Int J Hypertens [JOURNAL]
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200 papers
Mediterranean Diet as a Therapeutic Strategy for Hypertension and Cardiovascular Health.
Liweleya S, Sibbenga F, Luwaya E … +8 more , Muchaili L, Siame L, Chipuma M, Muyupi K, Tembo T, Lwiindi PC, Hatwiko H, Siakabanze C
Int J Hypertens · 2025 · PMID 41384010 · Full text
BACKGROUND: The Mediterranean diet (MedDiet) is a well-established cardioprotective dietary pattern with demonstrated efficacy in managing hypertension (HTN) and cardiovascular disease (CVD). Its rich array of bioactive...
BACKGROUND: The Mediterranean diet (MedDiet) is a well-established cardioprotective dietary pattern with demonstrated efficacy in managing hypertension (HTN) and cardiovascular disease (CVD). Its rich array of bioactive compounds, including omega-3 polyunsaturated fatty acids, polyphenols and organosulfur compounds, targets multiple molecular pathways implicated in endothelial dysfunction, oxidative stress, inflammation and metabolic dysregulation. METHODS: This review employed a structured, integrative methodology following preferred reporting items for systematic reviews and meta-analyses, guidelines to analyze literature from PubMed, Scopus, Web of Science and Google Scholar (2000-2025). The population, intervention, comparator and outcomes (PICO) framework guided the research question, focusing on mechanistic, physiological and clinical evidence linking MedDiet components to HTN and vascular health. Inclusion criteria prioritized studies on the MedDiet -specific pathways, such as short-chain fatty acid (SCFA)-G-protein-coupled receptors 41/43 signaling, endothelial nitric oxide synthase (eNOS) activation, nuclear factor erythroid 2-related factor 2-antioxidant response element modulation and renin-angiotensin-aldosterone system regulation. Data were qualitatively synthesized to rank mechanisms by translational relevance and clinical tractability. MECHANISMS: The MedDiet exerts its antihypertensive effects through synergistic pathways: endothelial function enhancement via eNOS activation and nitric oxide bioavailability, oxidative stress reduction through nuclear factor erythroid 2-related factor 2-antioxidant response element pathway upregulation and nicotinamide adenine dinucleotide phosphate oxidase 4 inhibition. The third mechanism is anti-inflammatory actions via nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3 inflammasome suppression and cytokine modulation. The fourth is the renin-angiotensin-aldosterone system regulation through angiotensin-converting enzyme inhibition and angiotensin-converting enzyme 2 upregulation. Gut microbiota-derived SCFAs further amplify these effects by activating G-protein coupled 41/43 receptors, improving vasodilation and attenuating systemic inflammation. CONCLUSION: Compelling evidence supports the MedDiet as a first-line strategy for HTN and CVD, but research must address adherence, implementation and precision-nutrition gaps to translate proven cardioprotection into personalized, scalable therapies across diverse and resource-limited populations.
Causal Associations Between Obstructive Sleep Apnea and Hypertension: Evidence From a Bidirectional and Multivariable Mendelian Randomization Analysis.
Tang S, Li Q, Yang H … +1 more , Liu Y
Int J Hypertens · 2025 · PMID 41358052 · Full text
BACKGROUNDS: Obstructive sleep apnea (OSA) and hypertension both had significant impacts on human health. Whether OSA increases the risk of hypertension in relation to heredity remains unclear. We sought to clarify this...
BACKGROUNDS: Obstructive sleep apnea (OSA) and hypertension both had significant impacts on human health. Whether OSA increases the risk of hypertension in relation to heredity remains unclear. We sought to clarify this issue using bidirectional Mendelian randomization (MR) analysis in large cohorts. METHODS: A bidirectional two-sample MR was conducted to evaluate the potential causality between OSA and hypertension by selecting single-nucleotide polymorphisms (SNPs) as instrumental variables (IVs) from meta genome-wide association studies (mGWAS). The inverse-variance weighted (IVW) method was the main approach for data analysis to estimate the possible causal effects. Alternative methods such as MR-Egger, the MR pleiotropy residual sum and outlier (MR-PRESSO), and leave-one-out analysis methods were also performed as sensitivity analysis approaches. In order to adjust the confounding factors, a multivariable MR (MVMR) was also performed. RESULTS: In the forward analysis, the IVW analysis demonstrated a significant association of OSA on increased hypertension risk (OR, 1.044; 95% CI, 1.012-1.076; and =0.006), DBP value (β, 0.041; 95% CI, 0.012-0.071; and =0.005), and hypertension of siblings risk (OR, 1.025; 95% CI, 1.003-1.049; and =0.028), but after adjusting the confounding factors (BMI, smoking, and alcohol consumption), the association disappeared. The reverse analysis demonstrated the causal effect of hypertension of father on elevated OSA risk (OR, 3.803; 95% CI, 1.135-12.726; and =0.030). CONCLUSIONS: Our forward analysis found the association between OSA and increased hypertension risk, DBP, and hypertension risk of siblings, but after adjusting the confounding factors, the association disappeared; on the reverse analysis, we found the causal effect of hypertension of father on elevated OSA risk.
Relationship Between Salt Consumption and Blood Pressure in Sub-Saharan African Population Living in an Urban Setting: The Case of a Group of Cameroonians.
