Hypertension

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 ...

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...

BackgroundHypertensive disorders of pregnancy (HDP) affect up to 15% of pregnancies and are linked to adverse maternal and fetal outcomes. Primary aldosteronism (PA) affects up to 25% of hypertensive patients. We examined PA prevalence in women with prior HDP and its relationship to hypertension trajectory. MethodsAdults from across the U.S.A. meeting guideline-recommended screening criteria for PA were prospectively tested. Women with a self-reported history of HDP completed a questionnaire ex...

Preclinical models have been instrumental in defining the immunological mechanisms underlying hypertension, yet human studies remain comparatively limited, leaving a major gap in translational understanding. To address this, we investigated immune cell dynamics in human hypertension by profiling peripheral blood mononuclear cells from 48 normotensive and hypertensive participants, characterised using ambulatory blood pressure (BP) monitoring. High{square}dimensional spectral flow cytometry revea...

BackgroundAngiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) are commonly prescribed alongside exercise to manage hypertension in individuals with metabolic syndrome (MetS). However, their potential to interfere with exercise-induced physiological adaptations remains unclear. MethodsIn this prospective, parallel-group study, 62 sedentary obese adults with MetS completed a 16-week supervised high-intensity interval training (HIIT) program. Participants were ...

Dietary fibre fermentation produces short-chain fatty acids (SCFAs) that lower colonic luminal pH, influencing host responses that contribute to blood pressure (BP) regulation. Fibre intake also alters gastrointestinal transit time, which has been linked to hypertension prevalence. Here, we aimed to determine the gastrointestinal pH and transit time in patients with hypertension. Using the SmartPill Motility Testing System, we assessed gastrointestinal pH and transit time in 55 participants with...

BackgroundHypertension affects over 30% of adults and is the leading risk factor for cardiovascular disease. It often presents without obvious symptoms, meaning that, although effective therapies exist, hypertension remains widely undiagnosed and insufficiently treated. Genomics-based prediction methods have shown only modest benefits for these disorders, but proteomic markers have demonstrated potential for greater predictive and clinical value. MethodsWe applied a novel machine-learning based...

BackgroundBlood pressure (BP) is routinely measured during healthcare visits. A standardized measurement is essential to ensure accurate values, particularly in outpatient settings, where patient preparation, environment, and technique can significantly influence results. MethodsA quasi-experimental study was conducted in adult outpatients. Demographic, anthropometric, and clinical data were collected through interviews and physical examination. BP was measured using a validated automated oscil...

BackgroundDespite the broad availability of antihypertensive drugs, approximately 40% of hypertensive patients fail to achieve the recommended blood pressure (BP) levels and may require alternative treatment(s). Currently, renal denervation is the only proven non-pharmacological device-based alternative treatment available but is a costly hospital-based invasive procedure that is unlikely to be widely available. Transcutaneous autonomic neuromodulation (tAN), if safe, acceptable and efficacious,...

BACKGROUNDCardiorespiratory fitness (CRF) is a strong predictor of cardiovascular risk, yet scalable approaches to improve CRF among adults with high-normal or high blood pressure (BP) remain limited. Telehealth lifestyle programs may address this gap, but trials with rigorous CRF endpoints are scarce. METHODSWe conducted a two-center, assessor-blinded, randomized controlled trial in Beijing and Shenzhen, China, from July 2022 to September 2024. Adults with high-normal or high BP were enrolled ...

BACKGROUNDWhether systolic blood pressure (SBP) time in target range (TTR) associates with cerebral small vessel disease (CSVD) in hypertensive patients remains unclear. METHODSBetween December 2020 and August 2023, participants were prospectively included from the Kailuan study. TTR was calculated using linear interpolation with the SBP target range between 120 and 140 mm Hg from 2006 to 2020. Beginning in 2020, brain MRI was conducted to identify CSVD burden and imaging markers, namely, lacun...

