by leveraging routine health checkup parameters and personal health data, and to develop a clinical predictive nomogram model for NH.

A total of 406 patients who underwent 24-hour ambulatory blood pressure monitoring (ABPM) at the Affiliated Hospital of Inner Mongolia Medical University between January 1, 2021, and June 30, 2024, were included. Baseline clinical data, laboratory test results, and echocardiographic findings were collected. Patients were randomly divided into a training set (n=284) and a validation set (n=122) in a 7∶3 ratio. A risk prediction model for NH was constructed using LASSO regression analysis and multivariate Logistic regression analysis, followed by Nomogram development. The ROC curve was plotted, and the area under the ROC curve (AUC) was calculated to validate the model's accuracy. Calibration curves were generated to assess the model's predictive capability and consistency between predicted and observed risks.

Based on 24-hour ABPM results, patients were categorized into an NH group (n=254) and a non-NH group (n=152). Four predictors identified via LASSO regression "body weight, total cholesterol (TC), hypertension, and stroke "were used as independent variables in multivariate Logistic regression analysis. The results indicated that increased body weight (OR=1.029, 95%CI=1.006-1.053), elevated TC (OR=1.496, 95%CI=1.136-1.972), hypertension (OR=2.372, 95%CI=1.214-4.632), and stroke (OR=7.850, 95%CI=4.157-14.824) were all risk factors for NH (P<0.05). The Nomogram revealed that stroke history (score: 0 or 62) and hypertension (score: 0 or 26) had a more pronounced impact on diagnostic rates compared to body weight and TC (scores varied linearly with variable values). The total model score was 240, with a 95%risk of NH when the score exceeded 176. ROC curve analysis demonstrated an AUC of 0.791 (95%CI=0.739-0.843) in the training set, with a sensitivity of 0.698 and specificity of 0.786. In the validation set, the AUC was 0.820 (95%CI=0.742-0.899), with a sensitivity of 0.817 and specificity of 0.725. The Hosmer-Lemeshow calibration curve indicated good model fit, and decision curve analysis showed that the validation set achieved high net benefit within a threshold probability range of 0.2-0.6, confirming optimal clinical utility.

This study established an NH risk prediction model incorporating four clinical indicators: body weight, TC, hypertension history, and stroke history. The model demonstrates robust calibration, discrimination, and clinical applicability for screening NH risk in suspected patients.

Neurofilament light chain (NfL), a sensitive biomarker of neuroal injury and neuroinflammation, has attracted increasing attention. Previous studies have demonstrated its associations with hypertension and adverse cardiovascular events;however, the potential relationship between NfL and left ventricular hypertrophy (LVH) in patients with nocturnal hypertension remains remains unclear.

To examine the association between serum NfL levels and the risk of LVH in patients with nocturnal hypertension.

A total of 351 patients with nocturnal hypertension who underwent 24-hour ambulatory blood pressure monitoring (ABPM) with complete clinical data at Renmin Hospital of Wuhan University from December 2022 to December 2024 were enrolled. Patients were divided into four groups according to NfL quartiles:Q1 (NfL≤62.82, n=88), Q2 (62.82<NfL≤92.00, n=88), Q3 (92.00<NfL≤136.40, n=87), and Q4 (NfL>136.40, n=88). Baseline characteristics, 24-hour ABPM data, laboratory results, and transthoracic echocardiographic parameters were collected. Left ventricular mass (LVM) and left ventricular mass index (LVMI) were calculated using the formula recommended by the American Society of Echocardiography. Spearman's rank correlation analysis was used to assess associations between NfL and echocardiographic parameters. Generalized linear models were applied to analyze the associations between NfL quartiles and LVMI. Logistic regression analysis was used to evaluate the relationship between NfL levels and the risk of LVH. Receiver operating characteristic (ROC) curves were generated to evaluate the predictive value of NfL and autonomic function-related indicators for the risk of LVH in patients with nocturnal hypertension, and subgroup analyses were conducted.

Significant differences were observed among the four groups in age, interventricular septal thickness in diastole (IVSd), left ventricular posterior wall thickness at end-diastole (LVPWd), LVM, and LVMI (P<0.05). Spearman correlation analysis showed that NfL levels were positively correlated with left ventricular internal diameter at end-diastole (LVIDd)(r_s=0.135, P=0.011), IVSd (r_s=0.128, P=0.016), LVPWd (r_s=0.146, P=0.006), LVM (r_s=0.162, P=0.002), and LVMI (r_s=0.277, P<0.001). After adjustment for confounding factors, the generalized linear model showed that, compared with Q1, NfL levels in Q3 (β=0.110, 95%CI=0.003-0.217, P=0.044) and Q4 (β=0.288, 95%CI=0.180-0.395, P<0.001) were significantly associated with LVMI. Logistic regression analysis showed that elevated NfL levels were an independent risk factor for LVH in patients with nocturnal hypertension (OR=1.012, 95%CI=1.007-1.016, P<0.001). Compared with Q1, NfL levels in Q3 (OR=3.328, 95%CI=1.152-9.611, P=0.026) and Q4 (OR=9.059, 95%CI=3.278-25.036, P<0.001) were associated with a significantly increased risk of LVH. ROC curve analysis showed that the areas under the ROC curve of NfL, norepinephrine (NE), acetylcholine (ACh), and the NE/ACh ratio for predicting LVH risk were 0.744, 0.618, 0.577, and 0.603, respectively, with sensitivities of 75.0%, 50.0%, 48.5%, and 48.5% and specificities of 63.3%, 69.3%, 51.5%, and 75.3%. Subgroup analyses indicated that NfL levels were positively associated with LVH risk in subgroups defined by age, male sex, BMI, and estimated glomerular filtration rate (P<0.05).

In patients with nocturnal hypertension, serum NfL levels are independently associated with the risk of LVH and may have clinical value in identifying individuals at high risk of LVH.

Early risk assessment of essential hypertension with left ventricular hypertrophy (EH-LVH) is crucial for clinical intervention, but existing predictive models often overlook Traditional Chinese Medicine (TCM) syndromes, pulse graph parameters, and other TCM clinical information. Therefore, integrating the aforementioned characteristic indicators to construct an EH-LVH risk prediction model will provide new evidence for risk stratification and clinical decision-making in integrated Traditional Chinese and Western Medicine.

To develop a nomogram model for predicting the risk of EH-LVH based on TCM syndromes and pulse graph parameters.

A total of 201 inpatients with essential hypertension admitted to Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, and Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from August 2018 to June 2021 were selected. Based on echocardiographic results, they were divided into the essential hypertension with left ventricular hypertrophy group (EH-LVH group) and the essential hypertension without left ventricular hypertrophy group (EH-NLVH group). General information, physicochemical indicators, and TCM inquiry data of the two groups were collected, and pulse graph parameters were detected using the SMART-Ⅰ TCM pulse analysis instrument. Multivariate Logistic regression analysis was used to explore factors independently associated with the risk of EH-LVH. Using the rms package in R software version 4.1.1, three nomogram models (Models A, B, and C) were established with pulse graph parameters, TCM syndromes, and pulse graph parameters + TCM syndromes + general information as variables, respectively. Receiver operating characteristic (ROC) curves were used to assess discrimination, calibration curves to evaluate accuracy, Hosmer-Lemeshow test to verify calibration, and decision curve analysis (DCA) to evaluate clinical utility, followed by model comparisons.

Multivariate Logistic regression analysis showed that low-density lipoprotein cholesterol (OR=1.511, 95%CI=1.709-2.115), Yin deficiency with Yang hyperactivity syndrome (OR=2.493, 95%CI=1.272-4.885), Qi stagnation and blood stasis syndrome (OR=7.866, 95%CI=2.201-28.110), T (OR=1.906, 95%CI=1.278-2.842), H3/H1 (OR=1.549, 95%CI=1.021-2.351), and W1/T (OR=2.129, 95%CI=1.369-3.310) were factors independently associated with the risk of EH-LVH (P<0.05). The areas under the ROC curves (AUC) of the nomogram models were as follows: the AUC of Model A was 0.642 (95%CI=0.571-0.713), that of Model B was 0.717 (95%CI=0.646-0.788), and that of Model C was 0.784 (95%CI=0.719-0.849). The calibration results showed that for Model A: χ²=0.133 (P>0.05), for Model B: χ²=4.316 (P>0.05), and for Model C: χ²=3.754 (P>0.05), indicating good agreement between the predicted probabilities and actual probabilities in the calibration curves of all three models. DCA curve analysis showed that when the threshold for predicting EH-LVH occurrence was between 0.05 and 0.80 (estimated value), Model C achieved optimal applicability, indicating its more significant clinical utility value.

This study successfully construct a nomogram for predicting the risk of EH-LVH, with TCM syndromes and pulse graph parameters as core predictive variables. The discrimination performance and predictive accuracy of this nomogram were validated to be favorable, demonstrating value for clinical promotion and application, and it can serve as a reference for clinical risk assessment of this disease.

Chronic obstructive pulmonary disease (COPD) is closely related to cardiovascular disease, but the mechanism of their interaction is still unclear. Hypertension is the most common comorbidity of COPD, and it is also an independent risk factor for cardiovascular diseases. Current studies believe that blood pressure variability is also a risk factor for cardiovascular disease, and blood pressure variability can better reflect the patient's blood pressure fluctuation than a single blood pressure value, so is blood pressure variability a bridge between COPD and cardiovascular disease. At present, there are no relevant studies in China.

To investigate the correlation study of pulmonary function and blood pressure variability in patients with COPD and hypertension.

A total of 341 COPD patients with hypertension who visited the respiratory and critical care medicine outpatient department of kailuan general hospital from september 2020 to september 2023. On the day of the patient's visit, data were collected on the patient's lung function indicators, height, weight, age, sex, use of antihypertensive medications, and lifestyle habits (whether they smoke or drink alcohol) . Multiple factor linear regression was used to analyze the correlation between lung function indicators (percentage of forced vital capacity to predicted value: FVC%pred; percentage of forced expiratory volume to predicted value in the first second: FEV₁%pred; the ratio of forced expiratory volume in one second to forced vital capacity: FEV₁/FVC) and blood pressure variability (standard deviation of systolic blood pressure: SDSBP, standard deviation of diastolic blood pressure: SDDBP) .

(1) Males had higher body mass index, smoking rate, and alcohol consumption rate than females, while females had a higher predicted forced vital capacity percentage (FVC%pred) than males (P<0.05) . (2) FEV₁%pred was negatively correlated with blood pressure variability (SDSBP, SDDBP) (r_s values were -0.149 and -0.114, respectively, P<0.05) . (3) FEV₁%pred was negatively linearly correlated with SDSBP and SDDBP, with B values (95% CI) of -0.566 (-1.078--0.054) and -0.427 (-0.761--0.093) , respectively; FVC%pred and FEV₁/FVC were not correlated with SDSBP and SDDBP.

FEV₁%pred is negatively linearly correlated with SDSBP and SDDBP.

Hypertension is characterized by unclear etiology, prolonged disease duration, and incurability, ranking highest in prevalence among metabolic disorders. To alleviate patient burden, hypertension health management (HHM) was incorporated into National Essential Public Health Services Program (NEPHSP). However, patient follow-up rates remain substantially below expected levels. Digital therapeutics (DTx) deliver evidence-based therapeutic interventions through high-quality software programs to prevent, manage, or treat hypertension. This approach significantly enhances clinician-patient communication frequency and optimizes healthcare resource utilization efficiency. This study examines hypertension DTx products within the Digital Therapeutics Alliance (DTA) product library and published randomized controlled trials (RCTs) to explore application prospects in China. Findings indicate that China should draw on international DTx experiences for HHM, leverage socio-environmental factors to enhance stakeholder acceptance of DTx concepts, establish regulatory frameworks aligned with product characteristics, strengthen enterprise's research and development capabilities, and accelerate DTx advancement in hypertension management.