Nganou-Gnindjio CN, Mahamat M, Meleuh MFD … +7 more , Tasong LA, Chemgne I, Elong JT, Ndobo V, Manon GE, Medjo PM, Ndemba PA
Int J Hypertens · 2025 · PMID 41322699 · Full text
BACKGROUND: Hypertension is a global health issue that affects millions of people in the world and is a significant risk factor for cardiovascular diseases, stroke, and kidney failure. Among the many lifestyle factors in...
BACKGROUND: Hypertension is a global health issue that affects millions of people in the world and is a significant risk factor for cardiovascular diseases, stroke, and kidney failure. Among the many lifestyle factors influencing hypertension, dietary salt consumption has emerged as a key determinant of blood pressure regulation. This study aimed to investigate the relationship between daily salt intake and blood pressure in a group of Cameroonian subjects living in Yaoundé. METHODS: We conducted a cross-sectional analytical study, with prospective data collection conducted from March to May 2024. We included people aged 21 and over with known or unknown hypertension, residing in the Biyem-Assi Health District and having given their free and informed consent. Pregnant women, people with chronic kidney disease, people who had recently taken diuretics, and people with secondary hypertension were excluded from the study. We used a stratified random sampling method. The measurement of the association between salt consumption and blood pressure was studied using Pearson's correlation test with a significance threshold of < 0.05. RESULT: Of the 203 participants included in our study, the median age was 36 [25-55] years. They were predominantly female (51.2%), overweight/obese (50.2%), living a sedentary lifestyle (90.6%), and had normal blood pressure (MAP: 97.79 ± 7.71 mmHg). All participants had a high salt intake (5067.23 ± 1195.23 mg), with extremes of 2005.94 mg and 8222.11 mg, the majority (80.8%) having more than double the recommended value, and the majority of family meals (75%) had a sodium content ≥ 0.6 g/100 g. There was a positive linear relationship between salt intake and mean daily blood pressure ( = 0.452, < 0.001). CONCLUSION: This study highlights the importance of reducing salt intake in the strategy for preventing and managing hypertension in Cameroon. Reducing salt intake through education, awareness, and policy changes could contribute to significantly reduce the burden of hypertension in Cameroon.
Transcriptome-Based Identification of Biomarkers Associated With Sphingosine-1-Phosphate Signaling Pathway in Aortic Dissection.
Li A, Chen X, Huang W … +3 more , Li N, Zhu L, Shao G
Int J Hypertens · 2025 · PMID 41132152 · Full text
BACKGROUND: Aortic dissection (AD) is the most dangerous disease in acute aortic syndrome and is associated with serious complications. Current studies have shown that sphingosine-1-phosphate (S1P) has a certain effect o...
BACKGROUND: Aortic dissection (AD) is the most dangerous disease in acute aortic syndrome and is associated with serious complications. Current studies have shown that sphingosine-1-phosphate (S1P) has a certain effect on AD. Therefore, this study focuses on exploring biomarkers related to S1P in AD. METHODS: Differentially expressed genes (DEGs) between AD and normal samples were identified from the GSE153434 dataset. Key module genes associated with the S1P score were then obtained using weighted gene coexpression network analysis (WGCNA). The DEGs were intersected with these key module genes to derive a set of intersection genes. Subsequently, a protein-protein interaction (PPI) network was constructed and screened to identify candidate genes. Further biomarker mining was performed through machine learning approaches followed by validation. Following this, gene set enrichment analysis (GSEA), immune infiltration analysis, investigation of regulatory mechanisms, and drug prediction were conducted. Finally, we quantified S1P concentration in human plasma using an ELISA kit, established an AD rat model, and validated gene expression levels using quantitative real-time polymerase chain reaction (qRT-PCR). RESULTS: A total of 651 intersection genes were identified from the overlap between the 702 DEGs and 7108 key module genes. Subsequently, 20 candidate genes were screened, yielding two biomarkers: CXCL5 and ITGA5. Both biomarkers were enriched in the p53 signaling pathway, porphyrin and chlorophyll metabolism, and the NOD-like receptor signaling pathway. Furthermore, eight types of immune cells, including central memory CD4 T cells and natural killer T cells, were significantly elevated in the AD group compared with controls. ELISA quantification confirmed elevated S1P levels in human plasma. Additionally, utilizing an established AD rat model, we provided the first experimental validation that ITGA5 is highly expressed in dissected aortic tissue. Notably, CXCL5 exhibited the strongest significant positive correlation with central memory CD4 T cells. Regulatory network analysis revealed a relatively complex lncRNA-miRNA-mRNA interaction network. Finally, seven potential small-molecule drugs targeting ITGA5 were predicted, including cilmostim, cilengitide, and dimethyl sulfoxide. CONCLUSION: This study identifies ITGA5 as a novel biomarker for S1P-associated AD and reveals its potential underlying mechanisms and therapeutic candidates, providing a theoretical foundation for AD diagnosis and treatment.
Factors Associated With Nonadherence to Hypertension Treatment Among Young Adults in Korea.
Cho YH, Lee J
Int J Hypertens · 2025 · PMID 41127503 · Full text
This study investigated hypertension management in young adults in Korea using data from the 2023 Korean Community Health Survey. We examined treatment patterns and identified factors associated with untreated cases amon...
