There you go: www.ahajournals.org/doi/10.1161/... @ahascience.bsky.social statement from HT heavyweights

High blood pressure often shows no symptoms, but raises risk of stroke, heart disease, kidney damage, and dementia. New American Heart Association guidelines: treat it early with diet & exercise. “If you catch it early, you can gain many more years of healthy life,” says Penn’s Dr. Jordana Cohen.

And that’s a wrap! In summary: screen carefully, stratify by risk, account for kidney health, and individualize therapy. For nephrology, the wins are undeniable: albuminuria testing is mainstream, CKD visibility is heightened, and aldosterone is on the radar. #NephJC

T4l 1️⃣2️⃣No aggressive IV treatment for severe asymptomatic HTN - avoid acute inpatient lowering if no target-organ damage (COR III: Harm, LOE C-LD). 📝Treat the patient (situation) not the number for acute HTN during hospitalization. I have trouble convincing nocturnists of this. #NephJC

T4j 🔟CKD with albuminuria - ACEi/ARB strongly recommended to delay CKD progression and reduce CVD (COR I, LOE A). 📝Still only 35-50% of eligible patients get them. How do we move the needle on this? #NephJC

T4i 9️⃣Cognitive protection🧠 - treat to SBP <130 to prevent mild cognitive impairment/dementia (COR I, LOE B-R). 📝Do you think BP control has a significant role in dementia? #NephJC

Proposed mechanism in Nature #NephJC www.nature.com/articles/s41...

I would dare to say many people: if too young, if single pill combo is not enough to control BP. PA is more common than we are used to think. Usually, for us nephrologists is even harder to screen when pts are already on 4-5meds #nephjc www.nephjc.com/news/primary...

T0b Is HTN still a problem worth our attention? Haven’t we conquered this ‘Silent Killer’ yet? Answers: YES it’s a problem, NO we’ve not conquered it. #NephJC

T0c Check out these sobering stats: ➡️More than 1.3 billion with HTN globally, 1.2 billion without control ➡️46.7 % HTN prevalence in the US from 2017 to 2020 ➡️Leading cause of death and disability worldwide #NephJC

Jordy Cohen from University of Pennsylvania here for what’s certain to be an exciting #nephjc! I’m perhaps biased as a member of the writing committee of the 2025 AHA/ACC BP guideline… No other COIs

⏰2 hours until #NephJC chat 🔍 Tonight we are talking about the 2025 ACC/AHA Blood Pressure guidelines! Eight years have passed since the last update. What’s different? What’s the same? Tonight we tackle it all!

Congratulations @robynwei.bsky.social RD/ PhD candidate for her poster #Hypertension25 highlighting underutilization of salt substitute use in the US @giaconajohn.bsky.social details in AHA News release newsroom.heart.org/news/u-s-sur... @ahascience.bsky.social

Dr Karol Watson starts with impactful message top 10 take away message #Hypertension25 high BP as predictor dementia and treatment reduces cognitive decline or dementia by 15% . Once you hit 120/80 , trajectory to high BP is steep. Don’t sit on high BP! @ahascience.bsky.social

Congratulations @ahascience.bsky.social @accintouch.bsky.social 2025 #BloodPressure #GLs Writing TaskForce incl @jordybc.bsky.social @drwanpen.bsky.social @daichishimbo.bsky.social @ycommodore.bsky.social ♥️ format #GLs 🔦 are presented with #patient case Hx & mgt 🥇 #Hypertension25

Beta blockers remain overused for #hypertension in the VA (though the tens line is going down, very slowly) jamanetwork.com/journals/jam... in @jama.com from @jordybc.bsky.social et al OTOH: I think ESRD should count as a somewhat compelling indication? Almost all HD pts here are on bisoprolol

Up next! New AHA/ACC hypertension guidelines #NephJC @ahascience.bsky.social @accintouch.bsky.social

The era of ASIs is slowly dawning www.nejm.org/doi/full/10.... (Yeah spironolactone is just as good and cheaper) Disclosure: we recruited patients for this one

❓What’s new in BP care? 🎥 Watch the #TargetBP webinar on the 2025 @AHAScience / @ACCinTouch Hypertension Guidelines w/ @drwanpen.bsky.social , @jordybc.bsky.social , Keith Ferdinand, & Dan Jones 👉 targetbp.org

Fascinating piece on the issues with AI slop in the mathematical research world (spoiler: it's a massive problem). Ping @carlbergstrom.com open.substack.com/pub/bristoli...

Join us @jordybc.bsky.social , Keith Ferdinand, and Dan Jones unpacking 2025 AHA/ACC guidelines on Thursday Aug 28 bit.ly/Guideline25W... @UTSWInternalMed @utswheart

Thanks for sharing. So many great recommendations! The devil is in the details, i.e. adoption/implementation. For starters, I suspect very few of the routine lab tests for new diagnosis of HTN are being ordered.

The AHA/ACC have released the 2025 High Blood Pressure Guideline, emphasizing prevention and early treatment to reduce cardiovascular disease risk. Read the Guideline in #Hypertension & #Circulation and check out our hub with commentaries and more: www.ahajournals.org/guidelines/h... #Cardiosky

Nice to see new AHA HTN guidelines emphasizing albuminuria detection! "[Urine ACR] (a test that assesses kidney health) is now recommended for all patients with high blood pressure. It was recommended as an optional test in the 2017 guideline." newsroom.heart.org/news/new-hig...