The Chinese visceral adiposity index (CVAI) is a new obesity index that has been proven to be associated with prehypertension and hypertension. Still, there is a lack of research on the relationship between the CVAI and nocturnal hypertension (NH).

To investigate the correlation between CVAI and NH in young and middle-aged adults.

A total of 981 young and middle-aged patients with essential hypertension admitted to the Department of Hypertension of the Fifth Affiliated Hospital of Xinjiang Medical University were consecutively enrolled from February to September 2023, and the general data, biochemical indexes, and 24-hour ambulatory blood pressure monitoring results of the patients were collected and the CVAI was calculated, and the patients were divided into 95 cases of the non-nocturnal hypertension (NNH) group and 886 cases of the NH group according to the whether they were combined with NH or not. Differences in age, gender, and other indicators were compared between the two groups. Correlation analysis was performed using the Pearson or Spearman method. Multivariate Logistic regression was used to analyze the correlation between CVAI and NH in young and middle-aged people.

Compared with the NNH group, the NH group had higher CVAI, 24-hour average systolic and diastolic blood pressure, daytime average systolic and diastolic blood pressure, nocturnal average systolic and diastolic blood pressure, and maximum systolic and diastolic blood pressure, and the differences were statistically significant (all P<0.05). Pearson correlation analysis showed that CVAI was positively correlated with 24-hour average systolic and diastolic blood pressure, daytime average systolic and diastolic blood pressure, nocturnal average systolic and diastolic blood pressure, and maximum systolic and diastolic blood pressure (r=0.202, 0.183, 0.200, 0.171, 0.168, 0.174, 0.132, 0.157, all P<0.05). Multivariate Logistic regression showed that high CVAI was an independent risk factor for NH in young and middle-aged adults after adjustment for relevant confounders (OR=1.009, 95%CI=1.002-1.016, P=0.014). According to the CVAI quartiles, the patients were categorized into Q1 group (<103.524 3, n=245), Q2 group (103.524 3-129.714 0, n=246), Q3 group (129.714 0-156.270 4, n=245) and Q4 group (>156.270 4, n=245). The risk of developing nocturnal hypertension in the Q2 group, Q3 group and Q4 group was 1.779 (OR=1.779, 95%CI=1.002-3.157), 2.023 (OR=2.023, 95%CI=1.061-3.858), and 3.053 (OR=3.053, 95%CI=1.383-6.737) times greater than that of the Q1 group. Subgroup analysis showed that the association between CVAI and NH was more significant in the overweight/obese (BMI≥24 kg/m²) population (P=0.021).

CVAI was associated with the risk of developing NH in young and middle-aged adults, and the association was more significant in the overweight/obese (BMI≥24 kg/m²) population, which was a risk factor for NH in this population.

Hypertension has emerged as the leading global cause of mortality, with hypertensive heart disease(HHD) representing one of its most severe long-term complications. Despite rising trends in HHD prevalence and mortality globally and in China, comprehensive analyses of its epidemiological patterns and evolving risk factors remain limited. This study aims to characterize the historical trends and risk factors associated with HHD globally and in China, providing evidence to guide effective prevention and control strategies.

To characterize the epidemiological patterns and identify key risk factors of HHD both globally and in China from 1990 to 2021, and to forecast future trends in its burden.

Data were obtained from the Global Burden of Disease Study 2021. Line charts and grouped bars plots were uesd to illustrate demographic and temporal distribution patterns. The estimated annual percentage change(EAPC) in age-standardized prevalence and mortality rates was calculated using R software(version 4.3.2). Changes in risk factor contributions over time were assessed using standardized mortality data. An ARIMA model was employed to forecast trends in HHD burden from 2022 to 2030.

Between 1990 to 2021, the global age-standardized prevalence rate of HHD increased slightly [EAPC=0.56%(0.52% to 0.59%)], while the mortality rate showed a slight decline [EAPC=-0.68%(-0.77% to 0.59%)]. In contrast, China experienced a significant decrease in both prevalence [EAPC=-0.68%(-0.90% to 0.45%)] and mortality [EAPC=-2.68%(-3.05% to 2.31%)]. In 2021, China's age-standardized prevalence and mortality rates were 192.47 and 18.85 per 100 000 population, respectively-substantially higher than global averages of 148.32 and 16.32 per 100 000. Both globally and in China, the burden of HHD was disproportionately higher among older adults compared to younger individuals, and in males compared to females. Throughout the study period, high blood pressure remained the leading risk factor for HHD-related mortality. By 2021, high dietary sodium intake had become the second most important contributor to HHD mortality in China. Projections suggested that by 2030, the global prevalence would rise marginally to 151.52 per 100 000, while China was expected to increase markedly to 279.09 per 100 000. Mortality rates were projected to decline further, reaching 12.68 per 100 000 globally and 15.27 per 100 000 in China.

While China has made considerable progress in reducing the overall burden of HHD since 1990, the disease remains a major public health concern, especially among elderly individuals and men. High blood pressure and high dietary sodium intake are currently important risk factors contributing to HHD mortality. Although China has achieved significant progress in the prevention and treatment of HHD, projected data still indicate a substantial burden of the disease in terms of prevalence and mortality. Therefore, it is necessary to further strengthen comprehensive prevention strategies across all stages of the disease continuum, with particular attention directed toward high-risk populations such as the elderly and males, as well as more effective management of key modifiable risk factors, including excessive dietary sodium intake.

The aging process in China is accelerating, and the number of older adults with chronic diseases is increasing. The association between hypertension, along with its comorbidities, and dementia in older adults requires further investigation.

To investigate the association between hypertension, its comorbidities, and dementia in community-dwelling older adults, and to provide evidence for dementia prevention.

This study utilized cross-sectional data from 14 732 individuals aged ≥65 years from the China Multicenter Dementia Survey (CMDS, 2018-2023). Data on sociodemographic characteristics, chronic diseases, and cognitive function were collected. We employed a multivariate Logistic regression model to analyze the association between hypertension and its comorbidities and dementia in the total population and different age and sex groups.

Among the 14 732 older adults (≥65 years), 8 293 (56.3%) had two or more comorbidities, and 7 786 (52.9%) had hypertension along with other comorbidities. Of these hypertensive individuals, the numbers with 1, 2, 3, and 4 comorbidities were 2 569 (17.4%), 2 064 (14.0%), 1 018 (6.9%), and 443 (3.0%), respectively. Dementia was identified in 1 111 participants (7.5%). After adjusting for covariates, multivariate Logistic regression results showed that the risk of dementia in the hypertension-only group was 1.516 times (95%CI=1.014-2.267, P=0.042), and the risk of dementia among those with hypertension and 1 to 4 comorbidities was 1.879 times (95%CI=1.312-2.692, P=0.001), 2.071 times (95%CI=1.428-3.004, P<0.001), 2.338 times (95%CI=1.612-3.392, P<0.001), 2.591 times (95%CI=1.634-4.108, P<0.001). The highest risk of dementia was observed in individuals with hypertension coexisting with cerebrovascular disease (OR=2.550, 95%CI=1.384-4.700, P=0.003). In analyses stratified by sex and age, the risk of dementia increased significantly with the number of hypertension comorbidities (P<0.05). The strongest association was observed for hypertension coexisting with cerebrovascular disease, with adjusted odds ratios of 2.842 (95%CI=1.095-7.375, P=0.032) in men and 2.348 (95%CI=1.060-5.203, P=0.036) in women. In the group aged <75 years, the highest risk was observed for hypertension coexisting with diabetes (OR=2.833, 95%CI=1.046-7.675, P=0.041), while in the group aged≥75 years, the highest risk was observed for hypertension coexisting with cerebrovascular disease (OR=2.707, 95%CI=1.168-6.273, P=0.020). Among participants with hypertension and two comorbidities, the highest dementia risk was observed in those with coexisting heart disease and cerebrovascular disease (OR=3.559, 95%CI=1.338-9.468, P=0.011). Similarly, among those with hypertension and three comorbidities, the highest prevalence of dementia was observed in individuals with coexisting heart disease, cerebrovascular disease, and autonomic dysfunction (OR=3.881, 95%CI=1.736-8.677, P=0.001).

The prevalence of hypertension and its comorbidities is high among Chinese older adults. Patients with hypertension and its comorbidities have a significantly elevated risk of dementia, which varies by age and sex. These findings underscore the importance of optimized management of chronic diseases in this population. Implementing tailored prevention and treatment strategies based on individual characteristics could contribute to reducing the risk of dementia.

Hypertension is a major cardiovascular disease. The relationship between Life's Essential 8 (LE8) score, a newly developed cardiovascular health metric, and hypertension risk remains unclear.

This study aimed to investigate the association between LE8 score and hypertension risk in the rural and pastoral population of Altay Prefecture, Xinjiang.

From October to November 2023, 27 natural villages were selected in Altay Prefecture using Proportionate to Population Size (PPS) systematic sampling. Eligible residents in the included natural villages were recruited for questionnaire surveys, physical examinations, and laboratory index tests. The LE8 score includes 4 health behaviors (diet, physical activity, nicotine exposure, sleep) and 4 health factors (BMI, blood lipids, blood glucose, blood pressure). In this study, the LE8 score was calculated based on the remaining 7 components excluding blood pressure. The LE8 score, subscales and components were divided into low group (0-49 points), medium group (50-79 points) and high group (80-100 points) according to their scores. A restrictive cubic spline plot was used to plot the dose-response curves of LE8, health factors and health behavior scores and hypertension. A multivariate logistic regression model was used to analyze its effect on the prevalence of hypertension.

A total of 2 872 study subjects were included in this study. Among the study subjects, 1 540 patients with hypertension were detected, yielding a crude prevalence of 53.62% and an age-standardized prevalence of 34.64%. The prevalence of hypertension was 61.13% in men (766/1 253) and 47.81% (774/1 619) in women, and the prevalence of hypertension in men was higher than that in women (P<0.05). In terms of LE8 score, the difference between the hypertensive group and the normal blood pressure group was statistically significant (P<0.05). After adjusting for confounders, the intermediate and high LE8 score groups had a lower risk of hypertension compared with the low score group (P<0.05). For every 10-point increase in LE8 score, the risk of hypertension decreased by 24.3% and 41.8%, respectively. A significant non-linear relationship was observed between LE8 scores and hypertension (P_{for non-linear}=0.010), while a linear relationship was found between health factor scores and hypertension (P_{for non-linear}=0.637). No significant association was observed between health behavior scores and hypertension (P>0.05). Participants with higher BMI, blood glucose, and physical activity scores had a significantly lower risk of hypertension compared to the low-score group (P<0.05). An interaction between LE8 scores and age was detected (P_{for interaction}<0.05), with a stronger effect of LE8 scores on reducing hypertension risk in individuals aged >50 years (P<0.05).

LE8 scores are non-linearly associated with hypertension risk. Maintaining higher LE8 scores can reduce the burden of hypertension, particularly in individuals aged ≥50 years.

