2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T40f,270 women were included in the final analysis (intervention n=132, usual care n=138; mean age 34, 60.4% from a self-reported non-Caucasian ethnic group). There was no difference in the primary outcome [hazard ratio (HR) 1.0, 95%CI 0.57-1.76; p=0.99]. There was also no difference in secondary fetal and maternal outcomes. The intervention group had fewer total antenatal attendances (median [inter-quartile range (IQR)]: 14 [10-17]) compared to usual care (16 [13-20]; p< 0.01), as well as fewer planned outpatient appointments (median [IQR]: 10 [8-12] vs. 13 [10-16]; p<0.01), without an associated increase in unscheduled hospital presentations. Women undertaking remote blood pressure monitoring were less likely to be admitted to hospital for any cause [HR 0.54, 95% confidence interval (CI) 0.30-0.97; p=0.04], as well as specifically for hypertension [HR 0.41, 95%CI 0.19-0.88, p=0.02]. More antihypertensive prescriptions filled per patient in the intervention arm compared to usual care (median [IQR]: 5 [3-9] vs. 3 [2-5]; p<0.01).31:Tc90,Women at high risk for developing preeclampsia are recommended to have additional blood pressure surveillance, but frequent outpatient attendances are demanding for patients and the healthcare system. It is unclear whether remote blood pressure monitoring can replace conventional office-based monitoring and improve healthcare utilisation without increasing the signal for harm. To evaluate the effects of substituting clinic blood pressure monitoring with remote blood pressure monitoring on fetal and maternal outcomes, and healthcare utilisation, in pregnant women at high risk of developing preeclampsia. Unblinded, non-inferiority, multicentre randomized controlled trial, with recruitment between July 2022 and February 2024 from 3 metropolitan hospitals in Australia. Participants were pregnant women at high-risk of developing preeclampsia based on clinical risk factors or combined first trimester screening tests, who are routinely referred to a specialist hypertension service for extra blood pressure surveillance, in addition to standard antenatal care. Women randomised to usual care attended these specialist hypertension clinics in-person, with frequency of appointments dictated by clinical need. Women randomised to remote blood pressure monitoring, in addition to receiving routine antenatal care, measured their own blood pressure using an automated blood pressure machine with data transmitted via a smartphone application for specialist review. The primary outcome was a perinatal composite of adverse events of at least one of perinatal loss, high-level neonatal care for over 48 hours or a small-for-gestational age baby (<10th centile for fetal weight). The primary outcome was assessed in the intention-to-treat population. The trial was prospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12620001049965p). 270 women were included in the final analysis (intervention n=132, usual care n=138; mean age 34, 60.4% from a self-reported non-Caucasian ethnic group). There was no difference in the primary outcome [hazard ratio (HR) 1.0, 95%CI 0.57-1.76; p=0.99]. There was also no difference in secondary fetal and maternal outcomes. The intervention group had fewer total antenatal attendances (median [inter-quartile range (IQR)]: 14 [10-17]) compared to usual care (16 [13-20]; p< 0.01), as well as fewer planned outpatient appointments (median [IQR]: 10 [8-12] vs. 13 [10-16]; p<0.01), without an associated increase in unscheduled hospital presentations. Women undertaking remote blood pressure monitoring were less likely to be admitted to hospital for any cause [HR 0.54, 95% confidence interval (CI) 0.30-0.97; p=0.04], as well as specifically for hypertension [HR 0.41, 95%CI 0.19-0.88, p=0.02]. More antihypertensive prescriptions filled per patient in the intervention arm compared to usual care (median [IQR]: 5 [3-9] vs. 3 [2-5]; p<0.01). Compared to usual care, remote blood pressure monitoring reduced antenatal outpatient appointments and the likelihood of inpatient admissions, without increasing adverse fetal and maternal outcomes. Women undertaking remote monitoring were also more likely to fill antihypertensive medication scripts.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Antihypertensive Therapy: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Antihypertensive Therapy (modality). Clinician-written summaries and actionable practice insights. 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The authors note these figures likely *overestimate* true prescribing rates, since the AHA control threshold (< 130/80 mmHg) is stricter than what was used.","limitations":"- Retrospective NHAMCS data with potential RFV coding inaccuracies\n- Study cohort predates 2025 ACEP and AHA guideline updates, limiting generalizability to current practice\n- Commentary format — no original data generated or analyzed","practice_takeaway":"Both ACEP (2025) and AHA now support prescribing antihypertensives at ED discharge for appropriate asymptomatic patients — evidence shows lower systolic BP at follow-up, fewer future hypertensive emergencies, and no increase in adverse events. Treat the uncontrolled BP visit as a public health opportunity, especially for patients with limited primary care access."