This study investigated hypertension management in young adults in Korea using data from the 2023 Korean Community Health Survey. We examined treatment patterns and identified factors associated with untreated cases among adults aged 20-39 years diagnosed with hypertension. Among young adults, 21.2% were receiving both drug treatment and lifestyle modification, while 28.6% were neither receiving drug treatment nor lifestyle modification. In addition, 35.5% were receiving only drug treatment, and 14.8% were practicing only lifestyle modification. The percentage of young adults who were not practicing both drug treatment and lifestyle modification was higher than that of adults aged 40 or older. These were associated with male sex (OR: 1.427, 95% CI: 1.12-1.82), BMI (OR: 0.932, 95% CI: 0.91-0.95), current smoking (OR: 1.366, 95% CI: 1.06-1.77), alcohol consumption (≤ once/week, OR: 1.654, 95% CI: 1.14-2.39; ≥ twice/week, OR: 2.484, 95% CI: 1.59-3.87), awareness of one's own blood pressure (OR: 0.194, 95% CI: 0.15-0.26), knowledge of myocardial infarction symptoms (OR: 0.779, 95% CI: 0.71-0.86), education about hypertension management (OR: 0.648, 95% CI: 0.52-0.80), and social network level (OR: 0.934, 95% CI: 0.91-0.96). These findings highlight the need for tailored interventions to improve hypertension awareness and management in young adults.
Constipation and Cardiovascular Mortality Risk in Patients With Hypertension: A Long-Term Cohort Study.
Wang J, Ye Y, Chen X … +2 more , Hu X, Peng Y
Int J Hypertens · 2025 · PMID 41050423 · Full text
Whether constipation serves as a risk factor for mortality in hypertensive patients remains an open question. The purpose of the study was to investigate the association of constipation in hypertensive patients with the...
Whether constipation serves as a risk factor for mortality in hypertensive patients remains an open question. The purpose of the study was to investigate the association of constipation in hypertensive patients with the prognosis for mortality. The study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted in 2009-2010 involving hypertensive individuals. Constipation was self-reported over the past 12 months. Cox regression analyses, adjusted for age, sex, and race/ethnicity, were employed to assess the association between constipation and all-cause mortality, as well as cardiovascular mortality. Subgroup and sensitivity analyses were conducted to explore variations in the relationship across different demographic and comorbidity groups. Of the 5199 individuals, 1285 had constipation. Hypertensive patients with constipation exhibited an increased risk of all-cause mortality (HR, 1.40, 95% CI, 0.99 to 1.97, =0.06) and cardiovascular mortality (HR, 1.83, 95% CI, 1.09 to 3.07, =0.02) compared to nonconstipated patients. The Kaplan-Meier survival curves also reflected higher rates of all-cause mortality (92.71% vs. 89.18%, < 0.001) and cardiovascular mortality (97.87% vs. 96.44%, =0.004) in the constipation group. Among hypertensive patients with a PIR ≤ 100, those with constipation exhibited significantly higher all-cause mortality risk than those without (HR 1.95; 95% CI 1.14-2.67; < 0.001). These patients also demonstrated increased cardiovascular mortality risk (HR 1.93; 95% CI 1.12-3.40; =0.019). Constipation shows a significant association with increased cardiovascular mortality risk in hypertensive patients.
Effect of Comprehensive Health Management on Medication Adherence and Healthy Lifestyle Behavior of Patients With Hypertension.
Lu X, Wang J, Chen S … +2 more , Lv L, Yu J
Int J Hypertens · 2025 · PMID 41018530 · Full text
Suboptimal medication adherence and unhealthy lifestyle behaviors are well-recognized contributing factors to poor blood pressure control in hypertension patients. We evaluated the effectiveness of comprehensive health m...
Suboptimal medication adherence and unhealthy lifestyle behaviors are well-recognized contributing factors to poor blood pressure control in hypertension patients. We evaluated the effectiveness of comprehensive health management in improving medication adherence and promoting healthy lifestyle behaviors among hypertension patients in China. A cluster randomized trial was implemented in rural areas of three provinces of China. Participants were individuals aged ≥ 40 years with uncontrolled hypertension. The intervention group received multidimensional health management measures codeveloped by healthcare organizations, village doctors, and patients, while the control group received standard care. The coprimary outcomes included the proportion of patients demonstrating good medication adherence and adherence to ≥ 3 healthy lifestyle components. Secondary outcomes comprised the proportion achieving controlled hypertension (BP < 140/90 mm Hg). From May 8th to November 28th, 2018, 9204 participants were enrolled. At 18-month follow-up, significantly higher medication adherence was observed in the intervention group compared with the control group, with an absolute difference of 5.0% (95% confidence interval (CI): 2.8-7.2; < 0.001). Similarly, adherence to ≥ 3 healthy lifestyles was achieved by 45.8% in the intervention group versus 33.7% in controls, yielding a 12.1% between-group difference (95% CI: 9.9-14.3; < 0.001). Hypertension control rates differed significantly between groups (43.2% vs. 23.9%; absolute difference 19.2% and 95% CI: 17.2-21.3; < 0.001). Hypertension patients receiving comprehensive health management in rural China demonstrated superior medication adherence and healthier lifestyle behaviors compared with those receiving standard care over 18 months. Further investigations are warranted to evaluate the cost-effectiveness and generalizability of this intervention. ClinicalTrials.gov identifier: NCT03527719.
