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.

Hypertension is a common disease among residents, characterized by insidious onset, high incidence, high disability rate, low control rate, and low awareness rate, posing a significant threat to residents' health. In recent years, medical research has discovered a certain association between the lipid accumulation index (LAP) and hypertension. However, current cohort studies on the risk of hypertension incidence related to adult LAP are still limited. This research aims to explore the association between adult LAP and the incidence of hypertension through long-term follow-up observation, providing reliable scientific evidence for the prevention and control of hypertension in the population.

To investigate the relationship between lipid accumulation index in adults and the incidence of hypertension.

A baseline survey was conducted in 2010 among 9 280 individuals from 48 townships in 12 counties (districts) in Guizhou Province. Baseline information, physical examination results, and laboratory test results were collected from the participants. Follow-up surveys were conducted in 2016 and 2020. Multivariable Cox proportional hazards regression analysis was used to assess the correlation between LAP and the incidence of hypertension in the population. The Schoenfeld residual method was employed to test the proportional hazards assumption.

Ultimately, 3 774 individuals were included in this study, with 806 new cases of hypertension (21.36%) and 2 968 individuals without hypertension (78.64%). Statistically significant differences were observed between the two groups in terms of LAP, LAP distribution, gender, age, residence, occupation type, current smoking, harmful alcohol consumption, excessive oil intake, waist circumference, and triglyceride (TG) levels (P<0.05). Participants were divided into four groups based on LAP quartiles: Q1 (198 cases), Q2 (238 cases), Q3 (297 cases), and Q4 (394 cases). Multivariable Cox proportional hazards regression analysis revealed that the risk of hypertension in the Q4 group was 1.43 times that of the Q1 group (P<0.05). A non-linear dose-response relationship was observed between LAP levels and the risk of hypertension in the overall population (P_non-linear=0.004). Subgroup analyses showed that, among males, the risk of hypertension increased in the Q3 (HR=1.67, 95%CI=1.24-2.25) and Q4 (HR=1.62, 95%CI=1.20-2.16) groups compared to the Q1 group (P<0.05). In the 18-45 and 46-60 age groups, the risk of hypertension increased in the Q4 group compared to the Q1 group (HR=1.58, 95%CI=1.20-2.09, P<0.001; HR=1.51, 95%CI=1.07-2.11, P=0.018). Among individuals primarily engaged in physical labor, the risk of hypertension increased in the Q4 group compared to the Q1 group (HR=1.28, 95%CI=1.02-1.59, P=0.030). Among individuals primarily engaged in mental labor, the risk of hypertension gradually increased with elevated LAP levels compared to the Q1 group (P<0.05) .

As a simple indicator for assessing abdominal obesity, LAP has a certain predictive effect on the risk of hypertension. Its predictive efficacy varies among different populations, with better performance in males and middle-aged and young adults. LAP can serve as a screening indicator for classifying individuals at risk of hypertension in primary healthcare or medical examination settings during health management services.

The British and Irish Hypertension Society (BIHS) summarized guidelines from the National Institute for Health and Care Excellence (NICE), the European Society of Cardiology and the European Society of Hypertension (ESH), and published Adult Hypertension Referral Pathway and Therapeutic Management in the Journal of Human Hypertension on January 9, 2023. Based on the existing evidence and expert opinions, this article focuses on the referral criteria of hypertensive patients and the treatment of patients during the referral waiting period, so as to optimize the management of hypertensive patients by primary doctors. The purpose of this article is to interpret the core points of the consensus statement to provide recommendations for primary care physicians in China on the referral criteria and treatment of hypertensive patients during referral waiting period. In view of the complexity and regionalism of China's primary medical problems, it is still necessary for primary doctors to conduct comprehensive evaluation and practice the clinical practice plan that is most beneficial to patients.

Hypertension as a risk factor can significantly increase the morbidity and mortality of cardiovascular and cerebrovascular diseases, and effective control of hypertension is the key to prevent and treat cardiovascular diseases.

Collect literature on the evaluation of the effectiveness of hypertension management models in China. Evaluate the management effects of different models and provide a reference for further optimization of hypertension management models.

Using StataSE-64, a network Meta-analysis of the 18 included hypertension management model papers was performed using blood pressure control rates as an evaluation metric. The models included five models: joint hospital-community management, community management, hospital treatment management, general management, and combined Internet management.

Joint hospital-community management, community management, hospital management, and combined Internet management are all effective for hypertension control. The order is joint hospital-community management ≈ combined Internet management> hospital treatment management>community management>blank control. Among them, the joint hospital-community management model has significant effect on hypertension control; the joint hospital-community management model and combined Internet management has similar effect; and hospital management has better effect than community management.

In order to improve the hypertension management model, the construction of hospital-community-family management model in primary health care institutions should be promoted, and the combination of chronic disease management model and combined Internet model should be guided to strengthen the whole-life, whole-cycle management of chronic disease patients.

Hypertensive disorders of pregnancy (HDP) is one of the most common complications of pregnancy and one of the leading causes of maternal mortality worldwide. In 2023, the Society of Obstetricians of Australia and New Zealand released the A Summary of the 2023 Society of Obstetric Medicine of Australia and New Zealand Hypertension in Pregnancy Guideline. This article interprets its key contents and proposes suggestions on non-drug intervention measures and refined management processes for HDP in China, in order to provide a new basis for the management of HDP in China.

Postmenopausal women with hypertension are susceptible to coronary heart disease (CHD), and their prevalence and mortality of CHD are significantly higher than those before menopause. Based on the team's previous research, this study further combined with glucose and lipid metabolism, vascular elasticity and other related indicators to diagnose CHD in postmenopausal women with hypertension, in order to provide new ideas for clinical identification of CHD risk in postmenopausal women with hypertension.

To explore the correlation and predictive value of triglyceride glucose (TyG) index, ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), pulse pressure index (PPI) and arteriosclerosis index (AI) in postmenopausal women with hypertension.

From January 2019 to December 2022, this study selected postmenopausal women with hypertension who underwent coronary angiography for the first time in the Department of Integrative Cardiology of China-Japan Friendship Hospital, and divided them into CHD group and non-CHD group according to the results of coronary angiography. The clinical data such as TyG index, ABI, baPWV, PPI, AI were collected at the time of admission. Multivariate Logistic regression analysis was used to construct a CHD risk prediction model for postmenopausal women with hypertension, and a nomogram was drawn. Calibration curve, receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to evaluate the diagnostic efficiency.

In this study, 300 postmenopausal women with hypertension who underwent coronary angiography for the first time were included, including 141 cases in non-CHD group and 159 cases in CHD group. Multivariate Logistic regression analysis showed that ABI, baPWV, TyG index, PPI and AI were the influencing factors of CHD in postmenopausal women with hypertension (P<0.05), and a nomogram was drawn according to which. The ROC curve analysis results showed that area under the curve (AUC) for ABI, baPWV, TyG index, PPI, AI and joint predictive model were 0.662, 0.687, 0.659, 0.700, 0.612 and 0.808, the sensitivity and specificity of the predictive model were 0.780 6 and 0.741 0, respectively. The calibration curve showed that the predicted results were in good agreement with the actual results. The decision curve analysis showed that the nomogram has good clinical value.

ABI, baPWV, TyG index, PPI and AI are independent influencing factors for the occurrence of CHD in postmenopausal women with hypertension. The newly developed model can better predict the risk of CHD.