}},{"doi":"10.1016/s1474-4422(26)00244-9","pmid":"42586098","title":"Intensive blood pressure lowering after spontaneous intracerebral haemorrhage for secondary stroke prevention (RECAP-ICH): a systematic review and individual participant data meta-analysis","journal_title":"The Lancet Neurology","journal_issn":"1474-4422","published_at":"2026-08-12T00:00:00.000Z","url":"https://doi.org/10.1016/s1474-4422(26)00244-9","source_score":49,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-17T13:33:15.358Z","updated_at":"2026-08-17T13:33:15.358Z","tags":[{"paper_doi":"10.1016/s1474-4422(26)00244-9","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s1474-4422(26)00244-9","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1016/s1474-4422(26)00244-9","tag_type":"condition","value":"Hypertension","value_numeric":null},{"paper_doi":"10.1016/s1474-4422(26)00244-9","tag_type":"condition","value":"Intracerebral Haemorrhage","value_numeric":null},{"paper_doi":"10.1016/s1474-4422(26)00244-9","tag_type":"condition","value":"Recurrent Stroke","value_numeric":null},{"paper_doi":"10.1016/s1474-4422(26)00244-9","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/s1474-4422(26)00244-9","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1016/s1474-4422(26)00244-9","tag_type":"modality","value":"Antihypertensive Therapy","value_numeric":null},{"paper_doi":"10.1016/s1474-4422(26)00244-9","tag_type":"sample_size","value":"n=2944","value_numeric":2944},{"paper_doi":"10.1016/s1474-4422(26)00244-9","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s1474-4422(26)00244-9","tag_type":"study_design","value":"Individual Participant Data Meta-Analysis","value_numeric":null},{"paper_doi":"10.1016/s1474-4422(26)00244-9","tag_type":"warning","value":"No specific antihypertensive drug classes or brand names were identified in the abstract; modality tags reflect the general therapeutic category only.","value_numeric":null},{"paper_doi":"10.1016/s1474-4422(26)00244-9","tag_type":"warning","value":"Only 4 of 24 assessed trials provided individual participant data, which may introduce selection bias and limit the breadth of conclusions.","value_numeric":null},{"paper_doi":"10.1016/s1474-4422(26)00244-9","tag_type":"warning","value":"The cohort is 75% Asian, so effect sizes may not fully generalize to non-Asian populations.","value_numeric":null},{"paper_doi":"10.1016/s1474-4422(26)00244-9","tag_type":"warning","value":"The PROSPERO registration number appears to contain a formatting anomaly (CRD420251274994) — may be worth verifying the exact registration ID.","value_numeric":null}],"summaries":{"what_studied":"This individual participant data (IPD) meta-analysis of 4 RCTs (n=2,944) evaluated long-term intensive blood pressure (BP) lowering vs. placebo or standard management for secondary stroke prevention in adults with prior spontaneous intracerebral haemorrhage (ICH), with median follow-up of 42 months.","key_result":"Intensive BP lowering reduced recurrent stroke (6.5% vs. 10.4%; adjusted HR 0.62, 95% CI 0.48–0.80; p=0.0002), driven largely by fewer recurrent ICH events (2.2% vs. 5.6%; adjusted HR 0.39, 95% CI 0.26–0.59; p<0.0001). A clinically meaningful 1% absolute risk reduction was achieved in just 6.1 months (95% CI 3.5–14.8). Serious adverse events were numerically lower in the treatment group (28.9% vs. 33.0%).","limitations":"Only 4 trials met full IPD eligibility criteria from 24 assessed, limiting breadth. The cohort was predominantly Asian (75.3%), which may limit generalizability to other populations. All trials used varied treatment strategies (fixed-dose vs. titrated targets), introducing potential heterogeneity in the intervention.","practice_takeaway":"Start or intensify BP-lowering therapy after ICH without delay — meaningful protection accrues within ~6 months and is consistent regardless of age, sex, baseline BP, or time since the index bleed. Sustained, long-term BP control should be the cornerstone of post-ICH secondary prevention."}},{"doi":"10.1161/jaha.125.048616","pmid":"42522939","title":"Population‐Level 10‐Year Implications of the New 2025 American Heart Association/American College of Cardiology Hypertension Guideline Recommendations for Primary Prevention in the United States: A NHANES‐Based Cohort Study (2009–2018)","journal_title":"Journal of the American Heart Association","journal_issn":"2047-9980","published_at":"2026-07-29T00:00:00.000Z","url":"https://doi.org/10.1161/jaha.125.048616","source_score":64,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-04T18:18:06.910Z","updated_at":"2026-08-04T18:18:06.910Z","tags":[{"paper_doi":"10.1161/jaha.125.048616","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1161/jaha.125.048616","tag_type":"category","value":"Cardiac & Cardiovascular Systems","value_numeric":null},{"paper_doi":"10.1161/jaha.125.048616","tag_type":"condition","value":"Cardiovascular Disease","value_numeric":null},{"paper_doi":"10.1161/jaha.125.048616","tag_type":"condition","value":"Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1161/jaha.125.048616","tag_type":"condition","value":"Diabetes Mellitus","value_numeric":null},{"paper_doi":"10.1161/jaha.125.048616","tag_type":"condition","value":"Hypertension","value_numeric":null},{"paper_doi":"10.1161/jaha.125.048616","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1161/jaha.125.048616","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1161/jaha.125.048616","tag_type":"modality","value":"Antihypertensive Therapy","value_numeric":null},{"paper_doi":"10.1161/jaha.125.048616","tag_type":"sample_size","value":"n=81000000","value_numeric":81000000},{"paper_doi":"10.1161/jaha.125.048616","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1161/jaha.125.048616","tag_type":"study_design","value":"Population-Based Cohort Study","value_numeric":null},{"paper_doi":"10.1161/jaha.125.048616","tag_type":"warning","value":"Simulation projections assume universal and sustained treatment uptake, which is a best-case scenario unlikely to be fully achieved in practice.","value_numeric":null},{"paper_doi":"10.1161/jaha.125.048616","tag_type":"warning","value":"The study was published July 29, 2026, but guideline-eligible subgroup definitions are based on the August 2025 AHA/ACC release; the guideline itself was not available at the time of data collection (2009–2018), so eligibility was applied retrospectively.","value_numeric":null},{"paper_doi":"10.1161/jaha.125.048616","tag_type":"warning","value":"The weighted sample of 81 million represents a survey-derived population estimate, not 81 million individually enrolled participants—effect size precision should be interpreted in that context.","value_numeric":null}],"summaries":{"what_studied":"This NHANES-linked cohort study (2009–2018, mortality follow-up through 2019) estimated the 10-year population-level impact of the 2025 AHA/ACC hypertension guideline—which recommends antihypertensive therapy at BP ≥130/80 mmHg for adults with diabetes, CKD, or ≥7.5% 10-year CVD risk—on US adults with hypertension but no baseline cardiovascular disease.","key_result":"Of 81.0 million US adults with hypertension, 22.8 million (28%) were newly guideline-eligible; 43% of those remained untreated. Antihypertensive therapy was associated with a 23% lower all-cause mortality (HR 0.77, 95% CI 0.63–0.94) and 50% lower cardiovascular mortality (HR 0.50, 95% CI 0.36–0.68). Universal treatment of the 9.7 million eligible but untreated adults was projected to prevent ~200,900 all-cause and ~162,600 cardiovascular deaths over 10 years, with the largest benefit in adults with diabetes.","limitations":"- Observational design limits causal inference; residual confounding cannot be excluded.