Digital-Based Nutrition Interventions Employing the Dietary Approaches to Stop Hypertension (DASH) Diet: A Systematic Scoping Review.
Dodge E, Kelly PJ, Aboul-Enein BH
Int J Hypertens · 2025 · PMID 40918606 · Full text
The Dietary Approaches to Stop Hypertension (DASH) diet is an internationally recognized anti-hypertensive dietary model. This systematic scoping review examines the effectiveness of digital-based interventions utilizing...
The Dietary Approaches to Stop Hypertension (DASH) diet is an internationally recognized anti-hypertensive dietary model. This systematic scoping review examines the effectiveness of digital-based interventions utilizing the DASH dietary pattern. A search was conducted using 14 databases to include relevant studies from 1997 to January 2025 using PRISMA guidelines for scoping reviews. The review included 24 studies with almost 7000 participants, including randomized controlled trials and cohort studies conducted in several countries. Interventions using the DASH dietary pattern positively affected blood pressure (BP), nutrition behavior, and weight. Some studies also reported secondary outcomes such as reduced healthcare cost savings. Technology-based DASH diet interventions yielded favorable health outcomes, particularly in reducing BP and dietary salt intake, as well as improved diet quality. This systematic scoping review supports the potential of digital-based interventions utilizing the DASH dietary pattern to improve nutrition and health outcomes, particularly those related to hypertension management. The findings emphasize the importance of using evidence-based approaches, which are grounded in theoretical frameworks and models to develop effective interventions, and thoughtful program design to maximize group effectiveness. Other factors that influenced the effectiveness of the intervention included the type of technology used, as well as participant comfort with using technology. Further research and development are needed to optimize these interventions for widespread impact and long-term sustainability.
Predictors of Antihypertensive Drug Adherence and Blood Pressure Control Among Hypertensive Patients: A Multicenter Cross-Sectional Study.
Elias TP, Minyilshewa AT, Tekle MA … +2 more , Gebreamlak TW, Adde BL
Int J Hypertens · 2025 · PMID 40918605 · Full text
Hypertension or elevated blood pressure is a serious medical condition that significantly increases the risk of diseases of the heart, brain, kidneys, and other organs. Antihypertensive drug adherence is key to controlli...
Hypertension or elevated blood pressure is a serious medical condition that significantly increases the risk of diseases of the heart, brain, kidneys, and other organs. Antihypertensive drug adherence is key to controlling blood pressure. This study aimed to assess factors associated with antihypertensive drug adherence and blood pressure control among hypertensive patients in selected public hospitals under the Addis Ababa City Administration. A hospital-based cross-sectional study was conducted among hypertensive patients on follow-up in randomly selected public hospitals under the Addis Ababa City Administration from November 1, 2022, to February 28, 2023. The study population included 393 patients who fulfilled the eligibility criteria and were selected by systematic random sampling. Data collection was conducted from the electronic medical records and by interviewing patients with a structured questionnaire. The data were entered into Epi-Info 7.2.1 and exported to SPSS version 25 software for analysis. Logistic regression analysis was performed to determine the associations between the dependent and independent variables. The rates of antihypertensive drug adherence and blood pressure control were 72.5% and 23.4%, respectively. Participants with uncontrolled blood pressure were 41.7% less adherent than those with controlled blood pressure (AOR = 0.59; 95% CI, 0.36-0.97). Nonadherence to dietary restriction (AOR, 3.31; 95% CI, 1.84-5.96) and chronic kidney disease (AOR = 3.85; 95% CI, 1.41-10.52) were associated with good adherence, whereas the use of a single antihypertensive drug (AOR = 0.53; 95% CI, 0.30-0.94) and nonadherence to moderate physical exercise (AOR = 0.30; 95% CI, 0.20-0.65) were associated with poor adherence to antihypertensive medications. Male sex (AOR = 1.95; 95% CI, 1.04-3.28) and blood pressure measured at home (AOR = 0.59; 95% CI, 0.36-0.99) were found to be independent predictors of controlled blood pressure. Drinking alcohol (AOR = 1.92; 95% CI, 1.05-3.49) was inversely associated with blood pressure control. Although adherence to antihypertensive medications was relatively good, blood pressure control remained low, indicating that medication adherence alone is insufficient. Public health policies should focus on strengthening primary care systems to deliver integrated hypertension management, including lifestyle counseling, dietary support, and improved access to medications and monitoring tools.
Analysis of Blood Pressure Status and Influencing Factors Among 7218 Emergency Department Nurses: An Observational Cross-Sectional Study.
Liu W, Liu J, Li J … +9 more , Chen N, Zhang S, Zhu Y, Wang Y, Zhang X, Hao X, Zhang L, Li Y, Zhao B
Int J Hypertens · 2025 · PMID 40909152 · Full text
As frontline healthcare workers, emergency department nurses face high levels of urgency in their work and are exposed to a high risk of contingencies. Their blood pressure status and influencing factors require close at...