Hypertension is a growing public health problem in China. In recent years, more and more studies have begun to focus on the quality of life of hypertensive older adults, and explore the factors affecting their quality of life, which is of great significance for the development of effective health management programs for hypertension.

To measure the health state utility (HSU) of hypertensive older adults in Northwest China using the EQ-5D-5L scale and the 15D scale, evaluate the health-related quality of life (HRQoL) of them, and explore the main factors affecting HRQoL in the elderly.

A total of 2 000 older adults were randomly recruited in Lanzhou City, Gansu Province in 2021, the clinical data were collected through questionnaires, basic physical examination and laboratory tests, and HSU was measured using the EQ-5D-5L and 15D scales. Subgroup analysis, Tobit regression analysis and multiple linear regression analysis were used to evaluate the factors affecting HRQoL.

A total of 1 784 older adults participated in this study, 50.9% of them had normal blood pressure, 676 (37.9%) had stage 1 hypertension, 152 (8.5%) had stage 2 hypertension, 48 (2.7%) had stage 3 hypertension, the HSU of these older adults were 0.949, 0.942, 0.933, and 0.921 in the EQ-5D-5L, and 0.875, 0.863, 0.851, and 0.840 in the 15D scale, respectively. Tobit regression analysis showed that gender, age, years of education, occupational status, and annual income were associated with HSU in older adults in the EQ-5D-5L scale (P<0.05), multiple linear regression analysis showed that gender, age, years of education, hypertension, and alcohol consumption were associated with HSU in older adults in the 15D scale (P<0.05) .

The HSU of older adults in both EQ-5D-5L scale and 15D scale gradually decrease with the increase of blood pressure level, indicating a progressive impairment of HRQoL. Factors affecting HRQoL in older adults include gender, age, hypertension, years of education, marital status, occupational status, annual income and alcohol consumption.

Hypertension is a major risk factor for cardiovascular disease. Antihypertensive drug therapy should not only consider the characteristics of the patient's blood pressure but also the patient's comorbid conditions. Currently, there is a lack of research on the medication status and influencing factors of hypertensive patients based on family doctor services.

To investigate the current medication status of hypertensive patients who purchased family doctor contract services in Jieshou City, Anhui Province, to describe the association between patient medication behavior and patient characteristics, to explore the influencing factors of medication adjustment, and to analyze the rationality of medication use in primary hypertensive patients.

Using cluster sampling, from July to August 2021, 48 administrative villages were randomly selected from Jieshou City, Anhui. Data on patient characteristics and medication were collected through face-to-face interviews using a self-made questionnaire. According to the "National Guidelines for the Prevention and Management of Hypertension at the Primary Level (2020 Edition) ", the antihypertensive drugs mentioned by patients in the questionnaire were divided into five categories: category A includes angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), category B includes beta-blockers, category C includes calcium channel blockers (CCBs), category D includes diuretics, and category E includes single-pill combination drugs. Blood pressure data uploaded by patients over the past year were obtained from the backend of iFLYTEK's intelligent voice blood pressure monitor to analyze the medication behavior of patients with different characteristics. Multivariate Logistic regression analysis was used to explore the influencing factors of medication adjustment in hypertensive patients. In this study, "combination medication" refers to taking a combination drug or two or more antihypertensive drugs, and "medication adjustment" refers to patients previously taking other antihypertensive drugs.

A total of 3, 005 hypertensive patients were included in this study, including 1 291 males (43.0%) and 1 714 females (57.0%), with an average age of (65.5±9.8) years. The medication rate of hypertension was 79.1%, and the rate of combination medication was 40.2%. Among the 2 376 patients taking antihypertensive drugs, the rates of different types of antihypertensive drugs from high to low were (some patients had combination medication) : category E (39.6%), category C (35.1%), category D (20.3%), category A (20.1%), and category B (3.7%) ; the most frequently taken antihypertensive drug was compound lisinopril (33.7%). For patients with an average annual blood pressure ≥160/100 mmHg, 12.2% and 4.9% still did not take antihypertensive drugs. Patients' combination medication mainly involved category E antihypertensive drugs. For patients with an average annual "diastolic pressure≥100 mmHg" and "with complications", the rates of adjusted category A and C antihypertensive drugs increased relatively more; for patients with an average annual "systolic pressure ≥160 mmHg" and "without complications", the rate of adjusted category E antihypertensive drugs increased relatively more. Multivariate Logistic regression results showed that longer duration of medication (OR=1.042, 95%CI=1.031-1.053, P<0.001), education level above junior high school (OR=1.488, 95%CI=1.195-1.853, P<0.001), combined hyperlipidemia (OR=1.267, 95%CI=1.052-1.525, P=0.013), combined cardiovascular diseases (OR=1.394, 95%CI=1.166-1.667, P<0.001), and combined cerebrovascular diseases (OR=1.258, 95%CI=1.040-1.522, P=0.018) were promoting factors for medication adjustment in patients, while advanced age (OR=0.980, 95%CI=0.971-0.990, P<0.001) was an inhibiting factor for medication adjustment.

The medication rate among rural hypertensive patients in Jieshou City is high, mainly involving category E and C antihypertensive drugs. Longer duration of medication, education level above junior high school, combined hyperlipidemia, combined cardiovascular and cerebrovascular diseases are promoting factors for medication adjustment in patients, while advanced age is an inhibiting factor for medication adjustment.

Adverse childhood experiences (ACEs) are traumatic events or situations that individuals may experience during their childhood. Children living with prolonged and persistent adverse experiences may have lifelong effects on their physical and mental health. Most studies in Europe and the United States confirm that ACEs increase the risk of hypertension in adulthood. However, the association between different types of ACEs and hypertension in adulthood remains controversial. This study provides a comprehensive review of studies on the association between different types of ACEs and hypertension, which explores the effects of ACEs on hypertension in adulthood and potential mechanisms. This study also summarizes the current status of studies on ACEs and hypertension. It presents a prospective view of providing a basis for improving the early childhood developmental environment and preventing hypertension in adulthood.

Obesity and hypertension are global public health problems that place a huge burden on individual health and social economy. There is a close correlation between obesity and hypertension, both are major risk factors for cardiovascular diseases. In 2023, the Obesity Medicine Association (OMA) conducted a deep investigation into the mechanisms of obesity-related hypertension and published the Clinical Practice Statement on Obesity and Hypertension in the Obesity Pillars. This statement presents new recommendations for the prevention and treatment of obesity and hypertension. It also identifies ten important considerations for managing these disorders. The goal of this article's interpretation of the OMA statement is to help primary care physicians treat patients with obesity and hypertension more effectively by furthering the updating of China's clinical guidelines for these illnesses.

Hypertension is a common chronic disease that seriously endangers the health of the population. The primary-care doctors are the main force in the management of hypertension. However, the doctor-induced therapeutic of inertia greatly affects the achievement of primary-care hypertension control.

The aim of this study is to investigate the current status of therapeutic inertia among primary healthcare providers in the diagnosis and treatment process of hypertension, and analyze the causes of therapeutic inertia, providing a reference basis for improving hypertension control rates in China.

A simple random sampling method was used to distribute questionnaires to primary healthcare providers in 32 primary healthcare institutions in Tianjin from July to August 2023. The therapeutic inertia in the diagnosis and treatment process of hypertension was evaluated from three dimensions: "soft reasons" and "overestimation of treatment efficacy" as well as "medical insurance policies". Binary Logistic regression analysis was employed to explore the influencing factors of therapeutic inertia.

