{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T06:41:23Z","timestamp":1777358483222,"version":"3.51.4"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Patients referred to specialist hypertension clinics often have complex disease characterized by secondary causes, treatment resistance and coexisting kidney disease. Real\u2010world outcome data in this setting remain limited. We conducted a retrospective cohort study of 199 patients attending a tertiary hypertension clinic between January 2017 and December 2023. Baseline demographics, comorbidities, antihypertensive therapy, and blood pressure (BP) were recorded. BP changes were assessed annually for up to 3 years. Subgroup analyses examined outcomes by age, sex, diabetes, chronic kidney disease, obesity, resistant hypertension, secondary hypertension, and baseline systolic BP. Cardiovascular events were identified from clinical records. Mean age of patients was 44.1\u00a0\u00b1\u00a014.0 years and 61.3% were male. Secondary hypertension was present in 32.7% and resistant hypertension in 17.2%. Median follow\u2010up was 13.8 months (IQR 4.7\u201330.1), with follow\u2010up BP available for 146 patients. Mean baseline BP was 156\/97\u00a0mmHg. At final follow\u2010up, significant reductions were observed, with mean systolic and diastolic BP decreases of \u221213.6 and \u22128.8\u00a0mmHg, respectively (both\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0&lt;\u00a00.001). BP improvements were consistent across clinical subgroups. Qualitative urine antihypertensive drug screening identified medication non\u2010adherence in a subset of patients, with targeted interventions associated with subsequent BP improvement. Cardiovascular events were infrequent (6.5%). This study shows that specialist hypertension care achieves substantial BP reductions in complex real\u2010world patients. Objective assessment of medication adherence appears clinically valuable, although BP control remains challenging and residual cardiovascular risk persists. Larger multicenter studies with longer follow\u2010up are needed to define predictors of cardiovascular outcomes and optimize care pathways.\n                  <\/jats:p>","DOI":"10.1111\/jch.70243","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T04:00:14Z","timestamp":1775016014000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient Characteristics and Clinical Outcomes in a Specialist Hypertension Clinic: A Pragmatic Real\u2010World Single\u2010Center Observational Study"],"prefix":"10.1111","volume":"28","author":[{"given":"William R.","family":"Marshall","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Sciences Faculty of Biology, Medical and Health Sciences The University of Manchester  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry H. L.","family":"Wu","sequence":"additional","affiliation":[{"name":"Renal Research Laboratory Kolling Institute of Medical Research Royal North Shore Hospital The University of Sydney  Sydney Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharmilee","family":"Rengarajan","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Northern Care Alliance NHS Foundation Trust  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David I.","family":"New","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Northern Care Alliance NHS Foundation Trust  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitrios","family":"Poulikakos","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Northern Care Alliance NHS Foundation Trust  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajkumar","family":"Chinnadurai","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Northern Care Alliance NHS Foundation Trust  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2022.11.005"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp20X708053"},{"key":"e_1_2_11_4_1","unstructured":"Office for National Statistics (ONS) Risk Factors for Undiagnosed High Blood Pressure in England: 2015 to 2019(Statistical Bulletin 27 April2023) accessed 2nd January 2025 available fromhttps:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/healthandwellbeing\/articles\/riskfactorsforundiagnosedhighbloodpressureinengland\/2015to2019."},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000084"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j3984"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp18X696221"},{"issue":"7","key":"e_1_2_11_8_1","first-page":"453","article-title":"Secondary Hypertension: Discovering the Underlying Cause","volume":"96","author":"Charles L.","year":"2017","journal-title":"American Family Physician"},{"key":"e_1_2_11_9_1","unstructured":"National Institute for Health and Care Excellence (NICE) Hypertension in Adults: Diagnosis and Management (NICE Guideline NG136)(London:NICE 2019 updated 2023) available via NCBI Bookshelf (NBK547161)."},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp24X736390"},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","DOI":"10.1177\/2048004020910628","article-title":"The Effectiveness of a Specialist Hypertension Clinic in Reducing Blood Pressure: Factors Determining Blood Pressure Response","volume":"9","author":"O'Callaghan G.","year":"2020","journal-title":"JRSM Cardiovascular Disease"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.7196\/SAMJ.2016.v106i8.9610"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfl701"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmt074"},{"key":"e_1_2_11_15_1","unstructured":"British and Irish Hypertension Society (BIHS) Blood Pressure Measurement\u2013Using Manual Blood Pressure Monitors(2025). Updated May 2025."},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41371-023-00882-2"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1402670"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00788-1"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30554-7"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.117.09631"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-305063"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.116.08729"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/jhh.2015.103"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41371-021-00646-w"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.121.17596"}],"container-title":["The Journal of Clinical Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jch.70243","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jch.70243","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jch.70243","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T05:49:14Z","timestamp":1777355354000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jch.70243"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,31]]},"references-count":24,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/jch.70243"],"URL":"https:\/\/doi.org\/10.1111\/jch.70243","archive":["Portico"],"relation":{},"ISSN":["1524-6175","1751-7176"],"issn-type":[{"value":"1524-6175","type":"print"},{"value":"1751-7176","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,31]]},"assertion":[{"value":"2026-01-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70243"}}