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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS

@spjuraschek.bsky.social
953 followers 443 following 481 posts

Internist, hypertension specialist, epidemiologist, and trialist interest in healthy food access, sodium, heart disease, blood pressure regulation, and gout

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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 05/10/2026
Check out this tour-de-force led by Drs. Davis and Yang @accintouch.bsky.social Optimizing Blood Pressure Care in Patients With Resistant Hypertension: 2026 ACC Expert Consensus Decision Pathway: A Report of the ACC Solution Set Oversight Committee www.jacc.org/doi/10.1016/...
jacc.org
Optimizing Blood Pressure Care in Patients With Resistant Hypertension: 2026 ACC Expert Consensus Decision Pathway: A Report of the American College of Cardiology Solution Set Oversight Committee
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 03/10/2026
With the @altnih4science.bsky.social grant deadline behind me, I am so excited for @ahascience.bsky.social AHA Hypertension this week in Arlington! So much is happening in our field - can't wait to take it in with colleagues and friends!
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Reposted by Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS
American Journal of Hypertension @amjhypertension.bsky.social · 02/10/2026
#HotOffThePress Effects of Anti-Hypertensive Agents on Orthostatic Changes: Secondary Analysis of the Treatment of Mild Hypertension Study (TOMHS) academic.oup.com/ajh/advance-...
academic.oup.com
Effects of Anti-Hypertensive Agents on Orthostatic Changes: Secondary Analysis of the Treatment of Mild Hypertension Study (TOMHS)
AbstractBackground. Orthostatic hypotension (OH) and orthostatic hypertension (OHT) are common among adults with hypertension and may complicate antihypert
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 02/10/2026
Love this study led by brilliant physician scientists, Esther Liu @bidmcreseach.bsky.social & Grace Lee @harvardmed.bsky.social ! We show how antihypertensive Wilder effects reduce orthostatic BP changes. Effects of Anti-Hypertensive Agents on Orthostatic Changes academic.oup.com/ajh/article-...
academic.oup.com
Effects of Anti-Hypertensive Agents on Orthostatic Changes: Secondary Analysis of the Treatment of Mild Hypertension Study (TOMHS)
AbstractBackground. Orthostatic hypotension (OH) and orthostatic hypertension (OHT) are common among adults with hypertension and may complicate antihypert
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 18/09/2026
Neat study, showing that a permissive primary aldo strategy captures more likely cases. Would have liked to see implications of reduced specificity too... Evaluation of Current Screening Thresholds for the Detection of Primary Aldosteronism www.ahajournals.org/doi/full/10....
ahajournals.org
American Heart Association Journals
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 12/09/2026
We just held our Gofresh closeout event at the Kroc Center in Dorchester. So great to hear from appreciative participants about how the study benefitted them and ideas for more community partnership. Huge thanks to NIH @ahascience.bsky.social @bidmcreseach.bsky.social for supporting our studies!
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 18/08/2026
This meta-analysis shows that if you want 80% population hypertension control (<140/<90), you need to target an individual SBP <125 mm Hg. Association Btw Follow-Up Mean BP & BP Control: A Meta-Regression Analysis of 101 Randomized Trials www.ahajournals.org/doi/full/10....
ahajournals.org
Association Between Follow-Up Mean Blood Pressure and Blood Pressure Control: A Meta-Regression Analysis of 101 Randomized Trials | Hypertension
BACKGROUND: The relationship between mean blood pressure (BP) and BP control remains uncertain, particularly the mean BP required to achieve BP control (&lt;140/90 mm Hg) in most patients. This review...
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 15/08/2026
Important study showing cardiovascular proteomic pathways are associated with OH, suggesting OH is a CVD risk enhancing state...statin anyone? www.sciencedirect.com/science/arti...
sciencedirect.com
Plasma Proteomic Profiling Reveals Alterations in Coagulation, Complement, and Extracellular Matrix Pathways in Orthostatic Hypotension
All content on this site: Copyright © 2026 Elsevier B.V., its licensors, and contributors. All rights are reserved, including those for text and data mining, AI training, and similar technologies. For all open access content, the relevant licensing terms apply.
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 05/08/2026
Happy to share our letter on the neutrality of the PCE to PREVENT transition in the 2025 Guidelines, using data from SPRINT. Really proud of the analysis led by Dr. Grobman new cardiology-bound intern at Vanderbilt! www.ovid.com/10.1097/HJH....
ovid.com
Hypertension treatment and risk of cardiovascular... : Journal of Hypertension
The 2025 AHA/ACC blood pressure (BP) management guidelines recommend BP treatment for 10-year cardiovascular disease (CVD) ≥7.5% from the PREVENT...