A total of 407 questionnaires were distributed in this study, and 386 valid questionnaires were collected, yielding an effective response rate of 94.84%. The average score for primary healthcare providers' knowledge of hypertension diagnosis and treatment was 6 (0.5), with a scoring rate of 61.11% (5.50/9.00). The total score for therapeutic inertia in hypertension management was 48 (7.0), with a scoring rate of 56.55% (45.24/80.00). The scores for the "soft reasons" dimension, "overestimation of treatment efficacy" dimension, and "medical insurance policies" dimension were 26 (4.8), 10 (2.0), and 6 (2.5) respectively, with scoring rates of 51.92% (25.96/50.00), 65.40% (9.81/15.00), and 46.40% (6.96/15.00) respectively. When comparing the average scores of the three dimensions of therapeutic inertia, the "overestimation of treatment efficacy" dimension had the highest score compared to the other two groups (P<0.05). Multivariate analysis indicated that gender, region, mastery of hypertension diagnosis and treatment, and a daily voulme of hypertensive individuals treated are the main factors influencing Therapeutic inertia among primary care physicians (P<0.05) .

Therapeutic inertia is prevalent among primary healthcare providers in the diagnosis and treatment process of hypertension. Low levels of hypertension treatment cognition, "overestimation of treatment efficacy", and "soft reasons" are the primary factors contributing to therapeutic inertia among primary healthcare providers. It is recommended to strengthen education on therapeutic inertia in hypertension, conduct diversified training on diagnostic and management knowledge, and promote clinical informatization and artificial intelligence decision-making systems to effectively improve the therapeutic inertia of primary healthcare providers in hypertension management.

Hypertensive disorders of pregnancy (HDP) is one of the leading causes of maternal and perinatal mortality worldwide, with increasing incidence and mortality year by year. In 2023, the U.S. Preventive Services Task Force (USPSTF) updated the recommendation statement on screening for hypertensive disorders of pregnancy by evaluating the latest research evidence and analyzing the benefits and harms of screening for HDP. The recommendation, compared with the 2017 version, further affirms the importance of blood pressure measurement in screening for HDP, affirms substantial net benefit, and recommends blood pressure measurement throughout pregnancy to screen for HDP. This article explores and analyzes the key points of this recommendation based on the RIGHT statement for introductions and interpretations of guidelines in Chinese (RIGHT for INT) and its implications for guiding general practitioners in China.

Hypertension, type 2 diabetes mellitus (T2DM), and dyslipidemia are collectively referred to as the "three highs", which often coexist in the same individual. It significantly increases the risk of hospitalization, death, and relevant burdens for affected people. It is necessary to jointly control the risk and standardize the treatment of hypertension, T2DM and dyslipidemia. Primary healthcare institutions have become the main battlefield for the prevention and treatment of chronic diseases. Existing clinical evidence provides important insights into the prevention, treatment, and management of the "three highs", although norms, consensus, and guidelines for the co-management of the "three highs" in primary healthcare institutions at domestic and foreign are current not available. Four academic organizations led by Beijing Hypertension Association organized primary healthcare workers and invited experts and scholars from medical fields of cardiovascular diseases, endocrine, pharmacy, and public health services to participate in the consensus. Through widely soliciting clinical practice needs of primary healthcare workers, integrating and evaluating the evidence related to the prevention and treatment of the "three highs" in primary healthcare institutions, the consensus for primary healthcare in the prevention and treatment of the "three highs" including 21 opinions was developed after multiple rounds of discussions, revisions, and voting. The recommended opinions of this consensus aim to improve the awareness and ability of primary healthcare workers in the prevention and treatment of the "three highs", provide scientific strategic support, implement management with primary healthcare characteristics, and lay a solid foundation for comorbidity co-management.

Although medicine is developing rapidly, many chronic diseases are still extremely challenging to manage and control at the moment. In China, the prevalence rates of hypertension are still on the rise, making early identification, therapy, and prevention of the condition crucial. Digital therapy makes use of the Internet to assist patients with hypertension in strengthening their understanding of hypertension, encouraging the proper administration of hypertension medication, and improving their ability to manage their own health. This paper aims to provide an overview of the current state of digital therapy application in the medical field, investigate the viability and suitability of these therapies for the treatment of hypertension, and anticipate the advancement of digital therapy-based hypertension management and treatment in the future. Future developments in digital therapy involve bringing together the knowledge of Chinese medicine health management, optimizing the benefits of digitizing both Chinese and western medicine for the diagnosis and treatment of hypertension, forming a professional team for digital therapy, safeguarding patient privacy and data security, and offering patients more convenient, effective, and secure preventive and treatment options.

Hypertension is a common chronic non-communicable disease in clinical practice, and its prevalence is on the rise globally due to population aging and changes in human lifestyles. Prolonged high blood pressure can lead to damage to various target organs such as the heart, brain, kidneys, and retina, severely threatening human health and being a major cause of global disease burden. The left ventricle, as the primary target of end-organ damage, its structural changes are also the pathological basis for the development of many cardiovascular diseases.

This study aims to explore the relationship between the atherogenic index of plasma (AIP) and serum lipoprotein-associated phospholipase A2 (Lp-PLA2) levels and left ventricular hypertrophy (LVH) in patients with primary hypertension.

A total of 167 patients with primary hypertension who visited the Department of Cardiovascular Medicine at the Second Affiliated Hospital of Zhengzhou University from October 2021 to June 2023 were enrolled in this study. Baseline data of the patients were collected, and fasting venous blood biochemical markers were measured. Echocardiograms were conducted within 24 hours of admission to calculate left ventricular mass (LVM) and left ventricular mass index (LVMI). Patients were divided into non-left ventricular hypertrophy (NLVH) group (87 patients) and LVH group (80 patients) based on LVMI. Pearson correlation test and Spearman rank correlation analysis were used to investigate the correlation between serum Lp-PLA2 level, AIP and echocardiographic parameters. Multivariate Logistic regression analysis was used to explore the influencing factors of LVH in hypertensive patients. Receiver operating characteristic (ROC) curve was plotted to explore the diagnostic value of serum Lp-PLA2 level and AIP in hypertensive patients with LVH, and the area under ROC curve (AUC) was calculated.

Patients in the LVH group had higher age, duration of hypertension, levels of N-terminal pro B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hs-CRP), left ventricular posterior wall thickness (LVWPT), interventricular septal thickness (IVST), left ventricular end-diastolic diameter (LVEDd), left atrial end-systolic diameter (LAESd), Lp-PLA2 levels, AIP, LVM, and LVMI compared to the NLVH group (P<0.05). Correlation analysis showed that LVMI was positively correlated with Lp-PLA2, AIP, NT-proBNP, hs-CRP, age, and duration of hypertension (P<0.05). LVWPT was positively correlated with Lp-PLA2, AIP, NT-proBNP, hs-CRP, and duration of hypertension (P<0.05). IVST was positively correlated with Lp-PLA2, AIP, hs-CRP, age, and duration of hypertension (P<0.05). LVEDd was positively correlated with Lp-PLA2, AIP, NT-proBNP, hs-CRP (P<0.05). Multivariate Logistic regression analysis showed that elevated hs-CRP (OR=1.249, 95%CI=1.007-1.548, P=0.043), elevated NT-proBNP (OR=1.009, 95%CI=1.002-1.017, P=0.011), increased AIP (OR=14.557, 95%CI=1.220-173.753, P=0.034), and increased Lp-PLA2 (OR=1.042, 95%CI=1.024-1.059, P<0.001) were risk factors for LVH in hypertensive patients. ROC curve results showed that the AUC for diagnosing hypertension combined with LVH using AIP, Lp-PLA2, and combined testing were 0.649 (95%CI=0.566-0.733), 0.780 (95%CI=0.705-0.854), and 0.804 (95%CI=0.733-0.874), respectively.