\n- Simulation projections assume sustained full treatment uptake and stable effect sizes, which may not reflect real-world adherence or changing population risk.\n- Mortality follow-up extended only through 2019, so projections rely on extrapolation.","practice_takeaway":"Nearly 1 in 3 US adults with hypertension qualify for antihypertensive therapy under the 2025 AHA/ACC guidelines, yet over 2 in 5 of those eligible remain untreated—closing this gap could prevent more than 200,000 deaths in a decade. Prioritize treatment initiation especially in patients with diabetes, where projected mortality benefits are greatest."}},{"doi":"10.1212/wnl.0000000000218280","pmid":"42385118","title":"Genetic Risk for Alzheimer Disease, Midlife Hypertension, and Dementia","journal_title":"Neurology","journal_issn":"0028-3878","published_at":"2026-07-01T00:00:00.000Z","url":"https://doi.org/10.1212/wnl.0000000000218280","source_score":38,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-22T06:53:42.653Z","updated_at":"2026-08-22T06:53:42.653Z","tags":[{"paper_doi":"10.1212/wnl.0000000000218280","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000218280","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000218280","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000218280","tag_type":"condition","value":"Alzheimer Disease","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000218280","tag_type":"condition","value":"Dementia","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000218280","tag_type":"condition","value":"Hypertension","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000218280","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000218280","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000218280","tag_type":"modality","value":"Antihypertensive Therapy","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000218280","tag_type":"sample_size","value":"n=11597","value_numeric":11597},{"paper_doi":"10.1212/wnl.0000000000218280","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000218280","tag_type":"study_design","value":"Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000218280","tag_type":"warning","value":"Age group tagged as 'adult' and 'older_adult' because participants were enrolled at midlife (~54 years) but followed into older adulthood over 24–27 years.","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000218280","tag_type":"warning","value":"Statistical significance for hypertension-dementia associations in low- and medium-genetic-risk Black subgroups was not achieved, which may reflect limited power rather than true absence of effect.","value_numeric":null},{"paper_doi":"10.1212/wnl.0000000000218280","tag_type":"warning","value":"The 'practice_changing' flag is applied cautiously — while the finding is clinically actionable and extends existing guidance, it is observational and does not directly test antihypertensive treatment as an intervention.","value_numeric":null}],"summaries":{"what_studied":"This prospective cohort study (ARIC, 1987–2022) examined whether genetic risk for Alzheimer disease (AD) — defined by tertiles of a race-specific polygenic risk score — modifies the association between midlife hypertension (measured at age ~54 years) and incident dementia among 8,931 White and 2,666 Black participants followed for a median of ~24–27 years.","key_result":"Midlife hypertension was significantly associated with dementia across all genetic risk groups in White participants (HRs 1.19–1.34) and in high-genetic-risk Black participants (HR 1.31; 95% CI 1.04–1.66); no significant interaction was found between AD genetic risk group and hypertension. Hypertension was linked to a 0–2% higher absolute probability of dementia by age 80 and a 6–13% lower probability of dementia-free survival to age 80.","limitations":"- Associations in low- and medium-risk Black participants were consistent in direction but did not reach statistical significance, likely reflecting smaller subgroup sizes.\n- Polygenic risk scores were race-specific but may not capture full genetic diversity, and findings may not generalize beyond White and Black US adults.\n- Hypertension was measured at a single midlife visit, which may not reflect long-term blood pressure trajectory.","practice_takeaway":"Genetic risk for AD does not change who benefits from treating midlife hypertension — clinicians should prioritize blood pressure control regardless of a patient's AD polygenic risk. All adults with midlife hypertension, across ancestry groups and genetic risk strata, appear likely to gain dementia-risk reduction from antihypertensive therapy."