Hypertension (HT) and Parkinson's disease (PD) have shown comorbidity in observational studies, but their shared genetic basis and causal relationships remain unclear.

This study utilized large-scale genome-wide association studies (GWAS) summary data to investigate the shared genetic etiology and causal relationships between HT and PD.

GWAS summary data was extracted from the R5 release of the FinnGen consortium (2 162 Parkinson's disease patients and 216 630 controls) and the summary data from the UK Biobank (including 129 909 hypertension patients and 354 689 controls), and both overall and local genetic correlations was assessed using linkage disequilibrium score regression (LDSC) and local genetic heritability estimation (ρ-HESS). Cross-trait Meta-analysis was used to identify pleiotropic single nucleotide polymorphisms (SNPs) shared between HT and PD, and bidirectional Mendelian randomization (MR) analysis was performed to infer potential causal relationships.

Genetic correlation analysis revealed no significant overall correlation between HT and PD (r_g=0.067, P=0.527). Local analysis identified three marginally significant regions (P<0.05), but none reached statistical significance after Bonferroni correction (P>0.05). Cross-trait Meta-analysis confirmed 37 significant SNPs associated with both HT and PD. Bidirectional MR analysis demonstrated a significant causal effect of HT on PD (β=0.655, SE=0.278, P=0.019), while the reverse causal effect of PD on HT was not significant (β=0.002, SE=0.001, P=0.179). Sensitivity analyses further validated the robustness of the results.

This study found that hypertension is a risk factor for Parkinson's disease, and there is a common genetic basis and causal relationship between the two. The identification of shared genetic loci is of great significance in disease prevention and treatment strategies.

Hypertension, as the leading modifiable risk factor for cardiovascular disease morbidity and mortality, requires accurate blood pressure measurement as a cornerstone of its management. Conventional blood pressure monitoring is limited by its intermittent and static nature, and inability to capture readings during daily activities. Emerging blood pressure measurement technologies are rapidly being integrated into clinical practice; however, their adoption is hindered by the lack of international consensus regarding validation criteria for accuracy, usability, acceptability, and reliability. In response, this article convenes expert interpretation of the latest International Society of Hypertension Position Paper on Innovations in Blood Pressure Measurement and Reporting Technology, aiming to inform evidence-based recommendations for community-based hypertension prevention and control strategies in China.

Hypertension is a major chronic disease managed by primary healthcare institutions in China. Cardiac autonomic dysfunction is a key cause of blood pressure regulation imbalance and adverse cardiovascular events. Therefore, in primary healthcare institutions, the use of efficient and portable single lead wearable electrocardiogram (ECG) devices can help explore the relationship between elderly hypertensive patients and the autonomic nervous system, providing a simple, efficient, low-cost, and sustainable suitable method and objective basis for the management and prevention of cardiovascular disease in primary hypertensive patients.

To investigate the correlation between the duration of hypertension and autonomic nervous system damage in elderly patients in Primary Care institutions in the Ningxia Hui Autonomous Region using a single lead wearable ECG device.

A total of 2 137 elderly hypertension patients aged 65 years or older from 20 primary medical institutions in the Ningxia Hui Autonomous Region were enrolled in this study. ECG data of 72 hours, along with basic information, psychological health, and lifestyle data, were collected and uploaded to the cloud platform using a single-lead wearable ECG device from January 2022 to December 2022. Based on the heart rate variability (HRV) time-domain parameter standard deviation of all sinus rhythm RR intervals (SDNN), subjects were divided into two groups: a normal group (SDNN>100ms, n=470) and an abnormal group (SDNN<100 ms, n=1 667). Propensity score was used to match subjects on a 1∶1 basis, adjusting for confounding factors with a caliper value of 0.02, and the matching effect was verified using inverse probability weighting. Single-factor and multivariate Logistic regression analyses were conducted to investigate the relationship between the onset of hypertension and autonomic nerve damage, and the matching effect was further verified. Subgroup analyses were performed using propensity score matching based on the onset of hypertension and autonomic nerve damage, with sensitivity analyses conducted before and after matching. Additionally, a nonlinear association between the duration of hypertension and autonomic nerve damage was examined using restricted cubic splines (RCS) analysis to test interaction effects.

Among the patients, 479 had grade 1 hypertension, and 1 658 had grade 2 hypertension. Disease duration was categorized as follows: 1 203 patients had less than 5 years of disease duration, 753 had 5-<10 years, 110 had 10-<15 years, 41 had 15-<20 years, 26 had 20-<30 years, and 4 had more than 30 years. The multivariate Logistic regression analysis showed that the relationship between autonomic nerve damage and hypertension duration was positive after matching (P<0.001). Subgroup analysis showed that the relationship between hypertension duration and autonomic nerve damage was stronger in the 80-year-old and younger, lower-educated, no comorbidities of coronary heart disease, female, and those with obstructive sleep apnea (OSA) subgroups before and after matching, with statistically significant differences (P<0.05) and interaction effects (P<0.05). However, the RCS analysis showed no nonlinear relationship between the course of hypertension and autonomic nerve damage in matched patients.

There was a positive correlation between the course of hypertension and autonomic nerve damage in elderly hypertension patients from the primary healthcare centers of the Ningxia Hui Autonomous Region. Primary healthcare facilities should strengthen health education for patients to improve their treatment adherence, which can delay autonomic nerve damage in hypertensive patients.

The prevalence of hypertension is high and the control rate is low. It is also a basic disease of comorbidity in the elderly. However, previous studies have mainly focused on the comorbidity of the elderly, and less consideration has been given to studying the comorbidity based on hypertension. Therefore, understanding the comorbidity of hypertension in urban and rural elderly is of great significance for the management of elderly patients with hypertension at the grass-roots level.

In order to understand the current situation and influencing factors of comorbidity in urban and rural elderly hypertension patients in Anshun City, and to improve the management strategy for elderly hypertension patients comorbidity in urban and rural areas.

The elderly hypertension patients who participated in physical examination in primary medical and health institutions in Anshun City in 2023 were selected as the research objects. After variable screening and transformation, missing values and outliers processing, 44 571 samples were finally included in the analysis. Demographic characteristics were selected from the basic information of elderly hypertension patients, including age, gender, marital status, etc. Behavioral habits and existing major health problems were collected from physical examination data. Apriori algorithm was used to mine common comorbidity patterns, and multi-classification Logistic regression analysis was used to explore the influencing factors.

A total of 44 571 valid samples were included, including 19 270 (43.23%) in urban and 25 301 (56.77%) in rural areas. There were statistically significant differences in the number of comorbidities among elderly hypertension patients in urban and rural areas, different genders, age groups, exercise status, smoking status, drinking status, medication status, medication compliance, and different educational levels (P<0.001). The comorbidity rate of elderly hypertensive patients in Anshun City was 70.44% (31 397 cases), of which the urban comorbidity rate was 74.45% (14 346 cases) and the rural comorbidity rate was 67.39% (17 051 cases). The co-morbidity patterns of urban and rural males and females were mainly "obesity + hypertension, dyslipidemia + hypertension, obesity + dyslipidemia + hypertension". The support of "obesity + hypertension" in urban areas is much higher than that in rural areas, while the support of "anemia + hypertension" in urban areas is lower than that in rural areas. There were strong association rules of "kidney disease + hypertension" in urban and rural males. Male medication in urban and rural areas, high school education and above, and women 's medication in urban and rural areas were all related to the coexistence of one disease (P<0.05). The age and exercise of women in urban and rural areas, the medication of men in urban and rural areas, and the education level of high school and above were related to the coexistence of the two diseases (P<0.05). The age, exercise status, medication status of urban males and urban and rural females, and the education level of high school and above of urban and rural males were all related to the coexistence of three or more diseases (P<0.05) .

The comorbidity rate of elderly hypertensive patients in urban areas was higher than that in rural areas in Anshun city. The main comorbidity mode was "obesity+dyslipidemia / diabetes+hypertension". Age, medication, exercise and d education level are the influencing factors of hypertension comorbidity in the elderly. Strengthen the health monitoring of elderly patients with hypertension, strengthen the patient 's awareness of comorbidities, implement urban and rural differentiated comorbidity prevention strategies and measures, and improve the level of comorbidity prevention and treatment.

Obesity-related hypertension (ORH) , as a long-term persistent chronic disease, is growing in prevalence in China. Exercise is an important means of prevention and treatment for ORH, but due to the limitations of space, distance and cost in exercise rehabilitation, exercise completion and compliance are mostly difficult to ensure, and the health benefits of exercise are greatly reduced. Therefore, it is important to explore appropriate exercise prescription and management models.

To evaluate the clinical efficacy and safety of five-body balance exercise based on the "hospital-gym-community" model for patients with ORH.

This was a prospective randomised controlled study. 84 ORH patients recruited at Guang'anmen Hospital, China Academy of Traditional Chinese Medicine from June 2022 to December 2023 were selected and randomly divided into the experimental group (n=42) and the control group (n=42) by using the SPSS 26.0 online random number generator. Subjects in both groups received the same lifestyle intervention. The control group was provided with moderate-intensity aerobic exercise, and the experimental group was provided with the five-body balance exercise training based on the "hospital-gym-community" rehabilitation model for a period of 6 months. Systolic blood pressure (SBP) , diastolic blood pressure (DBP) , mean arterial pressure (MAP) , waist circumference (WC) , body weight (BW) , BMI, hip circumference (HC) , waist-to-hip ratio (WHR) , waist-to-height ratio (WHtR) , fasting blood glucose (GLU) , total cholesterol (TC) , low-density lipoprotein cholesterol (LDL-C) , very low-density lipoprotein cholesterol (VLDL-C) , triglycerides (TG) , serum ceramides (Cer) , Self-rating Anxiety Scale (SAS) , Self-rating Depression Scale (SDS) , Short-form Health Survey-36 (SF-36) , and Pittsburgh Sleep Quality Index (PSQI) were observed before and after the intervention in the two groups of subjects. The major adverse cardiovascular events (MACE) and exercise injuries that occurred during the intervention were also recorded.

Eventually 37 subjects in the experimental group and 36 subjects in the control group completed the trial. After 6 months of rehabilitation, SBP, DBP, MAP, WC, BW, BMI, HC, WHR, WHtR, LDL-C, Cer, SAS, SDS, and PSQI in the experimental group were lower than those in the control group (P<0.05) , SF-36 was higher than that in the control group (P<0.05) , and there was no statistically significant difference between GLU, TC, VLDL-C, TG in the experimental group and the control group (P>0.05) . After intervention, SBP, DBP, MAP, WC, BW, BMI, HC, WHR, WHtR, GLU, LDL-C, VLDL-C, TG, Cer, SAS, SDS, and PSQI were lower than before the intervention in the experimental group (P<0.05) , SF-36 was higher compared to the pre-intervention in the experimental group (P<0.05) , and the difference in TC before and after the intervention was not statistically significant (P>0.05) . There were no MACE or exercise injuries in both groups.

The five-body balance exercise based on the "hospital-gym-community" rehabilitation model can promote the blood pressure and morphological indexes of patients with ORH, improve the quality of life, and its efficacy is better than the conventional aerobic exercise, with good safety. It also reduces serum Cer levels, reflecting to some extent the potentially beneficial effects of the exercise programme in reducing cardiovascular risk.

Hypertension, diabetes, and dyslipidemia-commonly referred to as the "three highs" —are significant risk factors for cardiovascular and cerebrovascular diseases. Co-managing these conditions is crucial for reducing the morbidity and mortality associated with cardiovascular and cerebrovascular diseases; however, there is a notable lack of relevant research on the comorbidities of the "three highs" in Xinjiang.