Serum Lp-PLA2 levels and AIP are closely related to changes in the morphological structure of the left ventricle. Combined testing of both can aid in the early clinical diagnosis of left ventricular hypertrophy in hypertensive patients, providing guidance for clinical diagnosis and treatment.

Hypertension and obstructive sleep apnea (OSA) often coexist, posing challenges in the management of blood pressure in these patients. A reliable and objective predictor is needed to anticipate the occurrence of hypertension and assess the status of blood pressure control in OSA patients, which would facilitate their blood pressure management.

To explore the correlation between red blood cell distribution width (RDW) and hypertension in patients with OSA.

A retrospective study was conducted at the Sleep Center of Peking University International Hospital, involving 510 patients who were diagnosed with OSA using polysomnography between January 2019 and September 2022. The derivation cohort comprised of 370 enrolled patients between January 2019 and December 2021, while the validation cohort included the remaining 140 patients enrolled between January and September 2022. Within the derivation cohort, patients were categorized into two groups based on their adherence to the definition of hypertension: hypertension group (n=211) and non-hypertension group (n=159). Subsequently, the hypertension group was further divided into two subgroups: blood pressure control subgroup (n=107) and blood pressure uncontrolled subgroup (n=104). The clinical characteristics and laboratory examination results of patients in the hypertension group and non-hypertension group, as well as those in the blood pressure control subgroup and blood pressure uncontrolled subgroup, were analyzed. Univariate and multivariate Logistic regression analyses were employed to investigate the predictors of hypertension in OSA patients and the status of blood pressure control in OSA patients with combined hypertension. The receiver operating characteristic (ROC) curve was plotted to evaluate the sensitivity and specificity of RDW in predicting the occurrence of hypertension among OSA patients, with its validity confirmed in the validation cohort.

The multivariate Logistic regression analysis revealed that an increased BMI (OR=1.087, 95%CI=1.007-1.174, P=0.032), diabetes (OR=3.310, 95%CI=1.484-7.380, P=0.003), and a decreased RDW (OR=0.598, 95%CI=0.507-0.704, P<0.001) were independent predictors of hypertension in OSA patients. Furthermore, an increased hemoglobin level (OR=1.027, 95%CI=1.005-1.050, P=0.016) and a decreased RDW (OR=0.804, 95%CI=0.669-0.965, P=0.019) were identified as independent predictors of poor blood pressure control status in OSA patients with combined hypertension. The results of ROC curve analysis for RDW in predicting hypertension in OSA patients showed that the area under the ROC curve was 0.779 (95%CI=0.732-0.826, P<0.001), with an optimal cut-off value identified at 39.9 fL. Considering the clinical usability, when using an RDW≤40 fL as the threshold value, the sensitivity and specificity for predicting hypertension in OSA patients were 70.14% and 81.76%, respectively. The validation cohort, utilizing an RDW cutoff value of ≤40 fL, demonstrated that RDW predicted the hypertension in OSA patients with a sensitivity of 63.64% and a specificity of 80.95%. The area under the ROC curve was 0.757 (95%CI=0.678-0.835, P<0.001) .

The reduction of RDW is associated with the occurrence of hypertension and poor blood pressure control status in patients with OSA. OSA patients exhibiting decreased RDW level are at an elevated risk for hypertension.

The low-pressure and low-oxygen environment at high altitude causes a series of changes in the metabolic level in the human body. The high altitude environment increases the level of oxidative stress and homocysteine in the body, which damages vascular endothelial cells. Hyperhomocysteinemia exacerbates oxidative stress, further aggravates the damage to the vascular endothelium, and accelerates the occurrence and development of hypertension. The combination of antioxidant drugs on the basis of traditional antihypertensive drug treatment provides a new direction for the treatment of H-type hypertension in high-altitude areas. This article reviews the relationship between vascular endothelial function and oxidative stress in patients with H-type hypertension in high-altitude areas, and explores its pathogenesis and possible treatments.

High prevalence and low control rate of hypertension have brought a significant disease burden globally. In order to improve the level of hypertension prevention and treatment, remote healthcare and digital medicine have been rapidly developed and widely used worldwide. Currently, there are no relevant regulations in China for these technologies. In 2023, the Italian Society of Arterial Hypertension issued a position statement to guide the development, validation, and clinical use of remote medicine and digital healthcare. This article will interpret this position paper, focusing on the forms of application of telemedicine and digital healthcare in managing hypertension and its related cardiovascular diseases, key research evidence, existing advantages, as well as current opportunities and challenges. The aim is to guide general practitioners in China on how to utilize these technologies in managing hypertension and related cardiovascular conditions.

The control rate for patients with hypertension remains suboptimal, with hypertensive patients experiencing a lower quality of life compared to healthy individuals. Enhancing life quality and lowering blood pressure in patients with hypertension through behavioral interventions is currently a critical area of research. Theoretical-based behavioral interventions are shown to be more effective and sustainable in modifying the behaviors of hypertensive patients. The Behavior Change Wheel (BCW) and Behavior Change Techniques (BCTs) are widely utilized in the management of chronic diseases globally to maximize the exploration of modifiable factors. Nevertheless, in the domestic context, studies on the impact of BCW and BCTs-driven behavioral interventions on the ambulatory blood pressure and quality of life of hypertensive patients are relatively limited, indicating a need for more comprehensive research.

This study aims to develop and evaluate the intervention based on BCW and BCTs, focusing on its impact on behavior, ambulatory blood pressure, and quality of life in hypertensive patients.

From December 2021 to August 2022, a hundred hypertensive patients who met the inclusion criteria were selected as study participants. They were allocated into an intervention group and a control group using a simple randomization method, with each group comprising fifty participants. Patients in the control group received conventional outpatient medication and health education lifestyle guidance. In contrast, patients in the intervention group was treated with standard medication supplemented by the BCW and BCTs-based intervention guidance.Before and after the intervention, assessments were conducted using the Hypertension Knowledge-Level Scale, the Chinese Version of the 8-item Morisky Medication Adherence Scale, the International Physical Activity Questionnaire-Short, the Patient Health Questionnaire-9, the General Anxiety Disorder-7, ambulatory blood pressure monitoring, and the 12-Item Short-Form Health Survey. The study examined changes in behavioral indicators, results of ambulatory blood pressure monitoring, and quality of life pre- and post-intervention.

The results indicated that after the intervention, the intervention group exhibited significantly higher levels of hypertension knowledge, medication adherence, quality of life scores, proportions of high medication adherence and engagement in moderate physical activity compared to the control group (P<0.05) . Additionally, the intervention group showed lower average daytime systolic and diastolic blood pressures, nighttime systolic and diastolic blood pressures, morning systolic and diastolic blood pressures, 24-hour systolic and diastolic blood pressures, variability coefficients of 24-hour systolic and diastolic blood pressures, BMI, anxiety scores, depression scores, and lower proportions of individuals with anxiety, depression, high sodium intake, and excessive alcohol consumption compared to the control group (P<0.05) .