}},{"doi":"10.1161/cir.0000000000001447","pmid":"42263147","title":"Use of Predicted Risk and Expected Benefit to Guide Decision-Making in Cardiovascular-Kidney-Metabolic Syndrome for the Primary Prevention of Cardiovascular Disease: A Scientific Statement From the American Heart Association and American College of Cardiology","journal_title":"Circulation","journal_issn":"0009-7322","published_at":"2026-06-09T00:00:00.000Z","url":"https://doi.org/10.1161/cir.0000000000001447","source_score":58,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-18T13:24:28.381Z","updated_at":"2026-06-18T13:24:28.381Z","tags":[{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"category","value":"Cardiac & Cardiovascular Systems","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"condition","value":"Atherosclerotic Cardiovascular Disease","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"condition","value":"Cardiovascular Disease","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"condition","value":"Cardiovascular-Kidney-Metabolic Syndrome","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"condition","value":"Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"condition","value":"Dyslipidemia","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"condition","value":"Heart Failure","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"condition","value":"Hypertension","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"condition","value":"Type 2 Diabetes","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"modality","value":"Antihypertensive Therapy","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"modality","value":"Cardiovascular Risk Assessment","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"modality","value":"Lipid-Lowering Therapy","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"modality","value":"Shared Decision-Making","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"study_design","value":"Scientific Statement / Clinical Practice Guideline","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"warning","value":"Study design label 'Scientific Statement / Clinical Practice Guideline' reflects the dual nature of this document; it accompanies the 2026 AHA/ACC CKM guideline.","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"warning","value":"The PREVENT equations are highlighted as the recommended tool, but external validation across all CKM subpopulations (e.g., advanced CKD stages, diverse ethnic groups) is not fully characterized in this document.","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001447","tag_type":"warning","value":"This is a scientific statement, not a clinical trial—no new primary outcome data are presented; level of evidence reflects expert consensus.","value_numeric":null}],"summaries":{"what_studied":"This AHA/ACC scientific statement evaluates a harmonized, risk-based framework for primary cardiovascular disease (CVD) prevention in adults with cardiovascular-kidney-metabolic (CKM) syndrome, using the PREVENT equations (PREVENT-CVD, PREVENT-ASCVD, PREVENT-HF) to guide initiation and intensification of antihypertensive, lipid-lowering, and CKM-targeted therapies.","key_result":"The statement recommends outcome-specific PREVENT risk thresholds to drive shared decision-making; integrating predicted risk with expected relative risk reduction yields individualized absolute risk reduction estimates, enabling quantitative benefit-based treatment decisions across obesity, diabetes, CKD, hypertension, and dyslipidemia.","limitations":"As a scientific statement rather than a primary study, it provides no new trial data or direct patient outcomes. Applicability of PREVENT equations across all demographic subgroups within CKM syndrome has not been fully validated. Implementation gaps in risk communication and clinician uptake are acknowledged but not quantified.","practice_takeaway":"Use the PREVENT equations (CVD, ASCVD, HF) to calculate a patient's 10-year risk, then pair that with the expected relative risk reduction from each therapy to estimate absolute benefit before starting or intensifying treatment. This approach supports individualized, shared decision-making for the full spectrum of CKM conditions—not just hypertension and lipids."}},{"doi":"10.1016/j.jacc.2026.05.007","pmid":"42263012","title":"Use of Predicted Risk and Expected Benefit to Guide Decision-Making in Cardiovascular-Kidney-Metabolic Syndrome for the Primary Prevention of Cardiovascular Disease","journal_title":"JACC","journal_issn":"0735-1097","published_at":"2026-06-09T00:00:00.000Z","url":"https://doi.org/10.1016/j.jacc.2026.05.007","source_score":31,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-13T15:34:39.730Z","updated_at":"2026-06-13T15:34:39.730Z","tags":[{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"category","value":"Cardiac & Cardiovascular Systems","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"condition","value":"Atherosclerotic Cardiovascular Disease","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"condition","value":"Cardiovascular Disease","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"condition","value":"Cardiovascular-Kidney-Metabolic Syndrome","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"condition","value":"Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"condition","value":"Diabetes","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"condition","value":"Dyslipidemia","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"condition","value":"Heart Failure","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"condition","value":"Hypertension","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"modality","value":"Antihypertensive Therapy","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"modality","value":"Cardiovascular Risk Assessment","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"modality","value":"Lipid-Lowering Therapy","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"study_design","value":"Scientific Statement / Clinical Practice Guideline","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"warning","value":"No sample size is applicable as this is not an interventional or observational study with enrolled participants.","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"warning","value":"The paper was published June 9, 2026; today is June 13, 2026 — this is a very recently released document and downstream clinical adoption data are not yet available.","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.05.007","tag_type":"warning","value":"This is a scientific statement/guideline narrative, not a primary research