Current Hypertension Reports[JOURNAL]
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200 papers
Patient Selection and Renal Denervation.
Ashoka A, Voora R
Curr Hypertens Rep · 2026 Jan · PMID 41563656 · Publisher ↗
PURPOSE OF REVIEW: To review the current data informing patient selection and provide guidance on when to refer potential patients for consideration of renal denervation. RECENT FINDINGS: Multiple sham-controlled randomi...
PURPOSE OF REVIEW: To review the current data informing patient selection and provide guidance on when to refer potential patients for consideration of renal denervation. RECENT FINDINGS: Multiple sham-controlled randomized trials have demonstrated favorable safety and efficacy outcomes for renal denervation (RDN) in the management of uncontrolled hypertension in patients across the hypertension (HTN) spectrum including patients with true resistant hypertension (TRH) and in patients both on and off antihypertensive therapy. In addition, sustained reductions in BP up to 3 years have been observed. Based on these favorable findings, guidelines and position papers recommend RDN as an adjunct to antihypertensive medications and lifestyle modifications in patients with uncontrolled hypertension and increased risk of cardiovascular (CV) complications like TRH patients and in patients who are unable or unwilling to optimize medical therapy for uncontrolled hypertension. However, data on RDN safety and efficacy remain limited in chronic kidney disease (CKD) and isolated systolic hypertension (ISH). Another area of active investigation is the identification of predictors of response to RDN which could help refine criteria for patient selection. Selection of patients for RDN requires an evaluation of the hypertension prior to referral in addition to engaging patients in shared decision-making (SDM). It is also recommended that patients being considered for RDN be evaluated by a multidisciplinary team who is knowledgeable about hypertension and RDN. RDN is an adjunct to lifestyle modification and medications for the treatment of hypertension. Appropriate patient selection for RDN is based on populations studied in clinical trials and should include a comprehensive evaluation of the uncontrolled hypertension prior to referral.
Addressing Hypertension Treatment Disparities Via Renal Denervation.
Spiazzi BF, Zingano CP, Laffin LJ
Curr Hypertens Rep · 2026 Jan · PMID 41563652 · Publisher ↗
PURPOSE OF REVIEW: To discuss available data on renal denervation (RDN) for treating hypertension and how expanding access to RDN may improve rates of controlled hypertension while helping address hypertension treatment...
PURPOSE OF REVIEW: To discuss available data on renal denervation (RDN) for treating hypertension and how expanding access to RDN may improve rates of controlled hypertension while helping address hypertension treatment disparities. RECENT FINDINGS: RDN is an FDA-approved procedure for the treatment of patients with confirmed uncontrolled hypertension, with proven efficacy and safety in randomized sham-controlled trials. Centers for Medicare & Medicaid Services completed a national coverage analysis for RDN coverage for the treatment of uncontrolled hypertension. By summarizing the available data on RDN and hypertension statistics among different race and ethnicities in the United States, our review highlights the potential for RDN to improve treatment control rates, without increasing medication burden. By expanding coverage for the procedure, RDN may be an important tool to reduce significant treatment disparities in hypertension.
Cardiometabolic Surgery for Treatment of Hypertension.
Schiavon CA, Drager LF
Curr Hypertens Rep · 2026 Jan · PMID 41504981 · Publisher ↗
PURPOSE OF REVIEW: The purpose of this review is to evaluate the impact of cardiometabolic surgery on hypertension in patients with severe obesity. It aims to provide an overview of the current surgical techniques and th...
PURPOSE OF REVIEW: The purpose of this review is to evaluate the impact of cardiometabolic surgery on hypertension in patients with severe obesity. It aims to provide an overview of the current surgical techniques and their effectiveness in reducing blood pressure levels. RECENT FINDINGS: Recent studies have shown significant advancements in cardiometabolic surgery, highlighting its positive effects on hypertension. The Gateway Study, the only randomized trial designed to study the hypertension impact, demonstrated that patients who underwent cardiometabolic surgery experienced substantial reductions in blood pressure. The study also found that these patients had improved cardiovascular health and reduced risk of hypertension-related complications. In conclusion, cardiometabolic surgery has emerged as a promising intervention for managing hypertension in patients with severe obesity. The recent findings, including those from the Gateway Study, underscore the potential benefits of these surgical procedures in improving blood pressure control and overall cardiovascular health.