The BCW and BCTs-based intervention model positively impacts behavioral interventions for hypertensive patients. It effectively improves the behaviors of these patients, lowers their blood pressure levels, and elevates their quality of life. This model is recommended for incorporation into the management of hypertension as a chronic disease.

Hypertension is a common chronic non-communicable disease affecting the health of the people in China. As an important gateway for hypertension management and control, the management ability of primary care directly affects the management effect. The current status and common rules of hypertension management in primary care in China need to be further explored.

To understand the current status of hypertension management in primary care in China, summarize the typical experience, and provide suggestions for the optimization of hypertension management in China.

From November to December 2021, semi-structured interviews were conducted with 29 hypertension management stakeholders in five provinces in China. Guided by the World Health Organization's health system, the interviews were analyzed from six dimensions of leadership and governance, service delivery, health workforce, health financing, access to medicines and equipment, and health information system.

For leadership and governance, hypertension management in primary care mainly relies on contracted family doctor service, and requires the collaborative management of medical institutions and public health departments. In terms of service provision, general practice and specialty integration services should be provided to meet the individual medical needs of patients. For health workforce, community general practitioners are the main force of hypertension management in primary care, and their work motivation should be improved by performance appraisal and distribution according to their work. For health financing, hypertensive patients can obtain preferential policy support of medical insurance reimbursement at primary care. For medicine accessibility, basic medical equipment and essential hypertension drugs are available in primary care. For health information system, the regional medical and health information platform can realize health information sharing and service coordination among contracted patients.

Primary health care institutions are responsible for the long-term follow-up and management of hypertension patients. It is necessary to further enhance the capacity of primary health care comprehensive management and primary health service supply, strengthen the capacity building of primary health care personnel, improve the reimbursement and payment system of medical insurance, improve the drug and equipment conditions for hypertension treatment in primary care, and effectively empower hypertension management in primary care through informatization, which can effectively improve hypertension management in primary care.

As the population suffering from hypertension tends to be younger, the National Basic Public Health Service Project focuses on monitoring individuals aged 35 and above. Presently, the number of hypertensive patients in the community is increasing annually, which significantly increasing the burden of community healthcare. However, few longitudinal studies have been conducted in recent years to investigate the changes in blood pressure and distribution of hypertensive patients after community management.

To explore the trends in blood pressure changes among hypertensive individuals aged 35 and above in community management, unveiling the trajectory and distribution characteristics of hypertension in this population.

This study relied on a retrospective cohort study established from 2020 to 2022 under the National Basic Public Health Service Project. From January 2020 to December 2022, hypertensive patients meeting the diagnostic criteria in the National Basic Public Health Service Specification (The Third Edition) were selected from community health service centers/stations in a certain district in Guiyang City responsible for basic public health services. Baseline data were collected using personal basic information forms (gender, age, and duration of hypertension). Follow-up data, including height, BMI, blood pressure, waist circumference (WC), follow-up methods, medication adherence, and control satisfaction, were collected using follow-up record forms. BMI, waist-to-height ratio (WHtR) of the research subjects were calculated. Follow-up was conducted every six months for a total of five times. Latent growth curve models (LGCM) and growth mixture models (GMM) were employed to explore the trajectories of blood pressure values during follow-up among hypertensive individuals aged 35 and above, and to identify latent clusters with similar trajectories. Further analysis was conducted to examine the distribution characteristics of different blood pressure trajectory groups.

A total of 15 958 hypertensive patients were included in the study, and both the baseline level and change rate of blood pressure in the hypertensive population were associated with the baseline level and change rate of BMI. Both systolic and diastolic pressures presented three similar trajectories of change. The three trajectories of systolic and diastolic blood pressure were defined and accounted for as 2.1% (332/15 958) /19.1% (3 052/15 958) in the group of low blood pressure increase, 5.7% (905/15 958) /6.1% (975/15 958) in the group of high blood pressure decrease, and 92.2% (14 721/15 958) /74.8% (11 931/15 958) in the group of stable mid-range blood pressure. Differences in disease duration, medication adherence, follow-up methods, control satisfaction, BMI, WHtR, and WC were statistically significant among different systolic pressure trajectory groups (P<0.05). Similarly, differences in gender, age, disease duration, medication adherence, follow-up methods, control satisfaction, BMI, WHtR and WC were statistically significant among different diastolic pressure trajectory groups (P<0.05) .

Blood pressure trajectory changes in the community-based management of hypertensive individuals aged 35 and above were primarily characterized by stable mid-range blood pressure. The trajectory of blood pressure change in people with different characteristics manifested differently, suggesting that tailored management measures should be targeted for community healthcare workers managing hypertensive populations.

The current prevalence of hypertension is increasing year by year, and its ocular complication, hypertensive retinopathy, is also receiving increasing attention. However, little attention has been paid to neuronal damage in hypertensive retinopathy.

To investigate the application and value of optical coherence tomography as a screening tool in the evaluation of neuronal damage in hypertensive retinopathy.

A total of 102 patients with hypertension who were admitted to Hospital Clínico Quirúrgico "Hermanos Ameijeiras" (HHA Hospital) from March 2019 to July 2020 were included as study subjects, as well as 45 healthy subjects as the control group to monitor 24-h ambulatory blood pressure. The average arterial blood pressure of 24-h diastolic and systolic blood pressure were taken, intraocular pressure (IOP) was measured and ocular perfusion pressure was calculated. The thickness of retinal nerve fiber layer (RNFL) and ganglion cell complex layer (GCC) in macular region were measured. The patients were divided into the control group (n=51) and uncontrolled group (n=51) according to their blood pressure control, with 45 healthy subjects as the control group. Pearson correlation analysis or Spearman rank correlation analysis were used to explore the correlation of blood pressure, ocular perfusion pressure, retinopathy and GCC thickness with blood pressure, as well as ocular perfusion pressure with retinopathy, and mediation analysis was performed using R 3.5.3 software.

There were significant differences in race, systolic blood pressure, diastolic blood pressure, average arterial pressure, IOP, ocular perfusion pressure and retinopathy among the three groups (P<0.05) . The average RNFL thickness in the uncontrolled blood pressure group was lower than that in the control group (P<0.05) , the average GCC thickness in the control group and uncontrolled blood pressure group was lower than that in the control group, and the minimum GCC thickness in the uncontrolled blood pressure group was lower than that in the control group (P<0.05) . Correlation analysis results showed that average GCC thickness, superior temporal GCC thickness and inferior temporal CCG thickness were negatively correlated with systolic blood pressure, diastolic blood pressure, ocular perfusion pressure and retinopathy (P<0.05) , while superior temporal GCC thickness was negatively correlated with systolic blood pressure, diastolic blood pressure and ocular perfusion pressure (P<0.05) ; inferior temporal CCG thickness was negatively correlated with diastolic blood pressure (P<0.05) , retinopathy was positively correlated with systolic blood pressure, diastolic blood pressure and ocular perfusion pressure (P<0.05) . The mediating effect showed a significant effect of "systolic blood pressure→average GCC thickness→hypertensive retinopathy" , with systolic blood pressure positively correlated with average GCC thickness, average GCC thickness positively correlated with hypertensive retinopathy (P<0.05) . Systolic blood pressure had a direct effect on the risk of hypertensive retinopathy (β=0.013, 95%CI=0.007-0.020, P<0.001) , and the average GCC thickness partially mediated the effect of systolic blood pressure on the risk of hypertensive retinopathy (β=0.117, 95%CI=0.014-0.360, P=0.04) , the mediating effect accounted for 11.7% of the total effect.