To analyze the comparison of prevalence and comorbidity of hypertension, diabetes and dyslipidemia in Xinjiang residents, thereby providing data support for the co-management of the "three highs" within the local population.

Data were collected from the baseline of the Chronic Disease Prevention and Control Project of the Xinjiang Production and Construction Corps. A total of 5 673 residents aged 18 years and older participated in a questionnaire survey, physical examination, and laboratory examination conducted in 2022. In this study, the survey data of 4 990 eligible residents (87.96%) were included. The prevalence of the "three highs" (hypertension, hyperglycemia, and hyperlipidemia) and the comorbidity rate were analyzed. Multivariate Logistic regression analysis was employed to identify the risk factors associated with comorbidity of the "three highs" .

A total of 4 990 cases were included in the study, comprising 2 043 (40.94%) Han individuals, 2 666 (53.43%) Uygur individuals, and 281 (5.63%) from other ethnic groups. The standardized prevalence rates for hypertension, diabetes, and dyslipidemia were 32.66%, 14.03%, and 39.20%, respectively. The standardized prevalence of comorbidities was as follows: hypertension with diabetes (8.83%) , hypertension with dyslipidemia (15.31%) , and diabetes with dyslipidemia (8.05%) . The standardized comorbidity rate of the "three highs" was 5.36%. The rates of comorbidity for two and three diseases increased with age and body mass index (BMI) while decreasing with higher levels of education (P<0.05) . The dyslipidemia of the residents primarily characterized by elevated triglyceride levels (TG) (16.47%, 822/4 990) and low high-density lipoprotein cholesterol (HDL-C) levels (15.29%, 763/4 990) , with the prevalence of high total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) being significantly lower in men than in women (P<0.05) . Results from multivariate Logistic regression analysis indicated that age, BMI grade, and educational level were influencing factors for the comorbidity of "three highs" (P<0.05) .

The prevention and control of comorbidities associated with the "three highs" in Xinjiang remains challenging. Advanced age, overweight/obesity, and low educational attainment were risk factors for the comorbidity of the "three highs" . The joint management of the "three highs" and the comprehensive management of risk factors are crucial for the prevention and control of chronic diseases in the region.

Primary hypertension is a critical risk factor for coronary heart disease (CHD) , with approximately 20% of patients comorbid with CHD and a doubled risk of cardiovascular events. Traditional prediction models relying on single indicators exhibit limitations.

To evaluate the predictive power of combined brachial-ankle pulse wave velocity (baPWV) , serum total cholesterol (TC) , and N-terminal pro-B-type natriuretic peptide (NT-proBNP) detection for CHD risk in patients with primary hypertension.

A total of 310 patients with primary hypertension admitted to the Department of Integrative Cardiology of China-Japan Friendship Hospital from September 2020 to January 2022 were included. Based on CHD comorbidity, patients were divided into a hypertension-only group (n=116) and a hypertension-CHD group (n=194) . General clinical data, baPWV, serum TC, and NT-proBNP levels were collected. Binary Logistic regression analysis identified independent risk factors for CHD, and receiver operating characteristic (ROC) curves was used to assess the predictive efficacy of single and combined indicators.

The hypertension-CHD group exhibited significantly higher baPWV, TC, and NT-proBNP levels compared to the hypertension-only group (P<0.05) . Binary Logistic regression analysis revealed that baPWV (OR=1.016, 95%CI=1.001-1.031) , TC (OR=2.723, 95%CI=1.648-4.498) , and NT-proBNP (OR=1.006, 95%CI=1.001-1.010) were independent risk factors for CHD (P<0.05) . ROC analysis showed that the areas under the curve (AUCs) for baPWV, TC, and NT-proBNP in predicting CHD were 0.647, 0.760, and 0.693, respectively (P<0.05) . Combined detection achieved the highest AUC of 0.825 (P<0.05) .

The multidimensional model integrating baPWV (vascular elasticity) , TC (lipid metabolism) , and NT-proBNP (myocardial injury) significantly improves CHD risk identification in hypertensive patients (AUC>0.8) . This noninvasive combined detection strategy serves as a complementary risk stratification tool to traditional coronary angiography, offering evidence-based insights for early intervention.

In January 2022, Longhua District, Shenzhen piloted a digitally enabled generalist and specialist collaborative care model to deliver consistent, continues services for patients with chronic conditions managed in community health centers. This system-level initiative integrated hospital-based specialists and community-based general practitioners through a vertically aligned care model supported by a shared digital platform.

To evaluate the effect of this digitally enabled generalist-specialist collaborative care model on hypertension management capacity at community health centers.

We employed a difference-in-difference approach to examine changes in center level outcomes before and after the model was implemented during 2021-2024. The treatment group included 84 health centers in Longhua District, and the comparison group included 448 health centers in the rest of districts that were not influenced by the policy. Health centers in treatment group used the collaborative care model to delivery follow-up services, whereas health centers in comparison groups continued to provide routine services in accordance to the National Basic Public Health Services Program Standards (Third Edition) . Multivariate linear regression with district and time fixed effects was constructed, controlling for health center characteristics and adjusting for inverse probability of treatment weights, with standard errors clustered at the center level. Robustness checks were conducted to evaluate the reliability and stability of the model.

After the implementation of the digitally enabled collaborative care model, compared to centers in comparison groups, on average, quarterly standardized hypertension management rate and hypertension control rate in the treatment group increased by 4.3-percentage-point (DID=0.043, SE=0.011, P<0.001) and 11.5-percentage-point increase (DID=0.115, SE=0.012, P<0.001) per center, respectively. On average, the quarterly number of upward referrals per center decreased by 17.1% (P=0.038) , and the quarterly number of total patient visits per centers increased by 22.1% in treatment group (P=0.003) , as compared to comparison groups.

Our study highlights the significance of the digitally enabled specialist and generalist collaborative care model in enhancing health center capacity in hypertension management, reducing upward referrals, and optimizing resource utilization. Our study underscores the importance of incorporating this initiative into national health strategies, such as the National Basic Public Health Services Program, to strengthen chronic care management services delivery in more areas of China. Future policies and research should focus on scaling up this approach to a broader range of medical conditions and prioritizing investments in health centers by ensuring stable funding streams and optimizing the implementation strategies for digital integration pathway.

While the effectiveness of generalist-specialist collaborative care in chronic care management has been well-documented in high-income countries, evidence from China is limited.

To systematically evaluate the effect of multidisciplinary team-based care, collaboratively provided by hospital-based specialists and community-based generalists, on hypertension and diabetic outcomes in primary care settings in China.

In October 2024, a comprehensive literature search was conducted across PubMed, Cochrane Library, Web of Science, Embase, CNKI, Wanfang Data Knowledge Service Platform, VIP Database, SinoMed, covering publications from 2011-07-06 to 2024-10-14. The control group received standard health management services, while the intervention group received the collaborative model in addition to standard care. Two independent researchers performed literature screening, quality assessment, and data extraction, with consensus reached for any discrepancies. Meta-analysis was conducted using RevMan 5.4.1 and Stata 17.0 software.

Seventeen randomized controlled trials involving 21 591 participants were included, with 13 819 in the intervention group and 7 772 in the control group. Meta-analysis showed that the generalist-specialist collaborative care significantly improved outcomes for diabetic patients, including reduced glycated hemoglobin (MD=-0.72, 95%CI=-0.96 to -0.48, P<0.001) , fasting blood glucose (MD=-0.84, 95%CI=-1.04 to -0.65, P<0.001) , and 2-hour postprandial blood glucose (MD=-1.12, 95%CI=-1.52 to -0.72, P<0.001) . For hypertensive patients, the model significantly reduced systolic blood pressure (MD=-6.49, 95%CI=-7.53 to -5.44, P<0.001) and diastolic blood pressure (MD=-6.00, 95%CI=-8.89 to -3.12, P<0.001) . Subgroup analyses revealed significant differences in intervention effects across gender, age, and intervention duration. Egger's test indicated potential publication bias for glycated hemoglobin (P=0.003) and fasting blood glucose (P=0.002) .

The collaborative service model between generalist and specialists significantly improves blood pressure and blood glucose indicators in patients with hypertension and diabetes at the primary care level, and should be promoted as a key measure in chronic disease management within national basic public health services. High-quality and large community trials are needed to identify strategies to enhance an in-depth collaboration between hospital-based specialists and community-based generalists, thereby further improving population health and enhancing the efficiency of healthcare utilization.

Single-pill combination (SPC) for hypertension is an intensive treatment that can improve a patient's adherence to medication and antihypertensive efficiency. However, few studies have been conducted on the present status and factors that affect adherence to medication and blood pressure control rate in hypertensive patients in the community, who are taking SPC therapy in China.

The present study aims to determine the medication adherence and blood pressure control rate of community hypertension patients using SPC drugs in Huai'an, Jiangsu Province.

The present cross-sectional study was conducted by performing a questionnaire survey to investigate 387 hypertensive patients who took SPC antihypertensive drugs in Huai'an, Jiangsu Province, from June 2022 to December 2022. Multivariate Logistic regression was performed to analyze the factors for blood pressure control, and Pearson's correlation analysis was conducted to determine the relationship among medication adherence, self-efficacy, and medication satisfaction. A structural equation model was established for medication adherence and blood pressure control rate, with self-efficacy and medication satisfaction, in this population (SEM), in order to determine the path relationships among variables.

The blood pressure control rate for the 387 hypertensive patients who took SPC drugs was 32.30%. Furthermore, the proportion of patients who were unmarried/divorced/widowed, and overweight or obese was significantly lower in the blood pressure controlled group, when compared to the blood pressure uncontrolled group (P<0.05). The questionnaire survey results revealed that the medication compliance, self-efficacy, and medication satisfaction scores were significantly higher for patients in the blood pressure controlled group, when compared to those in the blood pressure uncontrolled group [ (6.45±1.10) vs. (6.00±1.50), (32.10±6.65 ) vs. (30.65±6.66), and (52.45±8.83) vs. (48.27±11.85), respectively; P<0.001]. Furthermore, the multivariate Logistic regression analysis results indicated that overweight or obese (OR=1.717, 95%CI=1.058-2.787, P=0.029), medication adherence (OR=1.461, 95%CI=1.202-1.775, P<0.001), self-efficacy (OR=1.052, 95%CI=1.011-1.095, P=0.013), and medication satisfaction (OR=1.025, 95%CI=1.000-1.051, P=0.048) were the factors that affected the blood pressure control rate. The Pearson's correlation analysis results revealed a linear positive correlation among treatment adherence, self-efficacy, and medication satisfaction (r=0.294, 0.226 and 0.280, respectively; P<0.05). The SEM results revealed that both self-efficacy and medication satisfaction were positively correlated to adherence (path coefficient=0.29 and 0.13; P<0.05), and that adherence was positively correlated to the blood pressure control rate (path coefficient=0.15, P<0.05) .

The blood pressure control rate for community hypertensive patients who take SPC drugs remains low. Factors, such as overweight or obese, medication adherence, self-efficacy and medication satisfaction, can influence the blood pressure control rate. Improving the self-efficacy and medication satisfaction of community hypertensive patients who take SPC drugs can effectively improve the medication adherence of patients, and in turn, improve the blood pressure control rate.