study — no new clinical trial data or patient-level outcomes are reported. Level of evidence assigned as expert consensus (7).","value_numeric":null}],"summaries":{"what_studied":"This scientific statement evaluates a harmonized, risk-based framework for primary cardiovascular disease (CVD) prevention in adults with cardiovascular-kidney-metabolic (CKM) syndrome, using the AHA/ACC PREVENT equations (PREVENT-CVD, PREVENT-ASCVD, PREVENT-HF) to guide initiation and intensification of antihypertensive, lipid-lowering, and CKM therapies.","key_result":"The framework integrates predicted risk with outcome-specific relative risk reductions to estimate absolute risk reduction (expected benefit) from drug therapy; specific PREVENT-based risk thresholds are proposed for staging, subclinical CVD detection, and treatment decisions across obesity, diabetes, CKD, hypertension, and dyslipidemia.","limitations":"As a scientific statement and guideline narrative, it does not present new primary trial data or report patient-level outcomes; the real-world impact of the recommended thresholds depends heavily on implementation, patient awareness, and clinician adoption.","practice_takeaway":"Use the PREVENT equations to estimate both CVD risk and expected absolute benefit before starting or intensifying preventive therapies in patients with CKM risk factors — this shifts the conversation from 'what is the risk?' to 'how much will treatment actually help this person?' Incorporate shared decision-making, addressing gaps in risk communication and equitable access to evidence-based therapies."}},{"doi":"10.1001/jamaneurol.2026.1706","pmid":"42258192","title":"Personalized Blood Pressure Targeting After Endovascular Therapy for Acute Ischemic Stroke","journal_title":"JAMA Neurology","journal_issn":"2168-6149","published_at":"2026-06-08T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13247842/","source_score":59,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-14T13:34:43.534Z","updated_at":"2026-06-14T13:34:43.534Z","tags":[{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"condition","value":"Acute Ischemic Stroke","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"condition","value":"Hemorrhagic Transformation","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"condition","value":"Large Vessel Occlusion","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"modality","value":"Antihypertensive Therapy","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"modality","value":"Endovascular Thrombectomy","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"modality","value":"Vasopressor Therapy","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"sample_size","value":"n=440","value_numeric":440},{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"warning","value":"Serious adverse events were numerically higher in the intervention group (15.8% vs. 12.0%), though not statistically significant; this asymmetry warrants monitoring in future studies.","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"warning","value":"The study enrolled only anterior circulation large-vessel occlusions with mTICI ≥2b; findings should not be extrapolated to incomplete reperfusion or posterior circulation strokes.","value_numeric":null},{"paper_doi":"10.1001/jamaneurol.2026.1706","tag_type":"warning","value":"The trial is open-label; clinicians and treating teams knew the assigned BP target, which could influence co-interventions beyond BP management.","value_numeric":null}],"summaries":{"what_studied":"This multicenter RCT (11 Spanish stroke centers, June 2021–October 2025) evaluated whether a reperfusion-guided systolic BP strategy (140–160 mmHg for mTICI 2b; 100–140 mmHg for mTICI 2c/3) improved 90-day functional outcomes vs. guideline-recommended management (systolic BP <180 mmHg) in 440 adults with acute ischemic stroke after successful endovascular therapy.","key_result":"At 90 days, 60.0% of the intervention group achieved mRS 0–2 vs. 47.1% in controls (ARD +13.3%; 95% CI 4.1%–22.6%; P = .005). Hemorrhagic transformation was lower in the intervention group (22.3% vs. 31.6%; OR 0.62, 95% CI 0.41–0.95). Symptomatic intracranial hemorrhage (3.5% vs. 3.9%) and 90-day mortality (15.4% vs. 15.6%) did not differ.","limitations":"- Open-label design (blinded endpoint assessment only) may introduce treatment bias.\n- Single-country trial (Spain) limits generalizability to other health systems and demographics.\n- Mean age of 75 years and anterior circulation occlusions only; results may not apply to younger patients or posterior circulation strokes.","practice_takeaway":"After successful thrombectomy, tailor post-procedure BP targets to reperfusion quality: aim for systolic 100–140 mmHg with complete reperfusion (mTICI 2c/3) and 140–160 mmHg with partial reperfusion (mTICI 2b) for 72 hours. This approach significantly improved good functional outcomes and cut hemorrhagic transformation rates without raising mortality or symptomatic hemorrhage risk."}},{"doi":"10.1161/strokeaha.126.055632","pmid":"42212393","title":"Intensive Versus Conventional Blood Pressure Lowering After Successful Endovascular Thrombectomy: OPTIMAL-BP 1-Year Outcomes","journal_title":"Stroke","journal_issn":"0039-2499","published_at":"2026-05-29T00:00:00.000Z","url":"https://doi.org/10.1161/strokeaha.126.055632","source_score":19,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-31T13:37:12.563Z","updated_at":"2026-07-31T13:37:12.563Z","tags":[{"paper_doi":"10.1161/strokeaha.126.055632","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055632","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055632","tag_type":"condition","value":"Acute Ischemic Stroke","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055632","tag_type":"condition","value":"Large Vessel Occlusion","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055632","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055632","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055632","tag_type":"modality","value":"Antihypertensive