Optical coherence tomography is a non-invasive ophthalmological test that can detect hypertensive retinal neuronal damage superior to normal fundus examination, provide early prevention and warning of irreversible blindness and hypertensive target organ damage in hypertension-induced optic neuronal damage.

It is important to estimate the sodium intake of primary hypertension patients through 24-hour urine sodium excretion, but the collection and testing processes are complicated. It is not clear whether the existing equation for estimating 24-hour urinary sodium excretion from spot urine sample is valid in Chinese primary hypertension patients.

To evaluate the validity of the Kawasaki, INTERSALT, and Tanaka equations using spot urine samples to estimate 24-hour urinary sodium excretion among Chinese primary hypertension patients.

This study retrospectively selected hospitalized primary hypertension patients from Department of Cardiology Peking University International Hospital from March 2018 to March 2021. General data were collected. The 24-hour urinary sodium extraction in the 24-hour urine sample was measured. The 24-hour urinary sodium extraction from spot urine sample was estimated. Paired t-test was used to measure the significance of difference between the 24-hour urine sodium excretion from spot urine samples predicted using Kawasaki, INTERSALT or Tanaka equation and measured 24-hour urinary sodium excretion from 24-hour urine collections, and the correlation and agreement between them were analyzed using the Spearman correlation coefficient and Bland–Altman plots, respectively. Relative deviation was calculated. The accuracy of the three equations were also evaluated in patients with different levels of salt intake, diabetes or proteinuria.

One hundred and ninety-six patients were finally included for analysis. The average 24-hour urinary sodium excretion level was (165.04±78.53) mmol/d, which was equivalent to daily NaCl intake of (9.65±4.59) g/d. Female patients were older, had higher ratios of microalbuminuria and proteinuria, while lower BMI, diastolic blood pressure on admission, 24-hour average diastolic blood pressure compared with male patients (P<0.05) . Moreover, female patients were less likely to be smokers, and had lower spot urine sodium, as while as lower 24-hour urinary sodium excretion (P<0.05) . The 24-hour urinary sodium excretion estimated by Kawasaki equation was significantly higher than the measured value (t_paired=-8.008, P<0.001) , and the Bland-Altman plots showed that 94.90% spots were in 95%CI. The 24-hour urinary sodium excretion estimated by INTERSALT equation was significantly lower than the measured value (t_paired=4.167, P<0.001) . The Bland-Altman plots showed that 94.39% spots were in 95%CI. The 24-hour urinary sodium excretion estimated by Tanaka equation was higher than the measured value (t_paired=-0.547, P>0.05) without significant difference, and the Bland-Altman plots showed that 96.43% spots were in 95%CI. The relative deviation of Kawasaki, INTERSALT and Tanaka equations was -31.82%, 12.94 % and -1.90%, respectively. After dividing patients according to salt intake, the moderate correlation between predicted and actual values of each equation was no longer significant. There was no significant difference in the predictive accuracy of the equations between patients with and without diabetes or proteinuria.

The accuracy and consistency of the Kawasaki, INTERSALT and Tanaka equations in estimating 24-hour urinary sodium levels by spot urine in primary hypertension patients were poor. Tanaka's overall estimated value is the closest to the measured mean value. No comorbidity (such as diabetes, proteinuria) that might affect urinary sodium excretion was found to have a significant effect on the accuracy of the estimation equation.

H-type hypertension seriously affects people's health and quality of life. Currently, the clinical treatment of hypertension mainly selects drugs based on the experience, and the antihypertensive effect is not ideal. It is urgent to explore the pharmacogenetic polymorphisms of antihypertensive drugs and provide individualized medication guidance for hypertensive patients.

To investigate pharmacogenetic polymorphisms and the intervention effects of folic acid combined with vitamin D in patients with H-type hypertension in Jinan community, and provide reference for the implementation of integrated precision medicine for hypertension.

From June 2020 to June 2022, 200 hypertensive patients with poorly controlled blood pressure in 20 community health service centers of Huaiyin District, Jinan City, Shandong Province were randomly selected as the research objects. Before treatment, the gene polymorphisms of five commonly used individualized antihypertensive drugs, including diuretics, β-blockers, angiotensin-converting enzyme inhibitors (ACEI) , calcium channel inhibitors (CCB) , angiotensin-Ⅱ receptor antagonists (ARB) , were detected. Patients were randomly divided into the gene-directed treatment group (genome group) and gene-directed synergistic folic acid and vitamin D treatment group (gene-directed group) , with 100 cases in each group. The genome group adjusted the drug according to the characteristics of the detected hypertension gene loci; the gene-directed group received folic acid and vitamin D in addition to the genomic therapy regimen. Sitting systolic and diastolic blood pressures in the morning without antihypertensive drugs were collected from patients at the initial intervention (M₀) , 3 months of intervention (M₃) , and 6 months of intervention (M₆) . Case status, adverse reactions and stroke were recorded, gene sequencing was performed, and serum homocysteine (Hcy) concentration was detected. Pearson correlation analysis or Spearman's rank correlation analysis were used to explore the correlation between sex, age, systolic blood pressure, diastolic blood pressure and Hcy.

Gender (r_s=-0.463) , systolic blood pressure (r=0.181) and diastolic blood pressure (r=0.188) were correlated with Hcy level (P<0.05) . Among the 5 antihypertensive drug genes, CYP3A5 (A6986G) , CYP2C9 (c.1075A>C) , CYP2D6 (c.100C>T) were associated with polymorphism loci of drug metabolism enzyme genes, respectively. ADRB1, ACEI (I/D) , AGTR1 and NPPA were associated with the polymorphic loci of drug target sensitivity genes. Genome A6986G:CYP3A5*1/*1 (AA) , ACEI (I/D) :D/D, C.100 C>T:CYP2D6*1/*1 (CC) patients at M₃ and M₆ had lower diastolic blood pressure than M₀, A6986G:CYP3A5a1/a3 (AG) , ADRB1 C.1165 G>C:GG, c.1075A>C:CYP2C9*1/*3 (AC) , c.1075A>c:CYP2C9*3/*3 (CC) patients at M₆ had lower systolic and diastolic blood pressure than M₀, A6986G:CYP3A5*3/*3 (GG) , ADRB1 C.1165 G>C:CC, ACEI (I/D) :I/I, c.1075A>C:CYP2C9*1/*1 (AA) , AGTR1 C.1166A>c:AA, NPPA T2238C:TT, c.100 C>T:CYP2D6*10/*10 (TT) patients at M₃ and M₆ had lower systolic and diastolic blood pressure than M₀, ADRB1 C.1165 G>C:GC, ACEI (I/D) :I/D, c.100 C>T:CYP2D6*1/*10 (CT) patients at M₆ had lower systolic blood pressure than M₀, and lower diastolic blood pressure than M₀, the difference was statistically significant (P<0.05) . The results of intergroup comparison of Hcy levels showed that the Hcy level at M₃ and M₆ in the genome group was lower than the genome group, and the difference was statistically significant (P<0.05) . The results of intra-group comparison showed that Hcy level in the genome group at M₆ was lower than M₀, Hcy level in the gene-directed group at M₃ and M₆ was lower than M₀, and Hcy level at M₆ was lower than M₃, the differences was statistically significant (P<0.05) . The results of inter-group comparison of systolic and diastolic blood pressure showed that systolic and diastolic blood pressure of M₃ and M₆ gene-directed group were lower than the genome group, and the difference was statistically significant (P<0.05) . The results of intra-group comparison showed that systolic and diastolic blood pressure at M₆ in the genome group and gene-directed group were lower than M₀, and the systolic blood pressure at M₆ was lower than M₃, and the difference was statistically significant (P<0.05) .

