Hypertension is an important modifiable risk factor for morbidity and mortality associated with cardiovascular disease. The incidence of hypertension is increasing not only in Korea but also in many Western countries due to the aging of the population and the increase in unhealthy lifestyles. However, hypertension control rates remain low due to poor adherence to antihypertensive medications, low awareness of hypertension, and numerous factors that contribute to hypertension, including diet, environment, lifestyle, obesity, and genetics. Because artificial intelligence (AI) involves data-driven algorithms, AI is an asset to understanding chronic diseases that are influenced by multiple factors, such as hypertension. Although several hypertension studies using AI have been published recently, most are exploratory descriptive studies that are often difficult for clinicians to understand and have little clinical relevance. This review aims to provide a clinician-centered perspective on AI by showing recent studies on the relevance of AI for patients with hypertension. The review is organized into sections on blood pressure measurement and hypertension diagnosis, prognosis, and management.

Kim HY, et al. J Cardiovasc Imaging. 2021 Apr;29:e44. https://doi.org/10.4250/jcvi.2021.0014

Aims: Hypertrophic cardiomyopathy (HCM) is associated with a significant risk of arrhythmia and heart failure (HF), yet treatment options for patients with HCM have remained limited. We aimed to investigate the relationship between sodium–glucose cotransporter-2 inhibitor (SGLT2i) use and clinical outcomes among patients with concurrent HCM and diabetes in real-world settings. Methods and results: Using the Korean National Health Insurance Service database, we identified patients with a confirmed diagnosis of HCM and prescriptions for antidiabetic drugs from 2018 to 2022. After propensity matching, we compared 2063 patients who received SGLT2i with 2063 patients who did not for clinical outcomes. The primary outcome was a composite of all-cause death and HF hospitalization. Secondary outcomes included individual outcomes of all-cause death, HF hospitalization, sudden cardiac death, and ischaemic stroke. During a median follow-up period of 3.1 years, patients with HCM on SGLT2i had a significantly lower risk of the primary outcome [hazard ratio (HR) 0.76, 95% confidence interval (CI) 0.67–0.86]. Specifically, SGLT2i use was associated with reduced all-cause mortality (HR 0.56, 95% CI 0.46–0.68) and fewer HF hospitalizations (HR 0.82, 95% CI 0.72–0.94). Additionally, SGLT2i use was linked to a decreased risk of sudden cardiac death (HR 0.50, 95% CI 0.33–0.77) and ischaemic stroke (HR 0.74, 95% CI 0.62–0.88). Subgroup analyses by age, sex, and atrial fibrillation did not reveal any significant interactions. Conclusion: The use of SGLT2i was associated with a decreased risk of adverse clinical outcomes among patients with HCM with concurrent diabetes on antidiabetic drugs. Lay Summary: This population-based cohort study examined the association between sodium–glucose cotransporter-2 inhibitors (SGLT2is) and clinical outcomes in patients with hypertrophic cardiomyopathy (HCM) and diabetes.Patients with HCM and diabetes who used SGLT2i had a significantly lower risk of all-cause death and heart failure hospitalization compared with those who did not use SGLT2i.These associations were consistent across various subgroups, including sex, age, atrial fibrillation, and income levels.

Cho JS, et al. J Korean Med Sci. 2015 Jul;30(7):903-910. https://doi.org/10.3346/jkms.2015.30.7.903

Hong YJ, et al. Korean Circ J. 2008 Jul;38(7):366-373. https://doi.org/10.4070/kcj.2008.38.7.366

The aim of this study was to assess the changes in the left atrial (LA) shape and to identify the determinants of these changes in chronic mitral regurgitation (MR). We enrolled 125 consecutive patients (56 ± 16 years, 51% men) with chronic MR caused by myxomatous mitral valve disease in sinus rhythm and 45 control patients (54 ± 15 years, 55% men) undergoing transthoracic Doppler echocardiography. The LA eccentricity index (LAEi) and the LA volume index (LAVi) were used to estimate the LA shape and size, respectively. There were significant decreases in LAEi (r= −0.723, P< 0.001) and increases in LAVi (r= 0.642, P< 0.001) with increasing severity of MR. In multivariate stepwise linear regression analysis, regurgitant fraction (RF) was an independent determinant of the LAE, whereas RF, left ventricular (LV) mass index and LV diastolic dysfunction grade were independent determinants of the LA volume. The LAEi was positively related to the velocity of A′ in the entire population (r = 0.238, P = 0.002). On the receiver operating characteristic (ROC) curve analysis, LAEi ≤1.30 was the best cut-off value to reflect the LA systolic dysfunction (A′ velocity <7 cm/s; area under the curve was 0.78, P < 0.001). LA becomes more spherical with increasing severity of MR, suggesting a decrease in LAE, which is mainly determined by the volume overload. LAE might be closely related to the LA systolic function in chronic MR.