Therapy","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055632","tag_type":"modality","value":"Endovascular Thrombectomy","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055632","tag_type":"sample_size","value":"n=306","value_numeric":306},{"paper_doi":"10.1161/strokeaha.126.055632","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055632","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055632","tag_type":"warning","value":"The ITT primary endpoint (functional independence at 1 year) narrowly missed conventional statistical significance (P=0.051); the practice-changing flag is based on the convergent per-protocol result and consistency with prior short-term harm signals — clinicians should weigh this context.","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055632","tag_type":"warning","value":"The level of evidence is set to 2 (phase 3 RCT) rather than 1 because this is a 1-year follow-up extension of the original trial, not a pre-specified primary trial analysis.","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055632","tag_type":"warning","value":"The trial was conducted exclusively in South Korea; applicability to other ethnic or healthcare populations is uncertain.","value_numeric":null}],"summaries":{"what_studied":"This phase 3 RCT (OPTIMAL-BP, 19 centers in South Korea) compared intensive BP lowering (systolic BP target <140 mmHg) vs. conventional management (140–180 mmHg) for 24 hours after successful endovascular thrombectomy in acute ischemic stroke patients with large vessel occlusion and post-recanalization hypertension; 1-year outcomes were assessed in 294 of 306 randomized patients.","key_result":"Functional independence (mRS 0–2) at 1 year was lower in the intensive group vs. conventional group (40.5% vs. 52.7%; aOR 0.59 [95% CI 0.34–1.00]; P=0.051 by ITT; per-protocol: 41.1% vs. 54.7%, aOR 0.56, P=0.040); 1-year mortality and mRS shift from 3 months to 1 year did not differ between groups.","limitations":"- Open-label design (blinded endpoints only) may introduce management bias.\n- Single-country study (South Korea) limits generalizability.\n- ITT primary endpoint narrowly missed statistical significance (P=0.051), reaching significance only in per-protocol analysis.","practice_takeaway":"Avoid targeting systolic BP <140 mmHg in the first 24 hours after successful thrombectomy — the harm seen at 90 days persists at 1 year. Maintain systolic BP in the 140–180 mmHg range per current guidelines in this setting."}},{"doi":"10.1503/cmaj.251137-f","pmid":"42185004","title":"Prise en charge de la multimorbidité cœur–cerveau : un guide de pratique clinique","journal_title":"Canadian Medical Association Journal","journal_issn":"0820-3946","published_at":"2026-05-24T00:00:00.000Z","url":"https://doi.org/10.1503/cmaj.251137-f","source_score":10,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-06T13:22:59.649Z","updated_at":"2026-06-06T13:22:59.649Z","tags":[{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"category","value":"Medicine, General & Internal","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"condition","value":"Atrial Fibrillation","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"condition","value":"Cognitive Impairment","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"condition","value":"Coronary Artery Disease","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"condition","value":"Dementia","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"condition","value":"Depression","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"condition","value":"Dyslipidemia","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"condition","value":"Heart-Brain Multimorbidity","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"condition","value":"Hypertension","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"condition","value":"Myocardial Infarction","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"condition","value":"Stroke","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"modality","value":"Antihypertensive Therapy","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"modality","value":"Cognitive Behavioural Therapy","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"modality","value":"Herpes Zoster Vaccine","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"modality","value":"Influenza Vaccine","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"modality","value":"PCSK9 Inhibitor","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"modality","value":"Pneumococcal Vaccine","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"modality","value":"SSRI","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"modality","value":"Statin","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"study_design","value":"Clinical Practice Guideline","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"warning","value":"Evidence for vaccination and dementia outcomes is largely observational; recommendations on shingles vaccine and dementia are downgraded to level 3, grade C.","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"warning","value":"No sample size tag was applied: this is a guideline synthesizing multiple studies rather than a single primary study with one N.","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"warning","value":"Recommendations on behavioral interventions and diabetes–heart–brain comorbidity were not finalized due to insufficient evidence or failure to reach consensus threshold at time of publication.","value_numeric":null},{"paper_doi":"10.1503/cmaj.251137-f","tag_type":"warning","value":"This is a French-language translation of the original English guideline published March 30, 2026 (CMAJ 198:E425-39); the canonical citation should reference the English version.","value_numeric":null}],"summaries":{"what_studied":"This C-CHANGE clinical practice guideline evaluated the screening and management of concurrent heart–brain multimorbidity (atrial fibrillation + cognitive impairment, coronary artery disease + depression, hypertension + cognitive impairment, dyslipidemia + stroke risk, and vaccination for