Jeong-Hun Shin

Background/Objectives: Ambulatory blood pressure monitoring (ABPM) may disturb sleep during polysomnography (PSG), and the first-night effect (FNE) can complicate interpretation. We evaluated changes associated with ABPM and FNE across whole nights and individual measurements. Methods: This secondary analysis included 72 nominally healthy adults in a balanced two-night crossover, with ABPM on one randomly assigned night. Linear mixed-effects models estimated associations with PSG-derived sleep indices, a composite sleep quality index (SQI), and relative electroencephalographic (EEG) power. Analyses of individual measurements summarized EEG changes, sleep-stage transitions, and automated arousal detections. Benjamini–Hochberg false discovery rate (BH-FDR) adjustment was applied within defined analysis families. Results: FNE and ABPM were associated with lower SQI (β = −0.049 and −0.051, respectively; both BH-adjusted p = 0.028). FNE was associated with altered sleep continuity and architecture, whereas ABPM was associated with higher light-sleep and lower N3-sleep percentages and higher whole-night relative theta power. In the Night 2 paired analysis, relative delta power was lower and relative alpha, beta, and gamma power were higher during ABPM than before ABPM (all BH-adjusted p < 0.01); the theta difference did not reach significance (BH-adjusted p = 0.0632). Of 655 eligible ABPM measurements beginning during sleep, 395 (60.3%) contained at least one arousal detection within the 2 min measurement window. Conclusions: These detections indicate temporal co-occurrence and do not establish that cuff inflation caused arousal. Concurrent ABPM and study-night order should be considered when interpreting PSG. An adaptation PSG night may be considered when feasible, as may cuffless blood pressure monitoring once its accuracy has been established for the intended setting.

Ischemic heart disease is a major cardiovascular complication in patients with end-stage kidney disease (ESKD) who are undergoing dialysis. The prevalence of ischemic heart disease at the initiatio...

Remnant cholesterol is a known residual risk factor for cardiovascular disease in the general population. However, its prognostic value in patients undergoing dialysis, a population at a high risk of cardiovascular events, remains unclear. We aimed to evaluate the association between remnant cholesterol levels and cardiovascular outcomes in a high-risk population. This retrospective cohort study included 21,679 patients with end-stage kidney disease on long-term dialysis, who underwent health screening between 2009 and 2017. All participants were identified from the Korean National Health Insurance Service database. The participants were stratified into quartiles of baseline remnant cholesterol. The primary outcomes were the incidences of myocardial infarction and ischemic stroke. During a median follow-up of 8.1 years, 993 myocardial infarctions and 1,249 ischemic strokes occurred. High remnant cholesterol was associated with an increased risk of myocardial infarction; patients in Quartile 4 had a 26% higher risk compared with Quartile 1 (hazard ratio, 1.26; 95% confidence interval, 1.04-1.53), in the fully adjusted model including low-density lipoprotein cholesterol (LDL-C). Restricted cubic spline analyses showed a steady increase in myocardial infarction risk with rising remnant cholesterol. However, no significant association was observed with ischemic stroke. In patients undergoing dialysis, elevated remnant cholesterol was independently associated with a higher risk of myocardial infarction but not ischemic stroke. These findings suggest that remnant cholesterol is associated with myocardial infarction independent of LDL-C and may contribute to residual cardiovascular risk in this population.

Lee HY, et al. Clin Hypertens. 2026 ;32:e40. https://doi.org/10.5646/ch.2026.32.e40

Kim HJ, et al. Clin Hypertens. 2026 ;32:e41. https://doi.org/10.5646/ch.2026.32.e41

Lee EM, et al. Clin Hypertens. 2026 ;32:e31. https://doi.org/10.5646/ch.2026.32.e31

Kim BS, et al. Clin Hypertens. 2026 ;32:e15. https://doi.org/10.5646/ch.2026.32.e15

Kim BS, et al. Cardiometab Syndr J. 2026 ;6:e16. https://doi.org/10.51789/cmsj.2026.6.e16

Background/Aims: Cardiovascular-kidney-metabolic (CKM) syndrome reflects the interplay between metabolic dysfunction, chronic kidney disease, and cardiovascular disease. Insulin resistance (IR) is a key driver of CKM and is associated with adverse cardiovascular outcomes. The triglyceride-glucose (TyG) index is a cost-effective surrogate marker of IR; however, its prognostic value across CKM syndrome stages remains unclear.Methods: We conducted a retrospective cohort study using data of 1,497,913 adults enrolled in the Korean National Health Insurance Database between 2009 and 2012. The participants were stratified into four CKM stages (0/1, 2, 3, and 4) and further categorized into three TyG index tertiles: Group 1 (< 8.27), Group 2 (8.27–8.81), and Group 3 (> 8.81). The primary composite outcomes were all-cause mortality, heart failure, stroke, and myocardial infarction.Results: Over an average follow-up period of 12.6 ± 1.50 years, individuals in the highest TyG tertile demonstrated a significantly higher risk of the composite primary outcome compared to those in the lowest tertile (hazard ratio, 1.116; 95% confidence interval, 1.101–1.131; p < 0.001). This dose-dependent relationship was consistent across CKM stages, with the strongest associations observed in the early CKM stages (0/1 and 2). An elevated TyG index is also associated with an increased risk of secondary outcomes, including all-cause death, heart failure, stroke, and myocardial infarction.Conclusions: The TyG index independently predicted cardiovascular risk across the CKM syndrome stages. Its integration into routine clinical assessments could enhance early risk stratification and guide preventive strategies, particularly for patients in the early stages of CKM syndrome.