As frontline healthcare workers, emergency department nurses face high levels of urgency in their work and are exposed to a high risk of contingencies. Their blood pressure status and influencing factors require close attention. This study employed a census method and conducted a cross-sectional survey in 11 cities in Hebei Province from November 2016 to July 2018, measuring blood pressure and collecting questionnaires on influencing factors. Binary logistic regression and multiple linear regression were used to analyze the factors influencing blood pressure. Multivariate analysis of variance was used to examine the interaction effects between monthly night shift frequency and other influencing factors on the blood pressure of emergency department nurses. A total of 7218 emergency department nurses in Hebei Province were included (median [IQR] age, 29 [8] years; 6038 [83.65%] women). The prevalence of hypertension was 9.43%. The median SBP ( [IQR]) was 112.0 (13) mmHg, and the median DBP was 70.0 (14) mmHg. Analysis showed that gender, age, BMI, marital status, hospital location, monthly night shift frequency, hyperlipidemia, and antihypertensive medication were influencing factors for the blood pressure ( < 0.05). Significant interactions existed between monthly night shift frequency and marital status, monthly night shift frequency and hospital grade, and monthly night shift frequency and hyperlipidemia ( < 0.05). The systolic blood pressure of emergency department nurses who were divorced or widowed or in Class I hospitals or hyperlipidemia increased to a high degree with the increase of night shifts. The diastolic blood pressure of those combined with hyperlipidemia increased higher with the rise of night shifts. The blood pressure of emergency department nurses requires attention. Nursing managers should pay particular attention to nurses in the emergency department who are prone to hypertension and take proactive measures to prevent and manage hypertension.
Polymorphic and Expressional Analysis of Genes and in Cardiovascular Patients Using Conventional and qPCR Approach.
Bashir K, Batool SFTS, Zahra S … +3 more , Nasir H, Umar M, Ashraf T
Int J Hypertens · 2025 · PMID 40900941 · Full text
In the modern age, the problem of heart disease is increasing day by day which cause even more deaths than cancer. The study was designed to evaluate the polymorphism and expressional analysis of genes and in cardiovas...
In the modern age, the problem of heart disease is increasing day by day which cause even more deaths than cancer. The study was designed to evaluate the polymorphism and expressional analysis of genes and in cardiovascular patients. Blood samples of 300 cardiovascular patients and 300 controls were collected from Gannan and other hospitals of Pakistan. For polymorphism analysis, DNA was extracted followed, by conventional PCR to amplify the variants rs4977574, rs2383206, and rs2241766 of genes CDKN2B and ADIPOQ, respectively. For expressional analysis, mRNA was extracted from whole blood and converted into cDNA, followed by qPCR. The results show that heterozygous (AG) of rs4977574 of the gene showed highly significant association with 2-folds increased risk of cardiovascular disease (CVD) (OR = 2.03; 95% Cl = 1.26-3.25; < 0.0033) while heterozygous (AG) of rs2383206 of the gene exhibited significant association but with decreased risk of CVD (OR = 0.47; 95% Cl = 0.29-0.75; < 0.0017). The results of polymorphism rs2241766 show that the heterozygous genotype (TG) showed a significant association with a decreased risk of CVD (OR = 0.63; 95% CI = 0.39-1.01; < 0.05) while the homozygous mutant genotype (GG) of rs2241766 again showed a highly significant association with CVD which increased the risk of CVD by 2-folds (OR = 1.77; 95% CI = 1.11-2.80; < 0.0150). The results of expressional analysis show that is significantly overexpressed in cardiovascular patients, while the gene showed significant downregulation. The findings show that the and gene polymorphisms significantly raise the risk for CVD, while their expression shows a significant correlation with CVD.
Childhood Obstructive Sleep Apnea and Systemic Blood Pressure and Kidney Function: A Systematic Review and Meta-Analysis.
Rodriguez-Lopez S, Ofosu D, Gerdung C … +4 more , Keto-Lambert D, Sebastianski M, Lin M, Castro-Codesal M
Int J Hypertens · 2025 · PMID 40822139 · Full text
Obstructive sleep apnea (OSA) is a recognized risk factor for high blood pressure (BP) and chronic renal dysfunction in adults. However, it remains uncertain whether a similar association exists in children. This study...
Obstructive sleep apnea (OSA) is a recognized risk factor for high blood pressure (BP) and chronic renal dysfunction in adults. However, it remains uncertain whether a similar association exists in children. This study assessed the associations between childhood OSA and systemic BP and renal outcomes. Additionally, it examined the effects of OSA treatments on BP in children. A systematic literature search was conducted to identify relevant studies up to August 2024. Sixty-four studies, consisting of 44 observational studies and 20 OSA interventional studies, were included. Compared with healthy control groups, children with OSA had significantly higher daytime systolic BP (3.30 mmHg; 95% CI, 2.07-4.53), daytime diastolic BP (1.27 mmHg; 95% CI, 0.69-1.84), nighttime systolic BP (4.08 mmHg; 95% CI, 2.71-5.46), nighttime diastolic BP (2.12 mmHg; 95% CI, 0.96-3.27), daytime mean arterial pressure (MAP) (2.11 mmHg; 95% CI, 1.32-2.89), and nighttime MAP (3.60 mmHg; 95% CI, 1.11-6.09). Obesity was the only other contributing factor to daytime systolic BP elevation. Meta-analysis of studies on BP change after treatment (adenotonsillectomy or positive airway pressure) for OSA did not show significant changes in BP. Research on childhood OSA and renal outcomes is very limited. Our results demonstrate the association between childhood OSA and higher risk of adverse systemic BP outcomes. OSA treatment alone, however, has not been demonstrated to improve BP outcomes yet. Children with OSA and systemic hypertension should be assessed for further need of BP treatment to reduce long-term cardiovascular morbidity and mortality.