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 05/08/2026
Excited to share our article on orthostatic hypotension among adults age 78 yr and older led by Dr. Khan. Timing of Orthostatic Blood Pressure Changes and Its Association With Orthostatic Symptoms and Falls at Very Old Ages: Findings From the ARIC Study www.ahajournals.org/doi/10.1161/...
ahajournals.org
Timing of Orthostatic Blood Pressure Changes and Its Association With Orthostatic Symptoms and Falls at Very Old Ages: Findings From the ARIC Study | Hypertension
BACKGROUND: Assessment and treatment of orthostatic hypotension (OH) are recommended to prevent falls in older adults. However, the optimal timing of standing blood pressure (BP) assessments to identi...
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 27/07/2026
Excited to share our insights on motivational themes in digital ads for more efficient trial recruitment. Bottom line: it's more than click-through rate! Motivational themes in digital advertisements enhance recruitment efficiency in cardiovscular trials www.sciencedirect.com/science/arti...
sciencedirect.com
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 22/07/2026
Check out this scholarship opportunity in honor of George Bakris: George Bakris Scholarship Program 2026 | Cardiometabolic Health Congress www.cardiometabolichealth.org/george-bakri... I'm looking forward to participating in this conference this year. The line up looks great! Join us!
cardiometabolichealth.org
George Bakris Scholarship Program 2026
CMHC is accepting applications for the 2026 George L. Bakris Scholarship Program, honoring Dr. Bakris' commitment to cardiorenal metabolic medicine education.
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 20/07/2026
Happy to share our thoughts on the role of renal denervation in resistant hypertension inspired by this nice JAMA review article. Review of Diagnosis and Management of Resistant Hypertension jamanetwork.com/journals/jam...
jamanetwork.com
Review of Diagnosis and Management of Resistant Hypertension
To the Editor We read with interest the recent comprehensive Review on the management of resistant hypertension.1 We have concerns, however, about a disconnect between the article’s evidence and the a...
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 18/07/2026
Nice article on hospitalized patients with hypertension: 25% had orthostatic hypotension with alpha blockers being a common risk factor. link.springer.com/article/10.1...
link.springer.com
Orthostatic Hypotension in Hypertensive Patients Hospitalized in Italian Internal Medicine Departments: FADOI-HYP-OP Study - High Blood Pressure & Cardiovascular Prevention
Introduction Orthostatic hypotension (OH) is defined as a decline in systolic blood pressure of at least 20 mmHg or a reduction in diastolic blood pressure of at least 10 mmHg, within the first 3 min ...
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 18/07/2026
Interesting study on immediate OH and falls. Like our STURDY paper on timing, sustained seems more problematic, but in ARIC the early measures were especially associated with falls. academic.oup.com/ageing/artic...
academic.oup.com
Does immediate orthostatic hypotension in adults have clinical implications for syncope and falls? An analysis of the Irish longitudinal study of ageing
AbstractBackground and Aims. Orthostatic hypotension is a common cause of syncope and falls; however, it is unclear if the association differs by variant.
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 11/07/2026
Excited to share this paper by medical student and brilliant scientist Frances Wang, who shows that high-quality home monitoring can be simple for older adults! Optimizing Home Blood Pressure Monitoring Protocols in Older Adults academic.oup.com/ajh/article-... @amjhypertension.bsky.social
academic.oup.com
Optimizing Home Blood Pressure Monitoring Protocols in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study
AbstractBackground. Current clinical guidelines recommend home blood pressure monitoring (HBPM) to confirm hypertension diagnosis, guide therapy, and suppo
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 02/07/2026
Supine hypertension strikes again...this time afib! academic.oup.com/europace/art...
academic.oup.com
Validate User
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 18/06/2026
Super important work on GLPs and something I've personally encountered as a physician... www.medscape.com/viewarticle/...
medscape.com
GLP-1s Tied to Higher Risk for Dizziness, Fainting for Some
Hypotension-related events increased after starting GLP-1s in patients taking multiple antihypertensive medications.
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 13/06/2026
This study found an association between OH and white coat as well as OHTN and masked hypertension. Similar to what we found in SPRINT, CRIC, and ARIC. @patildhrumil.bsky.social pubmed.ncbi.nlm.nih.gov/42267569/
pubmed.ncbi.nlm.nih.gov
Association between orthostatic blood pressure change and masked and white coat hypertension: the Nagahama study - PubMed
We identified a physiological association between exaggerated postural BP variability and office-to-home BP differences, which were previously considered unrelated.