There are differential expression of hypertension drug-related gene polymorphisms in community-based H-hypertensive patients, and the effect of individualized medication is remarkable. And combination therapy of folic acid and vitamin D can significantly reduce the level of H-hypertension.

Pregnant women with gestational diabetes mellitus (GDM) are often comorbid with hypertensive disorders of pregnancy (HDP), which can severely impact pregnancy health and delivery outcomes. The relationship between gut microbiota and pregnancy health has received increasing attention, but its association with concurrent HDP in GDM remains to be investigated.

To explore the association between gut microbiota characteristics and concurrent HDP in GDM patients.

The 204 patients with GDM who underwent prenatal examination at the Hangzhou Women's Hospital from August 2019 to January 2020 were selected as the study subjects. Pregnant women diagnosed with GDM only were categorized as the GDM group (n=181), while those concurrently diagnosed with GDM and HDP were categorized as the GDM with concurrent HDP group (n=23). Clinical data and inflammation detection markers of the enrolled pregnant women were collected, and fecal samples of the same period were retained for gut microbiota 16S rDNA amplicon sequencing analysis. LEfSe analysis was used to compare microbiota composition between the two groups at the phylum, family and genus levels, and to identify distinct bacterial enrichments. Logistic regression analysis was performed to identify gut microbiota characteristics associated with concurrent HDP in GDM. Spearman's rank correlation analysis was performed to explore the association between gut microbiota and inflammatory markers.

No significant differences were found in overall gut microbiota composition and relative abundances of major phyla between the two groups (P>0.05). LEfSe analysis on family level showed that the Veillonellaceae family was enriched in the GDM with concurrent HDP group (P<0.05), while Mollicutes RF39 unclassified family and Lachnospiraceae were depleted (P<0.05). At the genus level, Dialister, Intestinibacter, Eubacterium and Parasutterella were enriched in the GDM with concurrent HDP group (P<0.05), whereas [Eubacterium] xylanophilum group, Ruminiclostridium 6, Mollicutes RF39 unclassified genus and Lachnospiraceae unclassified genus were enriched in the GDM group (P<0.05). Logistic regression analysis results showed increased abundances of Veillonellaceae (OR=1.06, 95%CI=1.01-1.11), Dialister (OR=1.26, 95%CI=1.10-1.45) and Intestinibacter (OR=2.07, 95%CI=1.12-3.84) were independent risk factors for concurrent HDP in GDM (P<0.05), while increased Lachnospiraceae was a protective factor (P<0.05). Spearman's rank correlation analysis results showed Veillonellaceae was positively correlated with the proportion of monocytes (r_s=0.149, P<0.05) ; Dialister was positively correlated with leukocyte count, eosinophil leukocyte, and eosinophil count (r_s=0.151, 0.163, 0.171, P<0.05) .

Increased abundances of Veillonellaceae, Dialister and Intestinibacter are independent risk factors for concurrent HDP in GDM pregnant women, while increased abundance of Lachnospiraceae unclassified genus is a protective factor. Veillonellaceae and Dialister are positively correlated with multiple inflammatory markers. Gut microbiota may be an important risk factor for concurrent HDP in GDM.

The hypertensive population has a large base in China, and its preventive and treatment measures rely mainly on the chronic disease management service program within the National Basic Public Health Service. However, current studies have shown low utilization rate of it, so it is of great significance for improving the participation of the National Chronic Disease Management Service and health level in the hypertensive population to conduct a survey of participants to determine the factors affecting their treatment adherence.

To investigate and analyze the current status and influencing factors of treatment adherence of hypertension management services within the National Basic Public Health Service, and provide reference for improving treatment adherence in hypertensive patients.

A total of 295 participants of hypertension management services in the community served by a community healthcare center in Guangzhou City from June to September 2022 as the study subjects by using a multi-stage sampling method. The General Information Questionnaire and the Emotional Balance Scale (positive and negative emotions) were used to investigate the basic information of the study subjects, and the Hypertension Treatment Adherence Scale was used to investigate the current status of treatment adherence among the study subjects. Multivariate Logistic regression analysis was used to explore the influencing factors of treatment adherence to the National Chronic Disease Management Service in the hypertensive population, and the influence of the combined positive and negative emotion status on treatment adherence to the National Chronic Disease Management Service in the hypertensive population.

A total of 310 valid questionnaires were distributed, 295 valid questionnaires were recovered, with a validity rate of 95.2%; the total score of the Hypertension Treatment Adherence Scale was (94.24±8.67), of which the score of medication adherence was (21.06±2.45), medication malpractice was (31.33±3.90), tobacco and alcohol management was (8.44±1.88), and management of daily life was (33.41±4.61), with good adherence rate of 52.2% (154/295) ; the positive emotion score in the Emotional Balance Scale was (3.76±1.02), and the negative emotion score was (2.63±1.12) ; the results of multivariate Logistic regression analysis showed that gender, age, BMI, education level, blood pressure control, self-perceived physical condition, satisfaction with the point of care, more positive emotions and less negative emotions were the influencing factors for good treatment adherence to the National Chronic Disease Management Service in the hypertensive population (P<0.05) ; treatment adherence to the National Chronic Disease Management Service in the hypertensive population with a combined status of more positive and less negative emotions was 15.867 times higher than that of less positive and more negative emotions (P<0.05), and the treatment adherence with the combined status of more positive and more negative emotions was 5.114 times higher than that of less positive and more negative emotions (P<0.05) .

There is still room for improving treatment adherence to the National Chronic Disease Management Service for hypertensive patients. In addition to objective factors such as gender and age, there is also a need to focus on the emotional management, feedback effect of the treatment and the experience of patients in community healthcare canters.

The prevalence of hypertension in population is still increasing by year, and the significant increase in the prevalence of chronic diseases caused by aging of the population results in a serious medical burden. There are still about 450 million people in China who use solid fuels for cooking or heating, causing indoor air pollution as an important public health problem in China. At present, the relationship between solid fuels use and the risk of hypertension in Chinese older adults still remains unclear.

To analyze the association between solid fuels use and the risk of hypertension in older adults in urban and rural areas of China through a prospective cohort study, so as to provide a theoretical basis for the prevention and treatment of hypertension in the elderly.

This study is a prospective cohort study. Data were obtained from 2011 to 2018 China Longitudinal Healthy Longevity Survey (CLHLS) by using baseline questionnaire and physical examination. A total of 1 453 non-hypertensive older adults aged 65 years and above from 2011 to 2012 cohort were included in the study, and the occurrence of hypertension during follow-up was considered as the outcome indicator, follow-up as of 2018-12-31. The included subjects were divided into the clean fuel (electrical appliances such as induction cooker, pipeline natural gas, solar energy) group (n=654) and solid fuel (charcoal, kerosene, coal, firewood) group (n=799). Multivariate Cox proportional hazard regression model was used to analyze the association between cooking with solid fuels and the risk of hypertension.