Neck Circumference and Hypertension in Middle-Aged and Older Adults: Baseline Phase Findings of the Ardakan Cohort Study on Aging, Iran.
Saatchi M, Fe'li SN, Pourhoseingholi A … +2 more , Saberian M, Bidkhori M
Int J Hypertens · 2025 · PMID 40740690 · Full text
Neck circumference (NC) is a measure to identify upper-body adiposity and has been hypothesized to be linked with hypertension (HTN). This study endeavors to examine the association between NC and HTN among middle-aged a...
Neck circumference (NC) is a measure to identify upper-body adiposity and has been hypothesized to be linked with hypertension (HTN). This study endeavors to examine the association between NC and HTN among middle-aged and elderly Iranian adults. In this cross-sectional study, adults over 50 years of age were recruited through a stratified random sampling approach. Anthropometric measurements, blood biochemical indicators, blood pressure (BP) readings, and evaluations of physical activity (PA) levels were conducted. In the univariable regression analyses, age, NC, body mass index, waist and hip circumference, waist-to-hip ratio, total cholesterol, presence of diabetes, PA levels, LDL-C, and HDL-C were found to be associated with HTN in both genders ( < 0.2). Notably, triglyceride levels showed a significant association solely among females. Subsequent multivariable regression analyses revealed an association between NC and HTN in both male and female participants (adjusted OR = 1.04 (95% CI: 1.008, 1.08) and 1.06 (95% CI: 1.01, 1.10), respectively). Individuals with higher NC demonstrated an increased likelihood of developing HTN. The strength of this association appeared to be slightly more pronounced in women. Consequently, individuals with larger NC measurements should undergo regular monitoring of BP levels to mitigate potential HTN risks.
Mechanisms and Prevention Strategies of Macrophage Involvement in the Progression From Hypertension to Heart Failure.
Zhang N, Cao P, Wang B … +3 more , Yang J, Zhao L, Shao W
Int J Hypertens · 2025 · PMID 40585349 · Full text
Hypertensive heart disease, a condition affecting millions worldwide, encompasses a spectrum from uncontrolled hypertension to heart failure. Despite the intricacies of its pathogenic mechanisms, recent attention has bee...
Hypertensive heart disease, a condition affecting millions worldwide, encompasses a spectrum from uncontrolled hypertension to heart failure. Despite the intricacies of its pathogenic mechanisms, recent attention has been directed toward the role of macrophages in the progression from hypertension to heart failure. Under normal circumstances, macrophages contribute to tissue homeostasis by clearing deceased cells. However, dysregulation during hypertension triggers inflammatory pathways, leading to tissue damage. Oxidative stress and mitochondrial dysfunction are implicated in this process. Exercise training, gaining popularity for its potential in regulating macrophage function, emerges as a promising intervention to improve outcomes in hypertensive heart disease. This review provides a succinct overview of previous research elucidating the involvement of macrophages in the transition from hypertension to heart failure. It underscores the current active areas of investigation and emphasizes the potential of exercise training in mediating macrophage responses, offering a glimpse into a hopeful avenue for therapeutic intervention in this challenging medical condition.
Incidence of Cardiovascular Events in Hypertensive Patients Based on the Quantity of Major Risk Factors According to the Isfahan Cohort Study.
Sadeghi M, Shokrani Foroushani R, Sabouri E … +5 more , Talaei M, Sarrafzadegan N, Oveisgharan S, Sheikhbahaei E, Roohafza H
Int J Hypertens · 2025 · PMID 40433464 · Full text
Hypertension is the most prominent established risk factor for adverse cardiovascular outcomes. The influence of hypertension in combination with other major cardiovascular disease risk factors (CVD-RFs) on mortality and...
Hypertension is the most prominent established risk factor for adverse cardiovascular outcomes. The influence of hypertension in combination with other major cardiovascular disease risk factors (CVD-RFs) on mortality and cardiovascular events has not been fully comprehended yet due to their overlapping and interconnected nature. This study was conducted to evaluate the impact of CVD-RFs quantity on the occurrence of cardiovascular events, CVD-related mortality, and all-cause mortality rates in hypertensive patients. In a secondary analysis of the Isfahan Cohort Study, demographic information, anthropometric measures, and laboratory results of participants were extracted. During the 15 years of follow-up, all-cause mortality, CVD-related mortality, and the occurrence of nonfatal cardiovascular events were assessed by separate panels of experts. Data analysis was performed using Cox proportional hazard models to estimate adjusted hazard ratios (HRs) among normotensive and hypertensive individuals in two subgroups of 3 CVD-RFs and≥ 3 CVD-RFs. Among 5432 eligible participants, hypertensive patients ( = 1509) had 1.3, 2, and 1.4 times higher HRs for all-cause mortality, CVD-related mortality, and nonfatal cardiovascular events, respectively. Compared to the normotensives, HRs for the mentioned outcomes were 1.2, 1.7, and 1.3 for hypertensive participants with < 3 CVD-RFs and 1.7, 3.4, and 2.3 for hypertensive participants with≥ 3 CVD-RFs. These rises were shown to be highly significant ( = 0.003, = 0.001) for CVD-related mortality and nonfatal cardiovascular events in hypertensives with ≥ 3 CVD-RFs compared with hypertensives with < 3 CVD-RFs. Hypertension alone or combined with other CVD-RFs increases the chance of all-cause mortality, CVD-related mortality, and nonfatal cardiovascular events. Rises in the quantity of other CVD-RFs (specifically to≥ 3) result in highly significant increases in fatal and nonfatal cardiovascular events. Therefore, to reduce mortality and cardiovascular events, hypertensive patients should be thoroughly evaluated for coexisting CVD-RFs, aiming to limit the synergistic effects of multiple CVD-RFs by properly managing modifiable RFs.