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 13/06/2026
I like how this paper questions the traditional view that OH in diabetes is neurogenic...I wouldn't be surprised if cardiovascular disease/hypertension were much more common contributors! www.mdpi.com/2227-9032/14...
mdpi.com
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 13/06/2026
Nice cross-sectional paper on antihypertensive drug class and out of office blood pressure patterns. www.nature.com/articles/s41...
nature.com
Relationship between medication class and ambulatory blood pressure profile in the chronic renal insufficiency cohort (CRIC) study - Journal of Human Hypertension
Journal of Human Hypertension - Relationship between medication class and ambulatory blood pressure profile in the chronic renal insufficiency cohort (CRIC) study
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 13/06/2026
Neat validation-style study showing good PPG performance compared to ABPM including sleep dipping. Now can it track changes in BP after medication titrations? Photoplethysmography based remote cardiac blood pressure: Blood Pressure Monitoring journals.lww.com/bpmonitoring...
journals.lww.com
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 09/06/2026
Thanks Dr. Foti for calling my attention to this article. Selective remeasurement of high BPs to improve control rates can lead to less intensive treatment and won't prevent CVD events. Evaluating the Consequences of a Hypertension Management Incentive jamanetwork.com/journals/jam...
jamanetwork.com
Evaluating the Consequences of a Hypertension Management Incentive
This quasi-experimental study examines the association of a physician-facing quality metric and financial incentive for hypertension management with clinical decisions and health outcomes for patients...
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Reposted by Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS
Marwah Abdalla, MD MPH @marwahabdalla.bsky.social · 26/05/2026
We have more ways to measure blood pressure than ever before but not necessarily more confidence in what those measurements mean. Our NHLBI workshop report in @jaccjournals.bsky.social chaired w/ @spjuraschek.bsky.social provides an implementation roadmap. www.sciencedirect.com/science/arti...
sciencedirect.com
Blood Pressure Assessment Across the Lifespan: Improving Clinical Research and Clinical Practice: A National Heart, Lung, and Blood Institute Workshop Report
Hypertension is a modifiable risk factor for cardiovascular disease (CVD) and its prevalence is high in the United States and worldwide. Adequate char…
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 23/05/2026
This is a nice letter on home blood pressure protocols for postprandial hypotension. More research is needed on this topic. Home monitoring may be one strategy. pubmed.ncbi.nlm.nih.gov/42145048/
pubmed.ncbi.nlm.nih.gov
Individualized Home Blood Pressure Monitoring and Postural Timing Strategies for Postprandial Hypotension: A Rehabilitation Perspective - PubMed
Individualized Home Blood Pressure Monitoring and Postural Timing Strategies for Postprandial Hypotension: A Rehabilitation Perspective
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 21/05/2026
This is a great read led by brilliant, aspiring geriatrician and current resident, Aldis Petriceks. Evaluation and Management of Hypertension in Older Adults - Clinics in Geriatric Medicine www.geriatric.theclinics.com/article/S074...
geriatric.theclinics.com
Evaluation and Management of Hypertension in Older Adults
Hypertension is the most diagnosed condition among adults aged 60 years and older and is a major contributor to morbidity and mortality. In this article, we review current evidence on blood pressure e...
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 21/05/2026
Lots of easter eggs in this paper...not including the 100 page supplement!!! The incoming IM intern Dr. Mate-Kole did a phenomenal job with the rigorous peer review. Orthostatic Blood Pressure, Cardiovascular Disease, and Hypotensive Events | Hypertension www.ahajournals.org/doi/10.1161/...
ahajournals.org
Orthostatic Blood Pressure, Cardiovascular Disease, and Hypotensive Events | Hypertension
BACKGROUND: Orthostatic hypotension is thought to be associated with coronary heart disease, falls, and syncope due to low blood pressure (BP) upon standing. METHODS: The ARIC study (Atherosclerosis...
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 19/05/2026
Check it out! Low vs high spironolactone... No difference in BP or renin or hyperkalemia...but more side effects from high spiro in men. ahajrnls.org/4fnEa6U
ahajrnls.org
American Heart Association Journals
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 13/05/2026
Likewise!!!