The Role of Mineralocorticoid Receptors in the Treatment of Primary Hypertension.
Bahrainwala JZ, Bhalla V
Curr Hypertens Rep · 2026 Jan · PMID 41489791 · Publisher ↗
Hypertension affects over one billion individuals worldwide and remains the leading modifiable risk factor for cardiovascular disease. While first-line therapies including thiazide-type diuretics, angiotensin converting...
Hypertension affects over one billion individuals worldwide and remains the leading modifiable risk factor for cardiovascular disease. While first-line therapies including thiazide-type diuretics, angiotensin converting enzyme inhibitors / angiotensin receptor blockers, and calcium channel blockers can effectively control blood pressure in many patients, 10-20% develop resistant hypertension requiring additional therapeutic approaches. Steroidal mineralocorticoid receptor antagonists (MRAs) have emerged as essential fourth-line agents for resistant hypertension, with spironolactone demonstrating superior efficacy compared to other add-on therapies in the landmark PATHWAY-2 trial. The pathophysiological rationale for MRAs includes natriuretic effects, vasodilatory properties and target organ protection through anti-fibrotic mechanisms. Novel non-steroidal MRAs offer improved selectivity and reduced endocrine side effects compared to traditional agents, potentially expanding the therapeutic window for mineralocorticoid receptor blockade. In this review, we discuss the established role of MRAs in primary and resistant hypertension management and discuss consideration of MRAs in certain hypertension patient populations. We also briefly review patient selection strategies and future directions for this important therapeutic class.
Obstructive Sleep Apnea and Hypertension: Is Aldosterone Blockade the Optimal Approach to Control Blood Pressure and Improve Oxygenation?
Ikeda AK, Mehra R
Curr Hypertens Rep · 2026 Jan · PMID 41483355 · Publisher ↗
PURPOSE OF REVIEW: Obstructive sleep apnea (OSA) is common and strongly linked with systemic hypertension, including resistant and nocturnal forms. Traditional OSA therapies lead to modest blood pressure (BP) reductions,...
PURPOSE OF REVIEW: Obstructive sleep apnea (OSA) is common and strongly linked with systemic hypertension, including resistant and nocturnal forms. Traditional OSA therapies lead to modest blood pressure (BP) reductions, but optimal antihypertensive strategies in this population remain unclear. This review examines OSA driven hypertension mechanisms, differential responses to standard OSA therapies, and evaluates evidence for mineralocorticoid-targeted treatment - including blockade of aldosterone - as a tailored BP lowering and airway improving strategy. RECENT FINDINGS: OSA promotes hypertension via intermittent hypoxia, sympathetic overactivity, sleep fragmentation, renin-angiotensin-aldosterone system (RAAS)-mediated fluid retention, and nocturnal fluid shifts that increase airway collapsibility. While continuous positive airway pressure (CPAP), oral appliances, weight loss, and other standard OSA therapies consistently yield modest BP reductions (typically 2-5 mmHg), patients with resistant hypertension, obesity, or high CPAP adherence derive greater benefit. Recent clinical studies demonstrate that mineralocorticoid receptor antagonists (MRAs) such as spironolactone or eplerenone reduce both apnea-hypopnea index (AHI) and BP in OSA patients with resistant hypertension. Emerging data from trials of selective aldosterone synthase inhibitors (ASIs) support meaningful BP reduction in obese hypertensive individuals with data on OSA specific outcomes remain forthcoming.
Obesity Medications Beyond Glucose Control and Weight Reduction: Updates on the Expanding Benefits, Clinical Challenges, and Future Directions.
Ntelis S, Wojeck BS
Curr Hypertens Rep · 2025 Dec · PMID 41460420 · Publisher ↗
PURPOSE OF REVIEW: This article summarizes the clinical effects of incretin therapies. We review data from recent clinical trials, beyond glycemic control and weight reduction. RECENT FINDINGS: Incretin therapies are ass...
