Hypertension

BACKGROUNDHypertension is a common condition worldwide, yet its underlying mechanisms remain largely unknown. This study aims at identifying urinary peptides associated with hypertension to further explore its molecular pathophysiology. METHODSPeptidome data from 2876 individuals without end-organ damage were retrieved from the Human Urinary Proteome Database general population (discovery) or type 2 diabetic (validation) cohorts. Participants were divided based on systolic and diastolic blood p...

BackgroundHypertension (HTN) is a major global contributor to cardiovascular morbidity and mortality, and improved biomarkers are needed to better characterize individual risk, disease progression, and treatment response. Uromodulin (UMOD), the most abundant protein in human urine reflects tubular health and renal sodium handling. Genome-wide association studies (GWAS) have identified common UMOD promoter polymorphisms associated with HTN across diverse populations, sparking interest in UMOD as ...

BackgroundWhile some individuals exhibit salt sensitivity, others demonstrate salt resistance or inverse salt sensitivity--blood pressure reduction during high sodium intake. The molecular mechanisms underlying heterogeneous blood pressure responses to dietary sodium remain poorly understood. Deep proteomics provides a new tool to identify molecular mediators of salt resistance and inverse salt sensitivity. MethodsWe conducted a randomized crossover trial in 20 normotensive adults comparing 8-d...

Epidemiological and animal studies have associated systemic inflammation with blood pressure (BP). However, the mechanistic factors linking inflammation and BP remain unknown. Fatty acid derived eicosanoids serve as mediators of inflammation and have been suggested to also regulate renal vascular tone, peripheral resistance, renin-angiotensin system, and endothelial function. We therefore hypothesize that specific pro- and anti-inflammatory eicosanoids are linked with BP. We studied a population...

BackgroundRecent studies show that the risk of cardiovascular disease (CVD) increases from a lower nadir of systolic blood pressure (SBP) in women than men, and increases thereafter at a greater rate. This has led to a suggestion that sex-based SBP thresholds are required. We aimed to investigate sex differences in the associations of SBP and incident atherosclerotic CVD in a large prospective cohort. Methods420,649 UK Biobank participants with no prior history of CVD were included. Age-adjuste...

BackgroundPotassium has biologic plausibility to lower blood pressure (BP) via natriuresis, vascular effects, and RAAS modulation. The clinical effect in untreated primary hypertension remains uncertain. ObjectivesTo estimate the effect of oral potassium supplementation on clinic and 24-h ambulatory BP (ABPM) and to summarize safety. MethodsWe included randomized trials (parallel or crossover) in adults ([≥]18 y) with untreated primary hypertension comparing oral potassium supplements vs pl...

BackgroundThe Rice Diet (RD), a low-sodium (<150mg/day), low-protein (20g/day), low-fat (<5g/day), diet was used to treat patients with malignant hypertension (MH) beginning in the 1940s, before any effective anti-hypertensive drugs were available. We retrospectively analyzed a curated cohort of RD patients with MH to assess factors, including dietary adherence, associated with blood pressure (BP) reduction. MethodsFrom 17,487 RD charts, we identified 544 MH patients (baseline systolic BP (SBP)...

Prolonged water-only fasting appears to reduce high blood pressure but randomized controlled trials are needed. This single arm pre-post interventional trial (clinicaltrials.gov, NCT04515095) investigates the safety, feasibility, and effectiveness of prolonged water-only fasting in the treatment of stage 1 and 2 hypertension. Twenty-nine participants with stage 1 and 2 hypertension, who were pre-approved to water-only fast for [&ge;]7 days, were enrolled from a residential fasting center. Partic...

BackgroundThe prognosis of high or markedly low diastolic blood pressure (DBP) with normalized on-treatment systolic blood pressure (SBP) on major adverse cardiovascular events (MACE) is uncertain. This study examined whether isolated diastolic hypertension (IDH) and isolated low DBP (ILDBP) were associated with MACE in treated patients. Methods7582 hypertensive patients with on-treatment SBP <130 mmHg from the Systolic Blood Pressure Intervention Trial (SPRINT) were categorized based on averag...

BackgroundHypertension affects over 1.28 billion adults worldwide, including a significant number of women. Although the gut microbiome is implicated in the onset and progression of hypertension, few studies have examined the relationship in middle-aged women. MethodsWithin an established cohort, we investigated the relationship between gut microbiota and its metabolites in normotensive vs. hypertensive middle-aged women (n=108) matched for age (56.6{+/-}0.91 years) and body mass index (24.3{+/...