A total of 1 453 non-hypertensive older adults at baseline with an average age of (77.6±8.8) years and a median follow-up of 7 years, and a total of 838 people developed hypertension at the outcome. The results of this study showed that the proportion of cooking with solid fuels in rural areas was significantly higher than that in urban areas (70.3% vs. 1.1%, P<0.05). Multivariate Cox proportional hazard regression model showed that cooking with solid fuels significantly increased the risk of hypertension〔HR=1.20, 95%CI (1.05, 1.38), P=0.01〕, and the adjustment for covariates still indicated that it increased the risk of hypertension〔HR=1.21, 95%CI (1.04, 1.41), P=0.01〕. In addition, cooking with solid fuels was positively associated with abnormal mean arterial pressure (MAP) 〔HR=1.26, 95%CI (1.02, 1.55), P=0.03〕; and the adjustment for covariates still showed positive association of it with abnormal MAP〔HR=1.28, 95%CI (1.02, 1.60), P=0.03〕.

Cooking with solid fuels in urban and rural areas of China significantly increases the risk of hypertension in the elderly, as well as affects MAP. Reducing the use of solid fuels for cooking and promoting the use of clean fuels is a simple and effective measure in the prevention and control of hypertension.

Hypertension and diabetes are two major chronic diseases affecting population health, and need to be controlled through chronic diseases follow-up. However, there is currently insufficient understanding of the impact of different chronic diseases follow-up forms and contents on disease control and healthy behaviors of patients.

To explore the impact of the chronic diseases follow-up on health behaviors and blood pressure/glucose control of patients with hypertension and diabetes in the context of treatment-prevention integration.

Yiyang County in Henan Province, Xianfeng County in Hubei Province and Yangqu County in Shanxi Province were selected as study sites to collect data from the basic public health information system from 2017-01-01 to 2022-06-30. Patient survey was conducted in July 2022 to collect information on basic public health follow-up receiving, health behaviors and disease control of patients. Finally, 102 769 patients with hypertension and 26 586 patients with diabetes were obtained from the basic public health information system, the data of 1 172 patients with hypertension and 456 patients with diabetes were obtained through patient surveys. Multivariate Logistic regression was used to analyze the effects of the standard-reaching frequency of follow-up, follow-up forms and contents on health behaviors and disease control of patients.

In 2021, the standard-reaching rates of follow-up frequency of patients with hypertension and diabetes were 90.83% (67 709/74 545) and 83.35% (13 390/16 065) , with frequency≥4 times/year as the standard. The follow-up forms included household follow-up〔25.74% (408/1 585) 〕, follow-up at institutional visits〔58.80% (932/1 585) 〕, telephone or network follow-up〔15.46% (245/1 585) 〕. The follow-up contents included blood pressure and blood glucose measurements〔91.15% (1 484/1 628) 〕, lifestyle guidance〔74.14% (1 207/1 628) 〕, disease inquiry〔70.02% (1 140/1 628) 〕, and drug use understanding〔69.29% (1 128/1 628) 〕. Multivariate Logistic regression analysis showed that patients with higher standard-reaching rates of follow-up frequency had higher rates of blood pressure control (OR=1.09, P<0.05) and glucose control (OR=1.31, P<0.05) , lower rates of smoking and drinking (OR=0.83, P<0.05) , and higher rates of regular exercise habits (OR=1.30, P<0.05) . The proportions of smoking and alcohol cessation (OR=2.38, P<0.05) and regular exercise habits (OR=1.62, P<0.05) were higher in the patients followed up at institutional visits than those followed up by telephone or network. The proportions of smoking and alcohol cessation (OR=2.33, P<0.05) and regular exercise habits (OR=2.54, P<0.05) of patients received household follow up were higher than those followed up by telephone or network. Patients who received lifestyle guidance, disease inquiry, and drug use understanding had higher rates of blood pressure control (OR=1.61, 1.34, and 1.62, respectively; P<0.05) , smoking and alcohol cessation (OR=3.59, 3.54, and 2.91, respectively; P<0.05) and regular exercise habits (OR=3.16, 2.15, 2.45, respectively; P<0.05) .

Receiving chronic diseases follow-up at least 4 times per year, with follow-up at institutional visits and household follow-up as the forms, provided with blood pressure and blood glucose measurements, lifestyle guidance, disease inquiry and drug use understanding as the contents in patients were positive correlated with blood pressure/glucose control, smoking and alcohol cessation, and regular exercise habits.

Previous studies have compared the first and another 3-day blood pressure levels in populations with no history of self-reported hypertension, but there have been few studies conducted in COVID-19 vaccine recipients.

To understand the blood pressure levels among 35-64-year-old COVID-19 vaccine recipients during regular COVID-19 containment, and to assess the differences between the first and another 3-day blood pressure levels and the factors affecting the fluctuation of blood pressure levels in the recipients with suspected hypertension, providing a reference and guidance for blood pressure measurement before COVID-19 vaccination.

In September 2021, 2 814 residents aged 35-64 with no history of self-reported hypertension were randomly selected for screening for hypertension before receiving COVID-19 vaccination at Qingling Community Health Service Center, Hongshan District, Wuhan City, Hubei Province. Blood pressure was measured and recorded as the first blood pressure measurement value, then based on this, those who were found with suspected hypertension〔systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg (1 mmHg=0.133 kPa) 〕standardizedly measured their clinic blood pressure for another three times on different days without the use of any antihypertensive drugs. Based on the 3-day blood pressure measurement results, the proportions of those with blood pressure in the ideal range (systolic blood pressure<120 mmHg and diastolic blood pressure<80 mmHg), in the high normal range (systolic blood pressure: 120-139 mmHg and/or diastolic blood pressure: 80-89 mmHg), and in the hypertensive range (systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg) were calculated, and the rate of hypertension diagnosis was compared between them by sex, age group, and the first blood pressure measurement level. The factors affecting the fluctuation of blood pressure levels (changes in blood pressure analyzed based on comparing the first blood pressure level and the 3-day blood pressure levels) in suspected hypertensive patients were analyzed using univariate and multivariate ordered Logistic regression.

Of the 2 814 cases, 36.67% (1 032/2 814) were suspected hypertensive patients. Analysis of the 3-day blood pressure levels indicated that the proportions of suspected hypertensive patients with a blood pressure level in the ideal range, high normal range and hypertensive range were 8.82% (91/1 032), 14.34% (148/1 032), and 76.84% (793/1 032), respectively. Among the cases with confirmed hypertension, the prevalence of stages 1, 2, and 3 hypertension was 63.68% (505/793), 26.48% (210/793) and 9.84% (78/793), respectively. The hypertension diagnosis rate was higher in females〔80.68% (380/471) 〕than that in males〔73.62% (413/561) 〕, with statistical significance (χ²=7.173, P=0.007). The hypertension diagnosis rate increased with the increase in the first blood pressure level in suspected hypertensive patients (χ² _trend =23.443, P<0.001). The factors affecting the fluctuation of blood pressure levels in suspected hypertensive patients were gender, age, time period for first blood pressure measurement, psychological factors and environmental noise≥40 dB during first blood pressure measurement (P<0.05) .

There are significant differences between the first blood pressure measurement results and 3-day blood pressure measurement results among suspected hypertensive patients. To improve the reliability of blood pressure measurement results to ensure the successful implementation of COVID-19 vaccination, it is suggested for community medical workers to ensure the vaccine recipients are in good mental state, and pre-vaccination blood pressure measurement for them is performed in a quiet environment, and to pay more attention to verify the reliability of pre-vaccination blood pressure level in males, the 55-64 age group, or individuals receiving blood pressure measurement at community health centers between 11: 01 in the morning and 14: 00 in the afternoon.