PURPOSE OF REVIEW: This article summarizes the clinical effects of incretin therapies. We review data from recent clinical trials, beyond glycemic control and weight reduction. RECENT FINDINGS: Incretin therapies are associated with a lower risk of atherosclerotic cardiovascular events and improved clinical outcomes in patients with heart failure and preserved ejection fraction. Recent studies demonstrate a much wider spectrum of clinical benefits, including nephroprotection in patients with diabetic kidney disease, diabetes prevention, therapeutic potential in the management of metabolic dysfunction-associated steatotic liver disease and obstructive sleep apnea, and even neuroprotective effects. Possible adverse events, primarily involving the gastrointestinal system, and the need for long-term continuation are factors that need to be considered before initiation of treatment. Incretin receptor agonists have changed the landscape of diabetes and obesity management. Their clinical benefits expand to a wide spectrum of cardiovascular and metabolic disorders and have major implications for clinical practice.
Chemerin as a Mediator of Hypertension and Cardiometabolic Diseases (A Comprehensive Review).
McMillan R, Kirabo A
Curr Hypertens Rep · 2025 Dec · PMID 41457200 · Full text
PURPOSE: Chemerin, a recently identified adipokine, has emerged as a critical mediator in multiple physiological systems with significant implications for human health and disease. This review synthesizes current knowled...
PURPOSE: Chemerin, a recently identified adipokine, has emerged as a critical mediator in multiple physiological systems with significant implications for human health and disease. This review synthesizes current knowledge on chemerin's multifaceted roles across cardiovascular, renal, immune, and metabolic processes. Acting through its primary receptor CMKLR1, chemerin influences sympathetic nervous system activity in key brain regions including the nucleus tractus solitarius and paraventricular nucleus, thereby regulating blood pressure and cardiovascular function. RECENT FINDINGS: In the kidneys, elevated chemerin levels correlate with declining renal function, serving as both a biomarker and pathogenic factor in chronic kidney disease progression and diabetic nephropathy. As an immune modulator, chemerin facilitates leukocyte recruitment, promotes macrophage polarization toward pro-inflammatory phenotypes, and enhances endothelial inflammation, establishing it as a pivotal link between metabolic dysregulation and chronic inflammatory states. Chemerin plays a central role in hypertension by altering endothelial function, renal function and sympathetic outflow. In metabolic regulation, chemerin influences adipocyte differentiation, glucose homeostasis, and central appetite control, connecting obesity with systemic inflammation and insulin resistance. The convergence of these diverse functions positions chemerin as an integrative signaling molecule with considerable therapeutic potential. This review highlights chemerin's role as a promising target for novel interventions in hypertension, kidney disease, inflammatory disorders, and metabolic syndrome, potentially transforming treatment strategies for these interconnected conditions.
Obesity in Cardiorenal syndrome: Management Opportunities and Challenges.
Reaves A, Jaffe E, McCallum W
Curr Hypertens Rep · 2025 Dec · PMID 41455079 · Full text
PURPOSE OF REVIEW: The prevalence of obesity continues to increase globally. There is accumulating evidence of the complex interplay between obesity, cardiovascular disease, particularly heart failure with preserved ejec...
PURPOSE OF REVIEW: The prevalence of obesity continues to increase globally. There is accumulating evidence of the complex interplay between obesity, cardiovascular disease, particularly heart failure with preserved ejection fraction, and chronic kidney disease (CKD). Here, we review the diagnostic and management considerations for these co-existent conditions and the current evidence regarding the impact of obesity treatments on long term health outcomes. RECENT FINDINGS: Recent evidence suggests the pathophysiology of obesity, heart failure with preserved ejection fraction and CKD are inextricably linked as adipocytes appear to play a role in promoting renal sodium avidity and volume overload, which are the hallmarks of the cardiorenal syndrome. The clinical landscape of obesity management has changed significantly with the approval of glucagon-like peptide-1 receptor agonists, which have been shown to have cardiovascular and kidney benefit among patients with obesity and a range of comorbid conditions including diabetes, CKD, and heart failure. Improved recognition, diagnosis and management of clinically consequential obesity is emerging as a key factor in improving outcomes for patients with comorbid conditions such as heart failure with preserved ejection fraction and CKD. The incorporation of comprehensive multi-disciplinary management, shared decision making with patients and broader access to therapies is critical to improving clinical outcomes.