Hypertension is the primary cause of both death from stroke and the increased DALY burden of stroke. As the most important modifiable risk factor, the effective prevention and control of hypertension has become the core task of primary and secondary prevention of stroke. In February 2025, the World Stroke Organization and the World Hypertension League released the 2025 WSO/WHL Position Statement: Application of Hypertension Control Strategies in Stroke Prevention and Management. Based on the strategies and recommendations of the statement, this paper analyzes and interprets the practical evidence in the prevention and control of hypertension in China, and gives thoughts on constructing a hypertension prevention and control path with Chinese characteristics, aiming to provide reference for future applications and research of stroke prevention and management in China.

Hypertension is a global health issue that is increasingly manifesting in younger populations. Early-onset hypertension (≤40 years old) presents with complex underlying pathological mechanisms, challenging diagnoses of secondary causes, ambiguous timing for treatment initiation, and unclear management paradigms throughout the entire process. To address these issues, the British and Irish Hypertension Society (BIHS) issued a position statement in 2024 titled Assessment and Management of Early-onset Hypertension which provides guidance for standardizing the clinical management process of early-onset hypertension. Given the current absence of management documents suitable for early-onset hypertension in our country, this article organizes a team of clinicians from general practice and cardiovascular medicine to interpret the statement. The aim is to provide a reference for the management of early-onset hypertension in our country and to lay the groundwork for the development of documents tailored to our national conditions.

Non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (HDL-C) ratio (NHHR), a novel composite lipid index, is a potential biomarker for assessing cardiovascular disease risk. Still, its relationship with left ventricular hypertrophy (LVH) is unclear.

To explore the correlation between NHHR and LVH in hypertensive patients.

This is a cross-sectional study based on rural areas, and a stratified whole cluster sampling method was adopted in 2004-2005, in which 7 out of 22 townships in a county in Henan Province were selected using the simple random number method, and 63 out of the 180 villages under its jurisdiction were chosen randomly, and screening was performed among the long-staying rural residents aged 40-75 years, and finally 4 551 patients with hypertension were integrated. Patients were categorized into Q1 (NHHR≤2.05), Q2 (2.06≤NHHR≤2.58), Q3 (2.59≤NHHR≤3.20) and Q4 (NHHR≥3.21) groups according to NHHR quartiles. The clinical data of the patients in the four groups were compared. Logistic regression analysis was used to explore the association between NHHR and LVH. The consistency of the associations was confirmed using subgroup analyses.

The differences were statistically significant in the comparison of BMI, diastolic blood pressure (DBP), alanine aminotransferase (ALT), fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), HDL-C, low-density lipoprotein cholesterol (LDL-C), serum uric acid (SUA), serum creatinine (Scr), stroke history, coronary heart disease history and diabetes history indicators in the four groups (P<0.05). In the fully adjusted model, NHHR was associated with the risk of LVH, with the probability of LVH risk in groups Q3, and Q4 compared with group Q1 being 1.346 (95%CI=1.102 to 1.644, P=0.004) and 1.344 (95%CI=1.053 to 1.717, P=0.018) ; after controlling for all covariates except grouping variables, this relationship remained significant in subgroup analyses in the subgroups of females, <60 years of age, ≥60 years of age, no history of coronary artery disease, no history of stroke, and history of diabetes mellitus (P<0.05) .

This study, based on hypertensive patients in rural areas and using cross-sectional studies, revealed that high levels of NHHR were independently associated with LVH in hypertensive patients. The association was stronger in women and older subgroups, suggesting that NHHR can be used to identify patients at high risk of LVH in hypertensive populations and provide a basis for stratified management of those at high risk of LVH.

The control of hypertension is still unsatisfactory, as the number of patients continues to increase in China, and self-management plays a positive role in the prevention of relevant complications and reducing the economic burden of the disease. The influencing factors of prevalence and self-management are varied, but few studies have identified path coefficients and indirect effects between factors.

The aim of this study was to analyse the prevalence of hypertension and self-management and their influencing factors in rural Dayao County, Yunnan Province.

A multistage stratified random sampling method was used to select 2 499 rural residents aged≥35 years from Dayao County. Each participant received a questionnaire survey and underwent physical examination. Principal component analysis was used to construct the index of socioeconomic position (SEP) , whereas structural equation modelling (SEM) was used to analysis the possible influencing factors of the prevalence of hypertension and self-management.

Among the surveyed population, the prevalence of hypertension was 53.7%, and the rate of compliance to anti-hypertensive drugs, self-monitoring of blood pressure and taking measures to control hypertension was 84.5%, 82.0% and 88.3%, and was 52.4%, 82.2%, 80.8% and 87.8% for males and 55.0%, 86.8%, 83.2% and 88.8% for females, respectively. The prevalence of hypertension increased with age (χ²_trend=224.142, P<0.001), whereas the rate of self-monitoring of blood pressure decreased (χ²_trend=4.012, P<0.05). A greater prevalence of hypertension was observed in those with lower education levels and SEP (χ²=28.036, χ²_trend=12.147, P<0.001) . Individuals with good access to medical services had a higher rate of self-monitoring of blood pressure than their counterparts did (χ²=10.137, P<0.05) . The result of SEM indicated that the following factors had a direct statistically significant effect on the prevalence of hypertension: SEP (-0.43) , body shape (including overweight or obesity and central obesity status) (0.16) , physical inactivity (0.06) , and family history of hypertension (0.15) . However indirect effects on the prevalence of hypertension were observed for sex (0.23, through SEP) and age (0.35, through SEP and physical inactivity) . Similarly, the results also indicated that SEP (0.20) , alcohol consumption (-0.17) , and conditions of hypertensive patients (including the course of disease and complications) (0.53) had a statistically significant direct effect on the prevalence of self-management, while gender (0.06) had an indirect effect on prevalence of self-management through alcohol consumption.

There is a relatively high prevalence of hypertension and an overall high level of self-management in rural Dayao County. Future health education and management regarding hypertension should be strengthened for the elderly and individuals with low SEP and unhealthy lifestyles.

Hypertension is one of the most prevalent chronic diseases in China. As of 2021, there are over 270 million people suffering from hypertension in our country, which is the most significant risk factor for the death of urban and rural residents due to cardiovascular and cerebrovascular diseases. China has now entered the stage of comprehensively building a Healthy China, and exploring the construction of a chronic disease management path with the integration of healthcare and prevention as the core has become an important trend. This specification is based on the existing content and process of hypertension integration of healthcare and prevention services, and formulates standardized service diagnostic and treatment norms for the integration of hypertension healthcare and prevention. The content of the specification mainly includes basic requirements for service provision, service content, service process, etc., aiming to optimize the primary diagnosis and treatment and health management process of hypertension, control the incidence and mortality of hypertension, and reduce and delay the occurrence of complications, thereby effectively building a primary prevention and treatment line for chronic diseases.

Hypertension is one of the most prevalent chronic diseases in China, with its incidence showing a trend toward younger age groups. Unhealthy behavioral lifestyles are a significant risk factor for the development of hypertension. Therefore, it is crucial to investigate the impact of lifestyle behaviors on the quality of life in individuals with hypertension.

To investigate the impact of behavioral lifestyle on the quality of life in hypertensive patients and provide a scientific basis for developing effective behavioral intervention strategies.

The data for this study were derived from the 2022 Psychological and Behavioral Investigation of Chinese Residents (PBICR-2022), with hypertensive individuals as the study population (n=1 525). General characteristics and behavioral lifestyle information of the participants were collected. Physical activity levels were assessed using the International Physical Activity Questionnaire Short Form (IPAQ-7), and quality of life was evaluated using the EuroQol Five-dimensional Five-level Questionnaire (EQ-5D-5L). The impact of behavioral lifestyle on quality of life was analyzed using multiple linear regression and restricted cubic spline models.

The median EQ-5D-5L utility value was 0.951 (0.893, 1.000), and the median EQ-VAS score was 75.0 (60.0, 85.0) in hypertensive patients. The results of multiple linear regression analyses indicated that daily breakfast consumption, sleep quality, and daily sitting duration were significant factors influencing the EQ-5D-5L utility values and EQ-VAS scores (P<0.05). Current consumption of sugary beverages and average daily water intake were identified as factors influencing the EQ-VAS scores (P<0.05), while weekly physical activity level was found to be a significant factor for EQ-5D-5L utility values (P<0.05). The restricted cubic spline analysis revealed a linear dose-response relationship between daily sitting duration and both EQ-5D-5L utility values and EQ-VAS scores (P_{overall trend}<0.05, P_non-linear>0.05), with both utility values and EQ-VAS scores declining as daily sitting duration increased when the daily sitting duration exceeding four hours. Additionally, a near "n" -shaped nonlinear dose-response relationship was observed between weekly physical activity level and EQ-5D-5L utility values (P_{overall trend}<0.05, P_non-linear<0.05). As weekly physical activity level increased, the EQ-5D-5L utility values initially increased and then slightly decreased, with the peak occurring at a weekly physical activity level of 3 750 MET-min/week.

Adopting the habit of eating breakfast, increasing daily water intake, developing good sleep habits, and reducing the consumption of sugary beverages can improve the quality of life in hypertensive patients. In contrast, daily sitting duration exceeding four hours, as well as insufficient or excessive physical activity, may negatively impact the quality of life of hypertensive patients.

Starting from chronic diseases such as hypertension in 2014, Xiamen City has innovatively launched the "Three Teachers Joint Management" family doctor contract service model, providing patients with continuous services of "prevention, screening, treatment, management, education, and health", improving service quality, promoting doctor-patient harmony, and enhancing patients' sense of gain. However, there is currently a lack of research on the application effect of this model.

This article takes elderly hypertensive patients as the starting point to understand the health management effect of the "three teacher co management" family doctor contract service in Xiamen on elderly hypertensive patients, and analyzes the factors that affect patient blood pressure control, providing reference for continuously improving the health management effect of this service model.

Using a retrospective cohort study method, in March 2024, hypertensive patients aged 65 and above who participated in family doctor contracted services for the first time in 2021 and received family doctor contracted services for two consecutive years in six administrative districts under Xiamen City were selected as the contract group (n=15 154) , and hypertensive patients aged 65 and above who had never participated in family doctor contracted services were selected as the non contract group (n=8 838) . Collected general demographic information, lifestyle information, illness and medication status of patients through the Xiamen Basic Public Health Cloud Platform, match patients' participation in family doctor contracted services through the "Xiamen eHealth" platform, and collected patient physical examination results through the Xiamen Elderly Health Examination Data Platform. Compared and analyzed the blood pressure control, physical examination results, lifestyle, and medication compliance of patients in the contracted and unsigned groups in 2021 (baseline) and 2023, and used multiple Logistic regression analysis to investigate the impact of family doctor contracted services on patient blood pressure control.

The blood pressure control rate of patients in the contracted group in 2023 was higher than that in 2021 [60.10% (9 108/15 154) vs 76.78% (11 635/15 154) , P<0.05] ; the blood pressure control rate of patients in the unsigned group in 2023 was not significantly different from that in 2021 [62.24% (5 501/8 838) vs 68.61% (6 064/8 838) , P>0.05] . Compared with 2021, the average decrease in left diastolic blood pressure and right systolic blood pressure of contracted patients was significantly different from that of unsigned patients (both P<0.05) . The mean BMI and waist to height ratio of the contracted group patients decreased compared to 2021 (P<0.05) . The proportion of abnormal BMI, excessive waist to height ratio, fasting blood glucose measurement≥7.0 mmol/L, and abnormal electrocardiogram also decreased (P<0.05) . The exercise performance and medication adherence were significantly improved (P<0.05) . The results of Logistic regression analysis showed that signing up was more beneficial for blood pressure control in elderly hypertensive patients than not signing up (OR=1.625, 95%CI=1.536-1.719, P<0.05) .