Associations of Genetically Predicted NPR3 and NPR2 Perturbation and Preeclampsia Risk: A Two-Sample Mendelian Randomization Analysis.
Harpe R, Rogne T, Nyberg M … +4 more , Cronjé HT, Burgess S, Karhunen V, Gill D
Int J Hypertens · 2025 · PMID 40406480 · Full text
Preeclampsia, a pregnancy complication marked by hypertension after 20 weeks of gestation, arises from placental factors that impair maternal vascular function. C-type natriuretic peptide (CNP), known for its vasodilator...
Preeclampsia, a pregnancy complication marked by hypertension after 20 weeks of gestation, arises from placental factors that impair maternal vascular function. C-type natriuretic peptide (CNP), known for its vasodilatory role, may help counter preeclampsia-related vascular dysfunction. This study aimed to explore the effect of CNP on preeclampsia risk using the Mendelian randomization (MR) framework. Genetic instrumental variables that mimic the effects of CNP signaling (through natriuretic peptide receptor 2 [NPR2] activation or reduced NPR3-mediated clearance) were identified in the genes encoding the two receptors. This discovery emerged from a multiancestry genome-wide association study (GWAS) involving over 5 million individuals. Female-specific genetic association estimates were obtained from individual-level data comprising 198,402 female participants in the UK Biobank. Two-sample MR analyses were conducted to investigate the effects of NPR2 activation and NPR3 function on preeclampsia, utilizing the largest publicly available GWAS on preeclampsia, which included 296,824 female participants. Genetically proxied reduced NPR3 function was associated with a lower risk of preeclampsia (odds ratio (OR): 0.46, 95% confidence interval 0.30-0.69). In contrast, genetically proxied increased NPR2 activation lacked significant association, likely due to underpowered genetic instruments. Sensitivity analyses indicated robust findings with minimal pleiotropy, meaning the genetic variants used primarily influenced preeclampsia through the intended biological pathway rather than affecting multiple unrelated traits. This study employed the MR paradigm to provide genetic evidence supporting the protective effects of CNP (through reduced NPR3 function) on the risk of preeclampsia. However, it is important to gather additional evidence from other sources before moving forward with clinical development efforts to explore CNP as a potential treatment for preeclampsia.
Assessment of Serum Magnesium Mean Levels at Pre- and Postmagnesium Sulfate Uptake for Eclampsia Prevention: A Cross-Sectional Study.
Vo TM, Van Tran D, Nguyen DQ … +4 more , Nguyen TT, Nguyen MH, Nguyen TT, Le LB
Int J Hypertens · 2025 · PMID 40375921 · Full text
To assess serum magnesium mean levels in pregnant women with severe preeclampsia at three landmarks: prior to MgSO intake, 30 min, and 6 h postintake of loading dose plus maintenance dose. This cross-sectional study col...
To assess serum magnesium mean levels in pregnant women with severe preeclampsia at three landmarks: prior to MgSO intake, 30 min, and 6 h postintake of loading dose plus maintenance dose. This cross-sectional study collected blood samples over a timeframe of 0-6 h from 64 pregnant women diagnosed with severe preeclampsia who were receiving MgSO therapy at the emergency management department of Hung Vuong Hospital, Vietnam, in the period of November 2023 to April 2024. Serum magnesium levels were measured three times in the timeframe. Prior to MgSO intake, the serum magnesium mean level was 0.75 ± 0.13 mmol/L. At 30 min postloading dose intake plus maintenance, the level increased to 1.65 ± 0.32 mmol/L, and at 6 h, 1.6 ± 0.34 mmol/L, where 17.2% of patients had a serum magnesium level of 2 mmol/L or higher. There were no eclampsia incidents in patients with severe preeclampsia treated with a regimen of a loading dose of 4.5 g MgSO followed by a 1 g-hourly maintenance. Nevertheless, about 17% of participants achieved the desired threshold of 2 mmol/L, indicating a need for additional research to refine the loading and maintenance doses of MgSO for better management of severe preeclampsia in Vietnamese women.
Long-Term Effects of Sustained Regular Medication in Hypertensive Patients in Yunnan, China: A Cohort Study of 5 Years' Follow-Up.
Ma M, Wang H, Pang L … +12 more , Guo Z, Sun M, Zhao Y, Shi Y, Wu X, Song J, Zhu Q, Duo L, Wang Z, Xia Y, He L, Tang M
Int J Hypertens · 2025 · PMID 40375920 · Full text
The relationship between different grades of compliance to antihypertensive medication and blood pressure (BP) control rate remains unclear. This study highlighted the Chinese Basic Public Health Service (BPHS) program u...