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 12/05/2026
Excited to share this summary of our workshop related to blood pressure assessment in collaboration with hypertension experts and NIH/NHLBI! www.sciencedirect.com/science/arti...
sciencedirect.com
Blood Pressure Assessment Across the Lifespan: Improving Clinical Research and Clinical Practice: A National Heart, Lung, and Blood Institute Workshop Report
Hypertension is a modifiable risk factor for cardiovascular disease (CVD) and its prevalence is high in the United States and worldwide. Adequate char…
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 03/05/2026
Fascinating study showing that low BP is important for cerebral hypoperfusion. pubmed.ncbi.nlm.nih.gov/42034685/
pubmed.ncbi.nlm.nih.gov
Orthostatic hypotension without co-existent supine hypertension is associated with impaired cerebral oxygenation: findings from the Irish Longitudinal Study on Ageing (TILDA) - PubMed
Hypertension and orthostatic hypotension (OH) are common in older age, with both conditions recognized as risk factors for cardiovascular disease and end organ damage. Cerebral hypoperfusion is postul...
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 30/04/2026
Apply for our @amjhypertension investigator award!
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 25/04/2026
Excited to share this super comprehensive review article led by brilliant @harvard.edu medical student, Shreyas Rajesh, on hypertension agents and OH...love the framework below! link.springer.com/article/10.1...
link.springer.com
A Review of Clinical Trial and Meta-Analyses of BP Treatment Strategies for Patients with Orthostatic Hypotension: Blood Pressure Management in Patients with Hypertension and Orthostatic Hypotension -...
Current Hypertension Reports - To review clinical trial and meta-analysis data on the effects of blood pressure (BP) pharmacologic treatment for hypertension on orthostatic hypotension (OH) to...
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 23/04/2026
Important paper with similar findings to our own in ARIC: Limited evidence in support of sex-specific HTN thresholds pubmed.ncbi.nlm.nih.gov/41532301/ Sex Differences in Blood Pressure and Cardiovascular Disease in the UK Biobank: A Prospective Cohort Study academic.oup.com/ajh/article/...
pubmed.ncbi.nlm.nih.gov
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Reposted by Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS
Alex Chang, MD @alexchangmd.bsky.social · 22/04/2026
Interesting paper - Factors Associated With Discussing High Blood Pressure Readings in Clinical Notes. Naturally, nephrology, transplant, internal med are discussing the most (it's part of the job). ID, endocrine, sports medicine and GI > than cardiology? pubmed.ncbi.nlm.nih.gov/39661402/
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 18/04/2026
Thinking about this more...the notion that MRAs are the only way to protect from excess aldo seems illogical... Aldo itself is a necessary hormone. It's the excess thought to independently cause fibrosis (and hard to tease apart from high BP). I'm surprised this is promoted with trial evidence...
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 18/04/2026
I was told the reason spiro wasnt first line was purely due to history and how early trials were done. I think it's a great class that works synergistically with other classes (and with fewer side effects at lower doses)
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 18/04/2026
Can't wait!
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 17/04/2026
Interesting. So much to learn!
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 17/04/2026
And why not do mra/thz first? Why just mra alone? I guess that's the magic... If you get a good response upfront you use fewer agents. But if you dont, couldnt that imply secondary htn where additional classes might help?
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 17/04/2026
Super cool. Canada's doing awesome stuff!
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 17/04/2026
Thank you! Are you aware of an ongoing trial testing this?
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Reposted by Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS
Josh Leisring @joshleisring.bsky.social · 17/04/2026
I agree with this. Although it's based on observational data (so far), using renin as a biomarker when medically treating PA is part of the endo society guideline. I titrate MRA until renin rises, then if needed utilize A/C/D. tinyurl.com/yksmf5y8
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 17/04/2026
How prominent is AI in your scholarship? Personally I feel like Journals should have AI disclosures for every article - since even literature searches often involve some degree of AI....but lines get really blurry about writing vs editing, data analysis vs management, etc...
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 17/04/2026
I think MRA as firstline is right around the corner.
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 17/04/2026
Yeah. Given how sensitive new thresholds are I think patients previously considered salt sensitive or with primary htn can more easily meet criteria...while a mra should be considered upfront, the addition of other agents makes sense from a BP management perspective to me at least
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 17/04/2026
Yeah - I think I'm finding and treating milder cases now and not observing that magic response. But that said ASIs may upend a lot of "firstline" thinking pretty soon.
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 17/04/2026
There's more evidence for firstline agents in general, but screening for PA was not nearly as common. I wonder about BP reduction itself beyond focusing on the renin response. I think multiclasses makes sense for BP control.
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 17/04/2026
I'm seeing more spironolactone monotherapy for medical management of non-lateralizing PA. Any evidence for this practice? I confess my conservative thinking is to adhere to evidence-based practice with some firstline agents for BP management (vs maxing out spiro alone). Thoughts?
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Stephen P Juraschek, MD, PhD, FAHA, AHSCP-CHS @spjuraschek.bsky.social · 12/04/2026
I think it's complicated. We did a quality improvement project around food insecurity and found that a number of people did not consistently use their entitlement for food
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