The family doctor contract service in Xiamen has played a positive role in blood pressure control for elderly hypertensive patients. With the intervention of the family doctor team, patients can carry out more refined and personalized full process health management, improve their lifestyle, increase compliance, and achieve better hypertension control rates.

Obesity is the primary risk factor for essential hypertension, and patients with obesity-related hypertension exhibit higher rates of cardiovascular morbidity and mortality. Exercise-induced weight loss has become an effective therapeutic approach for these patients. However, cardiopulmonary function and blood pressure dynamics during different exercise phases in this population remain unclear.

To investigate the characteristics of cardiopulmonary function in obesity-related hypertensive patients across different BMI categories during various exercise stages, and to explore the relationship between cardiopulmonary exercise parameters and conventional left ventricular structural indices.

A total of 625 patients diagnosed with essential hypertension at the General Medicine Department/Hypertension Center/Cardiac Rehabilitation Center of Yan'an Hospital Affiliated to Kunming Medical University from January 2020 to July 2023 were retrospectively recruited. Participants were stratified into three groups based on the BMI: control group (n=209, 18.5 kg/m²< BMI <24.0 kg/m²), overweight hypertension group (n=210, 24.0 kg/m²≤ BMI <28.0 kg/m²), and obesity-related hypertension group (n=206, BMI≥28.0 kg/m²). Systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen uptake (VO₂), percentage of predicted VO₂ (VO₂%), VO₂ per kilogram (VO₂/kg), oxygen pulse (O₂ pulse), heart rate (HR) during cardiopulmonary exercise testing, and echocardiographic indices such as interventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVEDd), left ventricular mass (LVM), and left ventricular mass index (LVMI) at different exercise phases were recorded.

Peak-exercise SBP was significantly higher in the obesity-related hypertension and overweight hypertension groups compared to the control group (P<0.05). Peak-exercise O₂ pulse, VO₂, and anaerobic threshold VO₂ were significantly higher in the obesity-related hypertension group than those of the overweight hypertension and control groups (P<0.05). Conversely, peak-exercise VO₂/kg, VO₂%, and anaerobic threshold VO₂/kg, VO₂% were significantly lower in the obesity-related hypertension group than those of the overweight and control groups (P<0.05). Peak-exercise O₂ pulse was positively correlated with LVMI and BMI (r=0.098, 0.283; P<0.05). Peak-exercise VO₂/kg and VO₂% were negatively correlated with BMI (r=-0.372, -0.291; P<0.05). Peak-exercise SBP was positively correlated with BMI, LVM, and LVMI (r=0.069, 0.221, 0.151; P<0.05) .

Obesity-related hypertension patients exhibit reduced exercise cardiac function and exercise tolerance compared to normal-weight individuals. Higher BMI is associated with elevated peak-exercise SBP, O₂ pulse, LVM, and LVMI, suggesting abnormal increases in cardiac preload and afterload post-exercise. These physiological changes may contribute significantly to LVMI progression. Integrating cardiopulmonary exercise testing parameters with LVMI provides more precise cardiac function assessment for obesity-related hypertension.

Hypertension is a prevalent chronic condition with a sizable patient population and suboptimal blood pressure control rates, resulting in a substantial economic burden on individuals and society. Strengthening health management strategies for hypertensive patients is a crucial intervention to improve blood pressure control. Although standardized hypertension management has been widely implemented in primary care settings, existing studies indicate that blood pressure control rates in China remain unsatisfactory. This paper examines research did in China on the effectiveness of blood pressure control and the factors influencing it among hypertensive patients receiving standardized management. Several limitations in the current body of research are identified, including a paucity of high-quality studies, narrow research scope in terms of influencing factors, inconsistent selection of blood pressure metrics, varied approaches to evaluating long-term blood pressure management, and non-alignment of target blood pressure definitions with international guidelines. The paper proposes future research recommendations, such as standardizing blood pressure control criteria, expanding the study of patients under standardized management, broadening research perspectives to explore the impact of multilevel determinants on blood pressure control, and leveraging big data and artificial intelligence technologies to advance precision management for hypertensive patients.

While many studies have focused on the hospitalization costs of hypertensive patients, few have examined avoidable hospitalization in hypertensive patients using big data.

This study aims to assess the prevalence of avoidable hospitalization among elderly hypertensive patients in Guangdong Province, providing insights for the integration and optimization of healthcare resources in the province's medical communities.

Health data for elderly individuals in Guangdong and hospitalization records from 2022 were integrated using the Guangdong Province Primary Healthcare Information Management System, the Guangdong Province Universal Health Information Platform, and inpatient case data. Influencing factors such as the number of general practitioners (GPs) per 10 000 population and the number of visits to primary healthcare institutions were obtained from the 2022 Guangdong Provincial Health Statistics Yearbook. A Logistic regression model was used to analyze the factors contributing to avoidable hospitalization.

The rate of avoidable hospitalization among elderly hypertensive patients in Guangdong Province was 8.76%. The likelihood of avoidable hospitalization was significantly higher in females [OR (95%CI) =1.231 (1.217-1.246) ] compared to males. Using 90 years and older as a reference, hypertensive patients aged 65-69, 70-74, 75-79, and 80-84 years were 2.044 [OR (95%CI) =2.044 (1.981-2.109) ], and 1.640 times more likely to avoid the occurrence of hospitalization than older hypertensive patients aged 90 years and older, respectively [OR (95%CI) =1.640 (1.590-1.693) ], 1.288 times [OR (95%CI) =1.288 (1.248-1.329) ], and 1.110 times [OR (95%CI) =1.110 (1.073-1.147) ]. Using a GDP per capita of less than 100 000 yuan as a reference, hypertensive patients with a GDP per capita of 100 000 yuan and above were 1.314 times more likely to have an avoidable incidence of hospitalization than those with a GDP per capita of less than 100 000 yuan [OR (95%CI) =1.314 (1.278-1.350) ]. When the number of GPs was ≥4 per 10 000 population, hypertensive patients were 1.039 times more likely to have avoidable hospitalization compared to those in areas with fewer than 4 GPs per 10 000 population [OR (95%CI) =1.039 (1.105-1.063) ]. The probability of avoidable hospitalization decreased by 40.60% when the number of secondary and tertiary hospitals per 10 000 population was less than 0.20 [OR (95%CI) =0.594 (0.570-0.619) ]. Finally, compared to areas with fewer than 3 visits per capita to secondary and tertiary hospitals or grassroots institutions, those with ≥3 visits per capita had a 1.047 times higher probability of avoidable hospitalization in secondary and tertiary hospitals [OR (95%CI) =1.047 (1.021-1.074) ], and a 1.229 times higher probability in grassroots institutions [OR (95%CI) =1.229 (1.191-1.268) ] .

Gender and age are significant factors influencing avoidable hospitalization in elderly hypertensive patients. Higher GDP per capita, greater visit frequency, and more GPs were associated with increased likelihood of avoidable hospitalization, while the number of secondary and tertiary hospitals did not contribute to this risk.

The triglyceride-glucose-BMI (TyG-BMI) index is a novel indicator reflecting insulin resistance and has been proven to be associated with hypertension. However, there is a lack of research on the relationship between the TyG-BMI index and nocturnal ambulatory blood pressure parameters as well as nocturnal hypertension.

To explore the relationship between the TyG-BMI index and nocturnal ambulatory blood pressure parameters as well as nocturnal hypertension.

A total of 396 patients with essential hypertension who underwent ambulatory blood pressure monitoring (ABPM) at the Affiliated Hospital of North China University of Science and Technology from June 2022 to October 2023 were selected as the study subjects. Patients were divided into four groups based on the quartiles of the TyG-BMI index: Q1 (n=99), Q2 (n=99), Q3 (n=99), and Q4 (n=99). Baseline data, laboratory test results, and 24-hour ABPM results were collected. The TyG-BMI index, triglyceride-glucose (TyG) index, and triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) ratio were calculated. A generalized linear model was used to analyze the association between different TyG-BMI index groups and nocturnal ABPM parameters. Spearman correlation analysis was employed to assess the correlations of the TyG-BMI index, TyG index, and TG/HDL-C with nocturnal blood pressure indicators. Receiver operating characteristic (ROC) curves were plotted to analyze the predictive efficacy of the TyG-BMI index for nocturnal hypertension, and the area under the ROC curve (AUC) was calculated.

There were statistically significant differences in age, BMI, TG, total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), use of renin-angiotensin-aldosterone system (RAAS) inhibitors, and proportions of stroke, diabetes, and hyperlipidemia among the Q1 to Q4 groups (P<0.05). Significant differences were also observed in 24-hour average systolic blood pressure, 24-hour average diastolic blood pressure, daytime average systolic blood pressure, daytime average diastolic blood pressure, nocturnal average systolic blood pressure, nocturnal average diastolic blood pressure, nocturnal systolic blood pressure dip, nocturnal systolic blood pressure standard deviation, and nocturnal diastolic blood pressure standard deviation among these groups (P<0.05). The results of the generalized linear model indicated that the TyG-BMI index group was a significant influencer of nocturnal average systolic blood pressure (β=6.623, P=0.002) and nocturnal average diastolic blood pressure (β=4.553, P=0.001). When stratified by the presence of hyperlipidemia or diabetes, the Q4 group was found to be a significant influencer of nocturnal average diastolic blood pressure (β=8.462, P<0.001) in subjects without hyperlipidemia or diabetes, but no correlation was observed between the TyG-BMI index group and nocturnal average systolic blood pressure (β=4.604, P=0.097) or nocturnal average diastolic blood pressure (β=1.988, P=0.285) in subjects with hyperlipidemia or diabetes. Spearman correlation analysis revealed a positive correlation between the TyG-BMI index and nocturnal average systolic blood pressure (r_s=0.155, P=0.002) in hypertensive patients, and positive correlations between TG/HDL-C (r_s=0.193, P<0.001), TyG index (r_s=0.145, P=0.004), TyG-BMI index (r_s=0.250, P<0.001) and nocturnal average diastolic blood pressure. ROC curves were plotted for TG/HDL-C, TyG index, and TyG-BMI index to predict nocturnal hypertension, with AUCs of 0.570 (95%CI=0.513-0.627, P=0.017), 0.559 (95%CI=0.502-0.616, P=0.046), and 0.618 (95%CI=0.563-0.673, P<0.001), respectively. In subjects with hyperlipidemia or diabetes, the AUCs for TG/HDL-C and TyG-BMI index predicting nocturnal hypertension were 0.578 (95%CI=0.504-0.651, P=0.043) and 0.627 (95%CI=0.557-0.698, P=0.001), respectively.

In patients with essential hypertension, the TyG-BMI index is positively correlated with nocturnal average diastolic blood pressure. The TyG-BMI index has a high predictive value for nocturnal hypertension.

Hypertensive nephropathy, a common chronic kidney disease, is a significant contributor to end-stage renal disease. Analyzing and predicting its epidemiological trends is crucial for the prevention and control of chronic kidney disease.

This study aims to analyze the temporal trends in the incidence and mortality of hypertensive nephropathy in China from 1990 to 2021 and to provide a theoretical basis for developing prevention and control strategies.