BackgroundInterindividual variation in systolic blood pressure (SBP)-heart rate (HR) coupling reflects differences in autonomic and vascular regulation. The primary objective of this study was to determine whether SBP-HR synchronization identifies distinct hemodynamic phenotypes associated with demographic characteristics and blood pressure (BP) profiles in hypertensive and normotensive individuals. MethodsWe conducted a cross-sectional cohort analysis of 1,122 adults who underwent continuous 2...

BackgroundPre-eclampsia (PE) and gestational hypertension (GH) identify women at increased risk of chronic hypertension (CH) and cardiovascular disease, but as efforts to prevent PE and GH advance, fewer women at increased cardiovascular risk will be identified. MethodsCohort of 26,511 women seen in two consecutive pregnancies. Included were women without CH, with information on maternal characteristics and blood pressure (BP) at 11-13 weeks gestation, and development of PE or GH in the index p...

BackgroundIn 2024, the European Society of Cardiology (ESC) hypertension guidelines introduced an "elevated blood pressure" category (120-139/70-89 mmHg), lowering the normal diastolic BP threshold from 85 to 70 mmHg. The implications of this change for risk stratification in primary prevention are uncertain. MethodsWe conducted a cross-sectional study of adults undergoing standardized preventive health assessments at a dedicated center in Paris, France. Office blood pressure was measured with ...

ObjectivesEvidence from randomised trials on long-term blood pressure (BP) reduction from pharmacologic treatment is limited. To investigate the effects of antihypertensive drugs on long-term BP change and examine its variation over time and among people with different clinical characteristics DesignIndividual participant-level data meta-analysis Setting and data sourceThe Blood Pressure Lowering Treatment Trialists Collaboration involving 51 large-scale long-term randomised clinical trials P...

Hypertension during pregnancy increases the risk for adverse maternal and fetal outcomes, but mechanisms of pregnancy hypertension are not precisely understood. Elevated plasma renin activity and aldosterone concentrations play an important role in the normal physiologic adaptation to pregnancy. These effectors are reduced in patients with pregnancy hypertension, creating an opportunity to define features of the renin-angiotensin-aldosterone system (RAAS) that are characteristic of this disorder...

ObjectiveHypertensive disorders of pregnancy are associated with future cardiovascular risk, however, the underlying mechanisms are unclear. We sought to test the feasibility of postpartum remote blood sampling following a hypertensive disorder of pregnancy and subsequently identify differentially expressed proteins in individuals who developed hypertension. Study designWe used data from a randomized clinical trial evaluating the feasibility of lifestyle intervention and home blood pressure mon...

Angiotensin converting enzyme 2 (ACE2) is the cellular entry point for severe acute respiratory syndrome coronavirus (SARS-CoV-2) - the cause of COVID-19 disease. It has been hypothesized that use of renin-angiotensin system (RAS) inhibiting medications in patients with hypertension, increases the expression of ACE2 and thereby increases the risk of COVID-19 infection and severe outcomes or death. However, the effect of RAS-inhibition on ACE2 expression in human tissues of key relevance to blood...

Genetic predisposition is a risk factor for office hypertension. We tested whether genetic background could identify individuals with ambulatory daytime hypertension in a sample of white Europeans from Liechtenstein. We evaluated two measures of predisposition to hypertension: family history and polygenic risk scores (PRS). Our analytic sample contained 1444 participants aged 25 to 41. Of the participants, 12% had office hypertension, while 37% had out-of-office hypertension. The correlation bet...

BackgroundPreeclampsia (PE) is a complex disorder with significant maternal and fetal risks. The soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) ratio shows promise as a diagnostic tool, but its adoption in the U.S. is limited, due to a lack of widely available testing platforms, locally conducted studies based on the U.S. population and clear, evidence-based guidance on test implementation, including appropriate cutoff values. Patients/Materials and MethodsThis i...

BackgroundThe effect of intensive systolic blood pressure (SBP) lowering on left ventricular (LV) geometry remains unclear. MethodsPatients with hypertension aged 60-80 years without prior stroke were enrolled from 42 centers across China from January 2017. Eligible patients were randomly assigned to intensive (target: 110 to <130 mmHg) or standard (target: 130 to < 150 mmHg) SBP-lowering treatment. LV mass (LVM) was assessed by two-dimensional, M-mode, color flow Doppler echocardiography. LV h...