prevention of stroke/MI/dementia) primarily for primary care providers. Evidence was synthesized from systematic reviews, meta-analyses, and RCTs published up to August 2024.","key_result":"Eleven recommendations were issued: **Screen** patients with AF for cognitive decline (evidence level 2A, grade B) and CAD patients for depression (1B, grade B). **Treat** confirmed depression in CAD with SSRIs (1A, grade A) or CBT (1B, grade C); target systolic BP <120 mmHg in hypertensive patients at high CV risk to reduce cognitive impairment risk (1B, grade A); intensify LDL-lowering to <1.8 mmol/L in CAD (1A, grade A) and post-stroke (1B, grade B). **Vaccinate** routinely—especially those ≥65 years—against influenza (reduces CV death by 23–47%, stroke by 13–19%), pneumococcus (reduces MI RR 0.88, stroke RR 0.86–0.90), and shingles (reduces stroke OR 0.78, MI OR 0.63–0.73). Shared decision-making using evidence-based decision aids is also recommended (1A, grade B).","limitations":"- Most included studies were not designed to assess joint heart–brain outcomes directly, leading to evidence downgrading for nearly all recommendations.\n- Women and sex/gender-specific analyses were markedly underrepresented across the underlying trials (e.g., men comprised 75–83% of lipid-lowering trial participants).\n- Scope is intentionally narrow; many heart–brain comorbidity combinations (e.g., heart failure + cognition, diabetes + heart–brain disease, RSV/COVID-19 vaccination) lacked sufficient evidence for formal recommendations.","practice_takeaway":"Clinicians managing patients with AF, CAD, hypertension, dyslipidemia, or stroke should routinely screen for cognitive decline and depression, treat both cardiac and mental health conditions together, and proactively offer influenza, pneumococcal, and shingles vaccines to reduce downstream CV and dementia risk. Shared decision-making tools should be integrated into consultations to align care with patient values."}},{"doi":"10.1093/ckj/sfag128","pmid":"42125079","title":"Ten tips to control blood pressure in haemodialysis patients","journal_title":"Clinical Kidney Journal","journal_issn":"2048-8505","published_at":"2026-05-13T00:00:00.000Z","url":"https://doi.org/10.1093/ckj/sfag128","source_score":30,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-04-30","doi":"10.1093/ckj/sfag128","days":"14","issn":"2048-8505","rank":"6","field":"Clinical Medicine","score":"30","category":"Urology & Nephrology","categories":["Urology & Nephrology"],"_categories":["Urology & Nephrology"]},"pubmed":{"doi":"10.1093/ckj/sfag128","title":"Ten tips to control blood pressure in haemodialysis patients.","journal":"Clinical kidney journal","methods":"","results":"","abstract":"Hypertension is extremely common among individuals with kidney disease undergoing haemodialysis, with an estimated prevalence exceeding 80%. However, uncertainties remain on how best to manage hypertension in this group. 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Published by Elsevier Inc."}],"deposited":{"date-time":"2026-05-14T01:20:37Z","timestamp":1778721637000,"date-parts":[[2026,5,14]]},"issn-type":[{"type":"print","value":"0002-9378"}],"published":{"date-parts":[[2026,4]]},"publisher":"Elsevier BV","reference":null,"short-title":[],"update-policy":"https://doi.org/10.1016/elsevier_cm_policy","alternative-id":["S0002937826002103"],"content-domain":{"domain":["ajog.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"original-title":[],"container-title":["American Journal of Obstetrics and Gynecology"],"published-print":{"date-parts":[[2026,4]]},"reference-count":0,"published-online":null,"references-count":0,"short-container-title":["American Journal of Obstetrics and Gynecology"],"is-referenced-by-count":0},"unpaywall":{"doi":"10.1016/j.ajog.2026.04.025","is_oa":true,"title":"A randomized controlled trial comparing remote blood pressure monitoring with office-based blood pressure monitoring for women at high risk of preeclampsia","updated":"2026-04-22T09:11:45+00:00","published_date":"2026-04-01","best_oa_location":{"url":"https://doi.org/10.1016/j.ajog.2026.04.025","pmh_id":null,"url_for_pdf":null,"url_for_landing_page":"https://doi.org/10.1016/j.ajog.2026.04.025"}}},"created_at":"2026-05-07T22:49:41.119Z","updated_at":"2026-05-14T15:13:26.918Z","tags":[{"paper_doi":"10.1016/j.ajog.2026.04.025","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.04.025","tag_type":"category","value":"Obstetrics & Gynecology","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.04.025","tag_type":"condition","value":"Hypertensive Disorders of Pregnancy","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.04.025","tag_type":"condition","value":"Preeclampsia","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.04.025","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.04.025","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.04.025","tag_type":"modality","value":"Antihypertensive Therapy","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.04.025","tag_type":"modality","value":"Remote Patient Monitoring","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.04.025","tag_type":"sample_size","value":"n=270","value_numeric":270},{"paper_doi":"10.1016/j.ajog.2026.04.025","tag_type":"sex","value":"female","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.04.025","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.04.025","tag_type":"warning","value":"Brand name of the specific automated BP device/smartphone app used is not reported in the abstract, which may affect reproducibility.","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.04.025","tag_type":"warning","value":"The paper's DOI reflects a 2026 publication date, which is consistent with today's date but is ahead of typical indexing — verify final published version for any post-acceptance changes.","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.04.025","tag_type":"warning","value":"The primary composite outcome (HR 1.0, wide CI 0.57–1.76) is consistent with non-inferiority, but the upper CI boundary should be checked against the