Hypertension is a silent killer, with over half of affected adults unaware of their condition1,2. This lack of awareness is a major concern, as early intervention is critical for preventing major adverse cardiovascular events3,4. While cuffless wearable blood pressure (BP) monitors offer comfort and convenience, their reliance on periodic calibration and inconsistent accuracy have limited their clinical adoption5,6. Here we show that applying artificial intelligence (AI) pre-trained on almost 50...

ObjectivesVisit-to-visit blood pressure variability (VVV BPV) is an underutilised risk factor for cardiovascular disease (CVD). This study aims to determine the minimum number of BP measurements needed and to identify cut-off values for the standard deviation (SD), coefficient of variation (CV), and average real variability (ARV) of systolic and diastolic VVV BPV to predict CVD risk in primary care. MethodsWe analysed data from the electronic practice-based research network (ePBRN) in Southwest...

BackgroundHypertension is a major modifiable risk factor for cardiovascular disease, yet blood pressure (BP) control remain suboptimal, particularly in socially disadvantaged communities. Guidelines recommend initiating single-pill combination (SPC) therapy to improve adherence and BP control, but uptake in primary care is limited. ObjectivesTo evaluate the SOLO care improvement project, promoting SPC initiation among general practitioners (GPs) in Amsterdam Zuidoost, a disadvantaged, multi-eth...

BackgroundAortic aneurysm and dissection (AAD) are highly lethal conditions for which hypertension serves as a primary risk factor. The limited efficacy of conventional antihypertensive treatments suggests an inadequate understanding of the molecular mechanisms that connect these conditions. Despite their pivotal role in regulating biological functions, the specific proteomic signatures associated with both hypertension and AAD have not been extensively investigated. This study sought to conduct...

Pulmonary hypertension (PH) is a progressive condition characterized by increased pulmonary arterial pressure. Endothelial cell dysfunction is one important characteristic of PH. Recently, capillary endothelial cells, including aerocytes (aCaps) and general capillary cell (gCaps), have been detected in developing lungs but their role and the regulatory mechanisms underlying PH remain poorly understood. The goal of this study was to identify changes in Caps and their effects on hypertensive pulm...

Background and AimsNon-adherence to antihypertensive therapy is a major contributor to poor blood pressure (BP) control, increased cardiovascular risk, and higher healthcare costs. Behavioral economics suggests that financial incentives and mobile-based interventions may support behavior change, yet evidence for such strategies in central Europe is limited. ObjectiveThe BEHAVE-HTN study evaluates whether a multi-faceted medication adherence mobile application (mApp) with behavioral economic pri...

BACKGROUNDVisit-to-visit blood pressure variability (VVV BPV) is an important yet underutilised risk factor for cardiovascular disease (CVD) risk prediction. Incorporating VVV BPV in the model predicting CVD could improve its performance. This study aims to incorporate VVV BPV into a CVD risk prediction model and to evaluate its performance by comparing the discrimination and calibration of models using a single BP measurement versus those incorporating VVV BPV METHODSThis prospective cohort st...

BACKGROUNDSerum uric acid (SUA) has been associated with cardiovascular (CV) and all-cause mortality; however, its interpretation is influenced by renal function. The serum uric acid to creatinine ratio (SUA/sCr) has been proposed as a refined marker, integrating urate burden with renal excretory capacity. Evidence from real-world populations with preserved renal function remains limited. METHODSA retrospective observational analysis was performed using administrative and laboratory databases f...

BackgroundPatients with repaired coarctation of the aorta (CoAo) remain at risk for left ventricular hypertrophy (LVH) even in the absence of hypertension. Alterations in wave reflection and the timing of reflected pressure waves may contribute to ventricular remodeling beyond pressure load alone. MethodsWe performed a cross-sectional analysis of patients with repaired CoAo. Office and ambulatory blood pressure (ABPM), non-invasive central hemodynamics, and echocardiographic indices of left ven...