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(JAMA. 2021;326:1186–1191)Preeclampsia is a common cause of maternal morbidity and mortality around the world. In the United States, preeclampsia complicates 4% of pregnancies and contributes to 6% of preterm births and 19% of medically indicated preterm births. Preeclampsia is defined by a maternal blood pressure of 140/90 mm Hg or more on 2 separate office visits after 20 weeks of pregnancy, accompanied by maternal proteinuria. Preeclampsia is an inflammatory syndrome that can lead to multiple maternal risks including impaired liver function, thrombocytopenia, renal insufficiency, cerebral or visual disturbances, and pulmonary edema. It can lead to fetal risks including low birth weight, fetal growth restriction, and preterm birth from a lack of blood flow to the placenta. As the placenta develops, it may cause an overactive systemic inflammatory response and oxidative stress resulting in the development of preeclampsia.

Apparent treatment-resistant hypertension (aTRH) is associated with adverse cardiovascular outcomes. aTRH is common and disproportionately affects African Americans. The objective of this study is to explore psychosocial correlates of aTRH in a population-based cohort of African Americans with hypertension. The sample included 1392 participants in the Jackson Heart Study with treated hypertension who reported being adherent to their antihypertensive medications. aTRH was defined as uncontrolled clinic BP (⩾140/90 mm Hg) with ⩾3 classes of antihypertensive medication or treatment with ⩾4 classes of antihypertensive medication, including a diuretic. Self-reported medication adherence was defined as taking all prescribed antihypertensive medication in the 24 h before the study visit. The association of psychosocial factors (chronic stress, depressive symptoms, perceived social support and social network) with aTRH was evaluated using Poisson regression with progressive adjustment for demographic, clinical and behavioural factors. The prevalence of aTRH was 15.1% (n=210). Participants with aTRH had lower social network scores (that is, fewer sources of regular social contact) compared with participants without aTRH (P<0.01). No other psychosocial factors differed between groups. Social network was also the only psychosocial factor that was associated with aTRH prevalence in regression analyses. In age-, sex-adjusted and fully adjusted models, one additional unique source of social contact was associated with a 19% (PR=0.81; 95% confidence interval (CI): 0.68–0.94, P=0.001) and a 13% (PR=0.87; 95% CI 0.74–1.0, P=0.041) lower prevalence of aTRH, respectively. Social network was independently associated with aTRH and warrants further investigation as a potentially modifiable determinant of aTRH in African Americans.

Uncontrolled blood pressure (BP) is linked to increased risk of obstructive sleep apnea (OSA). However, few studies have assessed the impact of this relationship among blacks with metabolic syndrome (MetS). Data for this study were collected from 1035 blacks (mean age=62±13 years) enrolled in the Metabolic Syndrome Outcome study. Patients with a score ⩾6 on the Apnea Risk Evaluation System were considered at risk for OSA. Of the sample, 77.1% were low-to-high OSA risk and 92.3% were hypertensive, of which 16.8% had uncontrolled BP levels. Analysis also showed that 60.4% were diabetic, 8.9% had a stroke history, 74.3% had dyslipidemia, 69.8% were obese and 30.9% had a history of heart disease. Logistic regression analyses were employed to investigate associations between uncontrolled BP and OSA risk, while adjusting for known covariates. Findings showed that uncontrolled BP independently increased the odds of OSA risk twofold (odds ratio=2.02, 95% confidence interval=1.18–3.48, P<0.05). In conclusion, our findings show that uncontrolled BP was associated with a twofold greater risk of OSA among blacks, suggesting that those with MetS and who have uncontrolled BP should be screened for the presence of OSA.

The high prevalence of depressive symptoms in patients with coronary artery disease has been well documented. However, little is known about the prevalence and correlates of depressive symptoms in Latino patients with coronary artery disease.

Correction to: Journal of Human Hypertension (2017) 31, 474–478; doi:10.1038/jhh.2016.100; published online 26 January 2017 Since the online publication of this article, it has been noted that the author name A Bress was incorrect and should be replaced with AP Bress. This error has now been rectified and the corrected article appears in this issue.