trial's pre-specified margin.","value_numeric":null},{"paper_doi":"10.1016/j.ajog.2026.04.025","tag_type":"warning","value":"The trial is described as 'non-inferiority' but the abstract does not specify the pre-defined non-inferiority margin, making it difficult to fully assess whether non-inferiority was formally demonstrated.","value_numeric":null}],"summaries":{"what_studied":"Unblinded non-inferiority RCT (n=270) comparing remote blood pressure monitoring (self-measured via automated device + smartphone app with specialist review) vs. in-person specialist hypertension clinic visits in pregnant women at high risk of preeclampsia, across 3 Australian hospitals (July 2022–February 2024).","key_result":"No difference in the perinatal composite outcome (perinatal loss, high-level neonatal care >48h, or SGA <10th centile; HR 1.0, 95% CI 0.57–1.76; p=0.99). Remote monitoring reduced total antenatal visits (median 14 vs. 16; p<0.01), planned outpatient appointments (10 vs. 13; p<0.01), any-cause hospital admission (HR 0.54, 95% CI 0.30–0.97; p=0.04), and hypertension-specific admission (HR 0.41, 95% CI 0.19–0.88; p=0.02). More antihypertensive prescriptions were filled in the remote arm (median 5 vs. 3; p<0.01).","limitations":"- Unblinded design may introduce performance or detection bias.\n- Single-country, 3-centre metropolitan sample (60% non-Caucasian) limits global generalisability.\n- Non-inferiority margin and statistical power assumptions are not detailed in the abstract, making it hard to assess whether the trial was adequately sized for the primary composite.","practice_takeaway":"For pregnant women at high risk of preeclampsia, remote BP monitoring can safely replace frequent specialist clinic visits — reducing office attendances and hospital admissions without worsening fetal or maternal outcomes. Clinicians should also note that remote monitoring appears to improve antihypertensive medication adherence."}},{"doi":"10.1161/strokeaha.125.053989","pmid":"41873543","title":"Impact of Ultra-Early Perioperative Antihypertensive Therapy in Acute Intracerebral Hemorrhage","journal_title":"Stroke","journal_issn":"0039-2499","published_at":"2026-03-24T00:00:00.000Z","url":"https://doi.org/10.1161/strokeaha.125.053989","source_score":47,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-26T13:35:13.891Z","updated_at":"2026-05-26T13:35:13.891Z","tags":[{"paper_doi":"10.1161/strokeaha.125.053989","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1161/strokeaha.125.053989","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1161/strokeaha.125.053989","tag_type":"condition","value":"Intracerebral Hemorrhage","value_numeric":null},{"paper_doi":"10.1161/strokeaha.125.053989","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1161/strokeaha.125.053989","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1161/strokeaha.125.053989","tag_type":"modality","value":"Antihypertensive Therapy","value_numeric":null},{"paper_doi":"10.1161/strokeaha.125.053989","tag_type":"modality","value":"Surgical Hematoma Evacuation","value_numeric":null},{"paper_doi":"10.1161/strokeaha.125.053989","tag_type":"sample_size","value":"n=1506","value_numeric":1506},{"paper_doi":"10.1161/strokeaha.125.053989","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1161/strokeaha.125.053989","tag_type":"study_design","value":"Post Hoc Secondary Analysis of Stepped-Wedge Cluster-Randomized Trial","value_numeric":null},{"paper_doi":"10.1161/strokeaha.125.053989","tag_type":"warning","value":"It is unclear whether target BP was reached pre-, intra-, or postoperatively, which limits interpretation of the 'perioperative' framing.","value_numeric":null},{"paper_doi":"10.1161/strokeaha.125.053989","tag_type":"warning","value":"No multiple comparison correction was applied across numerous secondary outcomes.","value_numeric":null},{"paper_doi":"10.1161/strokeaha.125.053989","tag_type":"warning","value":"The 2-hour BP target cutoff was investigator-defined for this analysis and not a randomized exposure — residual confounding by disease severity (sicker patients may be harder to treat) cannot be excluded.","value_numeric":null},{"paper_doi":"10.1161/strokeaha.125.053989","tag_type":"warning","value":"This is a post hoc, non-prespecified secondary analysis; results are hypothesis-generating only and should not be used to change practice without confirmatory RCT data.","value_numeric":null}],"summaries":{"what_studied":"Post hoc secondary analysis of the INTERACT3 trial examining whether achieving systolic BP <140 mm Hg within 2 hours (vs. >2 hours) of treatment initiation is associated with better outcomes in 1,506 ICH patients who underwent surgical hematoma evacuation, with follow-up to 6 months.","key_result":"Achieving BP target within 2 hours was **not** significantly associated with lower 6-month mortality (aHR 0.81, 95% CI 0.63–1.04; P=0.09), but was associated with lower risk of death or disability (aOR 0.71; P=0.01), fewer serious adverse events (aOR 0.73; P=0.02), a favorable mRS shift (aOR 0.73; P<0.01), and better quality-of-life scores (health utility mean difference +0.05; P<0.01).","limitations":"- Post hoc analysis with no correction for multiple comparisons, raising risk of type I error.\n- Unable to determine whether target BP was reached pre-, intra-, or postoperatively, limiting timing-based subgroup interpretation.\n- Unmeasured confounding and complete-case analysis (no imputation) may bias results.","practice_takeaway":"For ICH patients going to surgery, don't delay intensive BP control while preparing for the OR — targeting systolic BP <140 mm Hg within 2 hours appears safe and is linked to better function and fewer serious adverse events. Treat BP reduction as a bridge to surgery, not a secondary step."}}],"initialOffset":12,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Antihypertensive Therapy"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Antihypertensive Therapy"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Antihypertensive Therapy"}}}]]

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