Data on the incidence and mortality of hypertensive nephropathy in China were obtained from the Global Burden of Disease (GBD) 2021 database. Joinpoint regression models were used to analyze the average annual percentage change (AAPC) in incidence and mortality. Age-period-cohort models were applied to estimate the age, period, and cohort effects by gender. Bayesian age-period-cohort (BAPC) methods were employed to predict the standardized incidence and mortality rates for both genders from 2022 to 2032.

After age standardization, the age-standardized incidence rates (ASIR) for both males and females showed a slight decline from 1990 to 1995, followed by a gradual increase. The age-standardized mortality rate (ASMR) for males decreased from 5.44 per 100 000 in 1990 to 4.72 per 100 000 in 2021, while for females, it decreased from 3.86 per 100 000 to 2.75 per 100 000, with a more pronounced decline in females. Joinpoint regression analysis indicated an overall increasing trend in ASIR (AAPC for males: 0.43%, females: 0.64%, P<0.05). The fastest decline in male ASIR occurred from 1990 to 1992 (APC=-1.62%, P<0.05), while the fastest increase was from 2019 to 2021 (APC=1.30%, P<0.05). For females, the fastest decline in ASIR was from 1990 to 1995 (APC=-1.31%, P<0.05). Overall, the ASMR rate showed a decreasing trend (AAPC for males: -0.51%, females: -1.09%, P<0.05), with a more significant decline in females. The fastest decline in male ASMR was from 2004 to 2007 (APC=-3.26%, P<0.05), while the fastest increase was from 1998 to 2004 (APC=1.30%, P<0.05). For females, the fastest decline in ASMR was also from 2004 to 2007 (APC=-4.47%, P<0.05). Age-period-cohort analysis revealed that males generally had higher incidence and mortality rates than females across all age groups, with rates increasing with age. The incidence growth accelerated after age 60-65, and mortality growth accelerated after age 70. The period effect on incidence risk was slightly higher in females than in males, while the cohort effect showed an overall increasing trend in incidence and a decreasing trend in ASMR for both genders. Predictions from 2022 to 2032 indicate a continued rise in ASIR and a sustained decline in mortality for both genders.

From 1990 to 2021, the ASIR of hypertensive nephropathy in China showed an overall upward trend, while ASMR decreased. Both incidence and mortality increased with age, particularly in the elderly. Over the next decade, ASIR is expected to continue rising, while ASMR will decline slowly. These findings suggest a need to focus on male and elderly patients in developing targeted prevention and control measures.

The occurrence and development of obstructive sleep apnea (OSA) -associated hypertension is not only driven by traditional risk factors like obesity, the prevalence is much higher in individuals with fluid retention, suggesting the potential role of sodium in the pathogenesis.

To identify the urinary sodium excretion in patients with OSA-associated hypertension in Kunming City, and its correlation with the severity of OSA and hypertension.

A retrospective analysis was performed on 493 patients diagnosed with OSA-associated hypertension at the Hypertension Center of Yan'an Hospital Affiliated to Kunming Medical University from 2019 to 2021. According to the results of apnea hypopnea index (AHI), patients were divided into mild (5 times/h≤AHI <15 times/h), moderate (15 times/h ≤AHI <30 times/h) and severe (AHI≥30 times/h) groups. Clinical characteristics, laboratory testing, polysomnographic (PSG) data, and ambulatory blood pressure were compared among three groups. The correlation of 24-hour urinary sodium excretion with PSG data, ambulatory blood pressure, BMI, age, gender, glomerular function, urinary protein and other indicators was identified. Multivariate linear stepwise regression analysis was used to identify risk factors for 24-hour urinary sodium excretion in patients with OSA-associated hypertension.

Among 493 patients with OSA-associated hypertension, 103 were in the mild group, 187 in the moderate group, and 203 in the severe group. The 24-hour urinary sodium excretion was significantly higher in the severe group than the mild and moderate groups (P<0.05). There were significant differences in the AHI, low oxygen saturation (LSaO₂), mean oxygen saturation (MSaO₂), and nighttime mean systolic blood pressure (nSBP) among the three groups (P<0.05). There was a positive correlation of 24-hour urinary sodium excretion with AHI, BMI, 24-h mean systolic blood pressure (24 hMSBP), 24-h mean diastolic blood pressure (24 hMDBP), and male gender (r=0.223, 0.126, 0.109, 0.226, r_s=0.177, respectively; all P<0.05), there was negatively correlated with LSaO₂, MSaO₂, and age (r=-0.103, -0.090, -0.098, P<0.05). Multivariate linear stepwise regression analysis showed that the increase of AHI, 24 hMSBP, BMI, and male gender were all independent risk factors for 24-hour urinary sodium excretion in patients with OSA-associated hypertension (P<0.05) .

The 24-hour urinary sodium excretion is significantly higher in patients with severe OSA-associated hypertension than those with mild and moderate condition. Urinary sodium excretion is correlated with AHI, 24-h blood pressure, BMI, male gender, among which AHI has a strong correlation. AHI and blood pressure synergistically affect urinary sodium excretion in patients with OSA-associated hypertension, with a more pronounced effect posed by AHI.

Poor control of blood pressure in patients with essential hypertension can lead to cardiovascular complications and end-organ damage. Nowadays, there are few interventions on the circadian rhythmicity of blood pressure in clinical practice and lack of effective serologic indicators to assess the risk of cardiovascular disease in hypertension patients.

To investigate the correlation between circadian rhythmicity of blood pressure and oxidized low-density lipoprotein/β2-glycoprotein I complex (ox-LDL/β2GPI complex), high-sensitivity C reactive protein (hs-CRP), interleukin-6 (IL-6) and carotid atherosclerosis (CAS) in patients diagnosed with essential high blood pressure.

A total of 208 patients who were diagnosed with essential high blood pressure and treated in the Department of Cardiovascular Medicine of the Second Affiliated Hospital of Zhengzhou University from January 2024 to June 2024 were selected to undergo the measure of 24-hour blood pressure and were categorized into three groups according to the reduction of nighttime blood pressure: dipper (83 cases), non-dipper (83 cases) and anti-dipper (42 cases) groups. We collecte the general data of patients in each group and examine levels of lipids, glucose, liver function, kidney function, thyroid function, electrolyte, IL-6, hs-CRP, ox-LDL/β2GPI complex, etc. Then the ultrasound examination was performed to evaluate the carotid plaque. Finally, data collection and statistical processing were performed to analyze the correlation between circadian rhythmicity of blood pressure and levels of ox-LDL/β2GPI complex, hs-CRP, IL-6 and atherosclerotic carotid plaque.

There was no statistically significant difference in gender, age, BMI, smoking, total cholesterol, triacylglycerol, high-density lipoprotein, low-density lipoprotein and glycated hemoglobin among the 3 groups (P>0.05). Compared with the patients with dipper pattern of hypertension, the non-dipper and anti-dipper pattern of hypertension patients had higher levels of hs-CRP, IL-6, ox-LDL/β2GPI complex, and higher incidence of atherosclerotic carotid plaque (P<0.05). Besides, the anti-dipper group had higher levels of hs-CRP than the non-dipper group (P<0.05). The Pearson correlation analysis results showed that hs-CRP, IL-6, ox-LDL/β2GPI complex were positively correlated with nSBP (r=0.424, 0.245, 0.480; P<0.05). Multivariate Logistic regression analysis showed that nSBP (OR=1.091, 95%CI=1.007-1.182), hs-CRP (OR=5.141, 95%CI=1.700-15.541), and ox-LDL/β2GPI complex (OR=1.033, 95%CI=1.023-1.044) were independent influencing factors to the CAS in patients with essential hypertension (P<0.05) .

Our findings suggest essential hypertension patients with abnormal circadian rhythmicity have higher levels of inflammatory factors, carotid atherosclerosis, and plasma ox-LDL/β2GPI complex. Plasma ox-LDL/β2GPI complex is expected to serve as a predictor of cardiovascular disease risk in patients with essential hypertension.

Hypertension remains a major contributor to the global disease burden and mortality, representing a critical public health challenge. While the cumulative lipid accumulation product (LAP), a marker of abdominal and visceral fat deposition, has shown cross-sectional associations with hypertension, existing studies inadequately address the impact of long-term cumulative LAP exposure on hypertension risk. Furthermore, causal relationships between cumulative LAP and incident hypertension remain underexplored.

To evaluate the association between cumulative LAP and hypertension risk and assess its predictive capacity for incident hypertension.

Data were derived from the Guizhou Natural Population Cohort Study database. Participants were enrolled from November 20, 2010, to December 19, 2012, and followed up from April 2016 to October 2020. A total of 3 548 subjects were ultimately included in the analysis. Participants were divided into four quartiles based on cumulative LAP (Q1-Q4 groups) : Q1 (cumulative LAP ≤14.54, n=887), Q2 (14.54<cumulative LAP≤24.35, n=887), Q3 (24.35<cumulative LAP≤39.21, n=887), and Q4 (cumulative LAP >39.21, n=887). Subjects were further categorized into non-hypertension group (n=2 696) and hypertension group (n=852) based on the development of new-onset hypertension. The relationship between cumulative LAP and hypertension was evaluated using the Cox proportional hazards regression model. The dose-response relationship between cumulative LAP and hypertension risk was assessed using restricted cubic splines. Time-dependent receiver operating characteristic (ROC) curves were constructed to evaluate the predictive ability of cumulative LAP for hypertension. Participants with follow-up duration <3 years and those with pre-hypertension were excluded.

Among the 3 548 adults included, 1 607 (45.3%) were men and 1 941 (54.7%) were women, with a mean age of (42.5±14.1) years. During the follow-up period, 852 (11.2%) subjects were newly diagnosed with hypertension. Significant differences were observed between the non-hypertension and hypertension groups in terms of gender, age, education level, family history of hypertension, excessive intake of oil, excessive intake of salt, insufficient intake of fresh fruits, proportion of inadequate sleep, BMI, diastolic blood pressure, fasting plasma glucose (FPG), and cumulative LAP (P<0.05). The results of the Cox proportional hazards regression model showed that, compared with the Q1 group, the risk of hypertension increased progressively in the Q2 group (aHR=1.330, 95%CI=1.053-1.681), Q3 group (aHR=1.706, 95%CI=1.364-2.134), and Q4 group (aHR=2.339, 95%CI=1.869-2.928) after adjusting for potential confounders (P<0.05). The restricted cubic spline analysis revealed a non-linear dose-response relationship between cumulative LAP and hypertension risk (P_{non-linearity}<0.01), with the risk of new-onset hypertension increasing with cumulative LAP but stabilizing after cumulative LAP >65. The time-dependent ROC curves for predicting hypertension incidence showed that the area under the ROC curve (AUC) for the overall population was 0.617, 0.590, 0.603, and 0.634 for continuous average exposure of 6, 7, 8, and 9 years, respectively. The AUC for men was 0.600, 0.561, 0.571, and 0.558, and for women, it was 0.638, 0.629, 0.647, and 0.711. For urban populations, the AUC was 0.596, 0.565, 0.602, and 0.621, while for rural populations, it was 0.629, 0.592, 0.594, and 0.635.

Cumulative LAP is an independent risk factor for the onset of hypertension, but it is not an ideal indicator for predicting the onset of hypertension, and its predictive value for the onset of hypertension is relatively limited.