The 2025 AHA/ACC Hypertension GL is out ! @CircAHA www.ahajournals.org/doi/10.1161/... please join us for the Targetbp Webinar as the first platform to digest the GL by @kcferdmd @jordybc.bsky.social and Dan Jones targetbp.org/events/ on August 28

New 2025 AHA/ACC Hypertension Guideline dropped! www.jacc.org/doi/10.1016/... #hypertension #medsky #nephsky

We screen everyone referred to our hypertension program for many years now We don’t refer anyone to endo Most patients just need Spiro The occasional peeps need AVS and few need an adrenalectomy Confirmatory tests are useless

Indeed I suspect these guidelines are trying to shift the Overton window (did I use the phrase correctly 😎 @jordybc.bsky.social ?) - I don’t think PCPs read the JCEM! Right now even referral centres nephrologists, endocrinologists, cardiologists are doing a shitty job of screening 🤷🏽‍♂️

New PA Endo guideline is also out by experts @anandvaidya17.bsky.social #Cardiosky @hswapnil.medsky.social doi.org/10.1210/clin...

The latest episode of @freelyfiltered.bsky.social is outstanding. If you are confused about target trial emulation and think of it as a statistical black box, I encourage you to take a listen. @jordybc.bsky.social and Ed Fu do a brilliant job of explaining it. www.nephjc.com/freelyfilter...

A medical adrenalectomy? ASIs advance - Baxdrostat in primary aldosteronism now www.nejm.org/doi/full/10.... n = 15 single arm trial from @adinaturcu.bsky.social and @astra-zeneca.bsky.social in @nejm.org ~ 25/10 mm Hg BP lowering and impressive aldosterone level drop #Hypertension #EndoSky

The Book Club is back Read ‘everything is tuberculosis’ from @johngreensbluesky.bsky.social with the #NephJC crew www.nephjc.com/news/2025/6/...

Hilarious (and sobering) essay on the use of AI in medical research & manuscript writing Read the whole thing! John Daugirdas has been on the cutting edge of tech in meded before #MedEd was thing onlinelibrary.wiley.com/doi/10.1111/... #MedSky #NephSky

The recognition that exercise is delayed gratification (in terms of large mortality benefit) and the lack of inclusion of any long-term exercise measurement in epidemiological studies should chill one's spine

& with this interesting editorial by Dr. Brook (cc: Dr. @jbrianbyrd.bsky.social) & Dr. @jordybc.bsky.social et al too: jamanetwork.com/journals/jam...

Delightful read of the day (with terrible implications) The journey of clonazepam from API in Guangzhou to the tablet being consumed is 63,162 kms www.cfp.ca/content/71/4... From McMaster (school of engineering and family medicine) h/t Chris Hannah of @theglobeandmail.com

Phase 2 trial of the new antihypertensive agent, ultra-long-acting (q6 month), subq, small interfering RNA against angiotensinogen (Zilebesiran), hit JAMA! h/t @drjmluther.bsky.social jamanetwork.com/journals/jam... 1/

I would really love to use ASIs in the patient with PA (bilateral dz) in whom I am struggling with 200-300 mg of spironolactone @kidneyboy.bsky.social #NephJC

Theoretically: - it targets the primary issue in many patients- unregulated aldosterone production. -avoid effect of further elevated Aldo during MRA treatment Obvs -avoid gynecomastia and off-target effects of Spiro. For other MRAs it has always been difficult to push dose high enough. #NephJC

As data emerges, the 3 new agents are much more selective than prior drugs. Still need more data on Vicadrostat (done but not shown in publications). #nephJC

It has been the main barrier to development- off target Cortisol inhibition, due to the high homology and overlapping functionality. #nephJC

Hypertension no one-size-fits-all targets, no universal meds, no cutter approach! Before, we start how do we tackle uncontrollable hypertension? Some insights by @jordybc.bsky.social. Also, saw her coming soon to next @freelyfiltered.bsky.social #NephJC #NephSky #MedSky thecurbsiders.com/cu...

Recording another @freelyfiltered.bsky.social, excited to have a methods master in the house! I suspect we won't even have time to get to the supplement 😂 @hswapnil.medsky.social @kidneyboy.bsky.social #nephjc #freelyfiltered

Dr. Kovell describes the complexity of blood pressure physiology during pregnancy. @ahascience.bsky.social @anastasiasmihaili.bsky.social Under Pressure Webinar

There you have it: BEDMED published in @jama.com jamanetwork.com/journals/jam... h/t @drjmluther.bsky.social No difference in bedtime versus morning BP meds - as expected #NephSky #Hypertension 1/

Also summarized in the @ahajournals.bsky.social HT journal here www.ahajournals.org/doi/10.1161/... feat @rickyturgeon.bsky.social @mikejohansenmd.medsky.social @jordybc.bsky.social @boback.bsky.social and more! 4/

!Register today! https://ahajrnls.org/3RGLjlT to join mods @AnastasiaSMihai @guto_montezano @carmendemigue12 for a @HyperAHA #HTNImpact Webinar! May 14, 2025 3pm – 4pm CT Under Pressure for Accurate BP Measurement – in Human & Animal Models

How do we calibrate a blood pressure device? I get asked by patients and often wonder myself how we know our validated blood pressure devices are still accurate. Do we compare it with a mercury tower? @jordybc.bsky.social #askrenal

In the @annalsofim.bsky.social www.acpjournals.org/doi/10.7326/... from @ucalgarymed.bsky.social team Saline suppression test not useful in confirming primary #aldosteronism - go straight to AVS if planning Sx (and ramp up MRA to target renin if Medical management) #NephSky #EndoSky

Also read the accompanying editorial from @jordybc.bsky.social www.acpjournals.org/doi/10.7326/... Don’t let the complexity of traditional PA screening and confirming diagnosis stop you - just measure renin to start and go from there