The relationship between different grades of compliance to antihypertensive medication and blood pressure (BP) control rate remains unclear. This study highlighted the Chinese Basic Public Health Service (BPHS) program upgraded antihypertension medication compliance to improve the blood pressure control rate contributing to the UN sustainable development goal of lowering chronic illness fatalities by one-third by 2030. In 2015, 1254 hypertensive patients aged ≥ 35 years were selected in the baseline survey in Yunnan Province by a multistage stratified random sampling method and followed up from 2018 to 2022. Then, they were divided into three groups by tertiles as antihypertensive medicine compliance "poor," "intermittent," and "sustained" groups. Then, the robust variance Poisson regression models were performed to estimate the association between three groups and the number of referrals. Kaplan-Meier curves calculated the cumulative risk of onset and survival probability of cardiovascular events from three medication compliance groups. A total of 1254 hypertension patients were included in the study; 992, 1218, 1121, 1066, and 999 hypertension patients were followed up annually. From the baseline to last follow-up, systolic BP declined with the largest decrease in the sustained group (2015: 152.88 ± 21.64 mmHg vs. 2022: 134.61 ± 10.49 mmHg, < 0.05) and the least decrease in the poor group (2015: 157.07 ± 15.37 mmHg vs. 2022: 140.33 ± 12.04 mmHg, < 0.05). Under the management of BPHS, the BP control rate of all three groups increased significantly. Compared with the baseline, the control rate in the sustained group reached 70% in 2022 ( < 0.01). The number of referrals from the poor group was 11.5%, higher compared with the sustained group (IRR = 1.115 and 95% CI: 1.043-1.193). The poor group also had the highest probability of cardiovascular disease (CVD). The survival probability in the sustained group was the highest and kept at 0.950 at the end of 5 years. High-grade compliance to antihypertensive drugs significantly improves BP control rate and reduces the risk of CVD events and mortality. The decline of medication compliance grades is closely related to decreasing BP control rate and increased risk of CVD and mortality.
Impact of Renin-Angiotensin-Aldosterone System (RAAS) Gene Polymorphism in Essential Hypertension and Antihypertensive Drug Therapy: A Review.
Adhikari A, Sharma C, Lhamu Sherpa M … +3 more , Karaunakran G, Dhakal M, Sharma A
Int J Hypertens · 2025 · PMID 40342617 · Full text
Genetic, demographic and environmental factors all play a role in the frequency of an intricate multifactorial condition known as hypertension. Approximately 30% and 50% of BP fluctuation are influenced by genetic variab...
Genetic, demographic and environmental factors all play a role in the frequency of an intricate multifactorial condition known as hypertension. Approximately 30% and 50% of BP fluctuation are influenced by genetic variability. Many genetic studies have confirmed the link between genetic variability and susceptibility to essential hypertension; hence, identifying genes associated with essential hypertension susceptibility will aid in understanding the pathophysiology and their influence on how an individual responds towards the antihypertensive therapy. There are also controversial results highlighted in some reports. This review summarises genetic variants of the renin-angiotensin-aldosterone system (RAAS), angiotensinogen (AGT) (M235T), angiotensin converting enzyme (ACE) (insertion/deletion), angiotensin II type 1 receptor (AT1R) (A1166C) and aldosterone synthase (C344T) that are known and might contribute towards the pathophysiology of essential hypertension. Furthermore, the review highlights the response of certain RAAS gene polymorphisms (renin, ACE and AT1R genes) to antihypertensive drugs.
Analysis of Adherence Status and Influencing Factors Among Middle-Aged and Elderly Hypertension Patients in Rural Areas of Northeast China.
Lu X, Wang J, Chen S … +2 more , Lv L, Yu J
Int J Hypertens · 2025 · PMID 40322455 · Full text
Hypertension remains a major public health challenge globally, with suboptimal adherence to treatment and lifestyle modifications exacerbating cardiovascular risks. This study evaluates multidimensional adherence (medica...
Hypertension remains a major public health challenge globally, with suboptimal adherence to treatment and lifestyle modifications exacerbating cardiovascular risks. This study evaluates multidimensional adherence (medication, diet, and behavior) and its determinants among hypertensive patients in rural Northeast China. A cross-sectional study enrolled 6352 adults aged ≥ 40 years with diagnosed and poorly controlled hypertension from rural villages across five cities (Benxi, Chaoyang, Dandong, Donggang, and Fuxin) in Liaoning Province, Northeast China, using multistage cluster sampling. Adherence was assessed via standardized questionnaires, with logistic regression analyzing sociodemographic, clinical, and behavioral predictors. Medication adherence was reported by 73.7% of participants, while dietary and behavioral adherence rates were 10.5% and 29.3%, respectively. Ethnic disparities emerged, with Han Chinese exhibiting lower medication adherence (aOR = 0.485, 95% CI: 0.377-0.624). Cohabiting with children enhanced dietary adherence (aOR = 2.184, 95% CI: 1.854-2.573), whereas widowed status reduced both dietary (aOR = 0.698, 95% CI: 0.528-0.924) and behavioral adherence (aOR = 0.726, 95% CI: 0.595-0.887). Higher hypertension knowledge scores positively influenced all adherence domains ( < 0.05). Adherence among rural hypertensive patients is multidimensional, shaped by cultural, socioeconomic, and behavioral factors. Targeted interventions addressing dietary sodium reduction, family-based support, and health literacy improvement are urgently needed. This study underscores the importance of integrating region-specific strategies into hypertension management programs to mitigate cardiovascular morbidity in high-risk populations.
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