Elderly hypertension combined with cognitive impairment has been one of the global public health problems. A systematic evaluation of the prevalence of mild cognitive impairment (MCI) in elderly hypertension patients in China helps provide data support for the prevention and treatment of cognitive impairment in elderly hypertension patients.

To analyze the prevalence rate of MCI in elderly hypertensive patients in China by meta-analysis, and further explore the development trend of the prevalence rate.

Chinese and English databases including CNKI, Wanfang Data, VIP, CBM, PubMed, Cochrane Library, Embase and Web of Science were systematically searched from self-built database to February 22, 2024. NoteExpress software was used for literature management and screening, and the American Institute for Agency for Healthcare Research and Quality (AHRQ) cross-section research evaluation criteria was used for literature quality evaluation. Meta-analysis and subgroup analysis were performed by StataMP 14.0 software.

Twenty-seven cross-sectional studies from 2008 to 2023 were systematically analyzed, involving 57 461 elderly patients with hypertension and 11 812 patients with the disease. A random effects model was used for meta-analysis, and the overall prevalence was 21.3% (95%CI=18.4%-24.2%, P<0.001). A total of 11 provinces/cities/autonomous regions were included in the study, and the prevalence rate varied greatly among provinces/cities/autonomous regions and among geographical regions. The overall prevalence rate showed a fluctuating trend with time from 2008 to 2023. Subgroup analysis showed that the prevalence of MCI was 33.6% (95%CI=6.4%-60.7%, P<0.001) in rural and 21.8% (95%CI=18.1%-25.4%, P<0.001) in urban elderly patients with hypertension. The prevalence in North China (14.0%, 95%CI=9.3%-18.7%, P<0.001) was lower than that in other regions. The prevalence of MMSE+MoCA combined application was 25.9% (95%CI=15.8%-36.0%), and the prevalence of MoCA alone was 21.4% (95%CI=18.5%-24.4%) and MMSE alone was 17.9% (95%CI=13.9%-21.9%) .

The overall prevalence rate of MCI in elderly hypertensive patients in China is high, and there are great differences between different provinces and cities, urban and rural prevalence rate, and the trend of dynamic change with time. The detection rate of MCI varies greatly among different assessment tools, which is affected by the quantity and heterogeneity of literature studies. The conclusion needs to be confirmed by further high-quality studies.

With the continuous development of the concept and practice of "patient-centered" medical and health service, the traditional family doctor contract service model, which focuses on single-disease treatment and management, cannot effectively meet the service needs of patients with multiple chronic diseases.

To explore that preference of patients with hypertension and type 2 diabetes for family doctor contract service in Hainan Province, and to provide empirical evidence for optimizing the contract service plan of family doctor.

A multi-stage stratified random sampling method was used to conduct a questionnaire survey from July 2023 to February 2024. The service preference of family doctors with hypertension and type 2 diabetes comorbid patients in Hainan Province was measured by discrete choice experiment (DCE). The set preference attributes were institutional nature, implementation environment, doctor's title, service mode, medication guidance and out-of-pocket expenses, service content attribute. A mixed Logit model was constructed with Python 3.11.7 software for preference analysis.

A total of 581 questionnaires were sent out, and 558 were valid, with an effective recovery rate of 96.0%. Six attributes, including institutional nature, implementation environment, doctor's title, service mode, medication guidance and out-of-pocket expenses, had significant effects on patients' preference for family doctor contracted service (P<0.05). The service content attribute had no significant effect (P>0.05). Patients with HTN-T2DM prefer to choose government-run institutions, door-to-door service, priority referral, senior doctor title, 50 yuan/month and 2 weeks medication guidance.

The institutional nature being government-run is the most highly valued attribute for patients. Home visit services and priority referral are important attributes that influence the preference for family doctor contracted services. It is suggested that a personalized family doctor contract service plan based on the preferences of patients with chronic diseases and comorbidities be formulated with a patient-centered approach to promote the high-quality development of family doctor contract services.

The incidence and prevalence of chronic kidney disease (CKD) remain high. Hypertension and diabetes frequently coexist and jointly accelerate the progression of kidney disease. The lipid accumulation product index (LAPI) is a novel indicator for predicting cardiovascular disease and abnormalities in glucose metabolism, and its relationship with CKD warrants further investigation.

This study aimed to investigate the relationship between LAPI and the risk of developing CKD in patients with hypertension and abnormal glucose metabolism.

A retrospective cohort of 2 033 patients with hypertension and abnormal glucose metabolism admitted to the Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region from January 2012 to May 2019 was enrolled. General patient information and laboratory test indicators were collected. The LAPI was calculated, and the population was divided into four groups based on LAPI quartiles: Q1 (LAPI≤44.03, n=509), Q2 (44.03<LAPI≤64.68, n=508), Q3 (64.68<LAPI≤98.90, n=508), and Q4 (LAPI>98.90, n=508). Patients were followed up, with the endpoint event being CKD. Kaplan-Meier curves were used to analyze the cumulative incidence of CKD at different LAPI levels, and the Log-rank test was used to compare differences. Multivariate Cox regression models were employed to analyze the relationship between LAPI and CKD. Restricted cubic splines were fitted to the multivariate Cox regression model to explore the dose-response relationship between LAPI and CKD. Subgroup analysis and sensitivity analysis were conducted to test the stability of the relationship between LAPI and CKD.

Significant differences were observed in age, gender, BMI, waist circumference, heart rate, diastolic blood pressure, smoking, alcohol consumption, uric acid, total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, glycated hemoglobin, fasting blood glucose, use of calcium channel blockers, and hypoglycemic treatment among the 4 groups (P<0.05). Log-rank test results indicated that the cumulative risk of CKD increased with elevating LAPI levels (χ²=14.48, P<0.001). Multivariate Cox regression analysis revealed that for each standard deviation increase in LAPI, the hazard ratio (HR) for CKD increased by 12.5% (HR=1.125, 95%CI=1.035-1.223, P=0.005) ; compared to the Q1 group, the Q4 group had a 54.9% higher risk of CKD (HR=1.549, 95%CI=1.129-2.125, P=0.007). Restricted cubic spline regression analysis showed that LAPI>65.59 was a risk factor for CKD (P=0.007). Interaction and subgroup analyses revealed that the association between LAPI and the risk of developing CKD remained stable.

In patients with hypertension and abnormal glucose metabolism, a higher LAPI in the early stages increases the risk of developing CKD.

Vascular endothelial growth factor signaling pathway (VSP) inhibitors have gradually increased and been widely used recently, with a high incidence of inducing hypertension adverse events. VSP inhibitor induced hypertension is difficult to diagnose in a timely and the management of uncontrolled blood pressure is neglected, active blood pressure management strategies are essential. This paper summarized the status of VSP inhibitors treatment and its related hypertension, as well as the blood pressure management strategies for VSP inhibitor-related hypertension. The aim was to increase the awareness of VSP inhibitor-related hypertension among healthcare professionals and provide blood pressure management strategies for patients using VSP inhibitors to improve blood pressure control and cardiovascular health.

With the increasing incidence of hyperhomocysteinemia (HHcy) and hypertension in high-altitude regions, the relationships among homocysteine (Hcy), polymorphisms of Hcy metabolizing enzyme genes, blood pressure, and oxidative stress levels remain unclear. Exploring these correlations may provide new diagnostic and therapeutic insights for H-type hypertension in high-altitude areas.

To analyze the impact of altitude on polymorphisms of Hcy metabolizing enzyme genes, compare differences in blood pressure, Hcy levels, and oxidative stress levels among different genotypes, and explore the correlations between Hcy levels and blood pressure as well as oxidative stress.

From July 2023 to July 2024, 60 hypertensive patients (high-altitude hypertension group) and 30 healthy subjects (high-altitude healthy group) from the Yushu region (altitude: 3 800-4 200 m) were recruited from the Affiliated Hospital of Qinghai University. Additionally, 60 hypertensive patients (low-altitude hypertension group) and 30 healthy subjects (low-altitude healthy group) from the Xining region (altitude: 2 260 m) were included in the study. Baseline information and laboratory test results were collected from the subjects, and polymorphisms of Hcy metabolizing enzyme genes were detected. Pearson correlation tests were used to investigate the correlations among Hcy, blood pressure, serum oxidized glutathione (GSSG), nitric oxide (NO), and superoxide dismutase (SOD) levels.

There were no significant differences in age, gender, BMI, smoking history, drinking history, medication history, family history of hypertension, or ethnicity among the groups (P>0.05). The high-altitude hypertension group had higher Hcy, systolic blood pressure (SBP), diastolic blood pressure (DBP), and GSSG levels, and lower NO and SOD levels compared to the high-altitude healthy group and the low-altitude hypertension group (P<0.05). The high-altitude healthy group had higher SBP, DBP, and GSSG levels, and lower SOD levels compared to the low-altitude healthy group (P<0.05). The low-altitude hypertension group had higher Hcy, SBP, DBP, and GSSG levels, and lower SOD levels compared to the low-altitude healthy group (P<0.05). There was a significant difference in the genotype frequency of the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism between the hypertension groups at different altitudes (P<0.05), but no significant differences in the genotype frequencies of the MTHFR A1298C and methionine synthase reductase (MTRR) A66G polymorphisms (P>0.05). There were no significant differences in the genotype frequencies of the MTHFR C677T, MTHFR A1298C, and MTRR A66G polymorphisms between the healthy groups at different altitudes (P>0.05). Among the 120 hypertensive patients, 56 (46.67%) had the CC genotype, 43 (35.83%) had the CT genotype, and 21 (17.5%) had the TT genotype at the MTHFR C677T locus; 62 (51.67%) had the AA genotype, 51 (42.50%) had the AC genotype, and 7 (5.83%) had the CC genotype at the MTHFR A1298C locus; 62 (51.67%) had the AA genotype, 48 (40.00%) had the AG genotype, and 10 (8.33%) had the GG genotype at the MTRR A66G locus. At the MTHFR C677T locus, the TT genotype was associated with higher Hcy, SBP, NO, and SOD levels and lower GSSG levels compared to the CT and CC genotypes, and the CT genotype was associated with higher Hcy, SBP, NO, and SOD levels and lower GSSG levels compared to the CC genotype (P<0.05). At the MTHFR A1298C locus, the CC genotype was associated with higher Hcy levels and a higher proportion of HHcy compared to the AC and AA genotypes, and the AC genotype was associated with higher Hcy levels and a higher proportion of HHcy compared to the AA genotype (P<0.05). At the MTRR A66G locus, the GG genotype was associated with higher Hcy, NO levels, and a higher proportion of HHcy compared to the CC and AG genotypes, and the AG genotype was associated with higher Hcy, NO levels, and a higher proportion of HHcy compared to the CC genotype (P<0.05). Patients with HHcy had higher DBP and GSSG levels and lower NO and SOD levels compared to non-HHcy patients. Correlation analysis showed that Hcy was positively correlated with DBP and GSSG and negatively correlated with NO and SOD in hypertensive subjects, and NO was negatively correlated with DBP (P<0.05) .

Hypertensive patients in high-altitude regions have higher blood pressure and oxidative stress levels compared to those in low-altitude regions. However, the genotype distribution of the MTHFR C677T polymorphism tends towards the normal type, with a lower proportion of mutant genotypes that lead to increased Hcy levels, which deviates from traditional views. The relationship between polymorphisms of Hcy metabolizing enzyme genes and Hcy and blood pressure levels remains unclear, and further exploration is needed in the future.