Novel Therapeutic Strategies for Obesity-Related Glomerulopathy.
Liu Y, Eirin A, Lerman LO
Curr Hypertens Rep · 2025 Dec · PMID 41455033 · Full text
PURPOSE OF REVIEW: Conventional management primarily focuses on weight reduction and renin-angiotensin-aldosterone blockade; however, these approaches are often insufficient to halt disease progression. RECENT FINDINGS:...
PURPOSE OF REVIEW: Conventional management primarily focuses on weight reduction and renin-angiotensin-aldosterone blockade; however, these approaches are often insufficient to halt disease progression. RECENT FINDINGS: Recent advances have identified novel therapeutic targets and strategies aimed at addressing the metabolic, inflammatory, and hemodynamic abnormalities, as well as gut microbiome dysbiosis, driving obesity-related glomerulopathy (ORG). Pharmacological agents like sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, finerenone, mitochondrial transfer, and fecal microbiota transplantation have demonstrated renoprotective effects through improving weight, insulin sensitivity, blood pressure, inflammation, and gut microbiome. The potential direct renoprotective effects of these medications in ORG, independent of weight loss, warrant further investigation. Additionally, artificial intelligence and emerging biomarkers represent promising strategies for personalized and precise management, early non-invasive diagnosis, and prognostic evaluation of ORG.
Tracing Human Sympathetic Cardiovascular Control Mechanism in the Brain.
Macefield VG, Henderson LA
Curr Hypertens Rep · 2025 Dec · PMID 41455030 · Publisher ↗
PURPOSE OF REVIEW: We review our approach of using MSNA-coupled fMRI to identify how different regions of the brain interact to control blood pressure. By performing functional magnetic resonance imaging (fMRI) of the br...
PURPOSE OF REVIEW: We review our approach of using MSNA-coupled fMRI to identify how different regions of the brain interact to control blood pressure. By performing functional magnetic resonance imaging (fMRI) of the brain at the same time as recording muscle sympathetic nerve activity (MSNA), via a microelectrode in the common peroneal nerve, we can identify areas of the brain involved in the generation of sympathetic outflow to the muscle vascular bed, a major contributor to blood pressure regulation. RECENT FINDINGS: Together with functional connectivity analysis of areas identified through MSNA-coupled fMRI, we have established key components of the human sympathetic connectome and their roles in the control of blood pressure. Whilst our studies confirm the roles of nucleus tractus solitarius (NTS), caudal ventrolateral medulla (CVLM) and rostral ventrolateral medulla (RVLM) in the baroreflex-mediated control of MSNA, we have identified cortical areas - dorsolateral prefrontal cortex, precuneus and insula - that are coupled to RVLM via the hypothalamus and midbrain periaqueductal gray (PAG). This emphasizes the roles of areas above the brainstem in the regulation of blood pressure.
Blood Pressure-Lowering Effects of SGLT2 Inhibitors and GLP-1 Receptor Agonists.
Siddiqi AK, Khan MS, Kulkarni A … +4 more , Hall ME, Böhm M, Díez J, Butler J
Curr Hypertens Rep · 2025 Dec · PMID 41324724 · Publisher ↗
PURPOSE OF REVIEW: Hypertension is the leading modifiable risk factor for cardiovascular disease. Despite multiple antihypertensive therapies, blood pressure (BP) control remains suboptimal in many individuals with persi...
PURPOSE OF REVIEW: Hypertension is the leading modifiable risk factor for cardiovascular disease. Despite multiple antihypertensive therapies, blood pressure (BP) control remains suboptimal in many individuals with persistent cardiovascular risk. This review evaluates the antihypertensive potential of sodium-glucose cotransporter-2 inhibitors (SGLT2-i) and glucagon-like peptide-1 receptor agonists (GLP-1RA), particularly in patients with comorbid diabetes, HF, CKD or resistant hypertension. RECENT FINDINGS: SGLT2-i consistently lower office SBP/DBP (2.5-4.0/1.5-2.0 mmHg) and 24-hour ambulatory BP (3.8/1.8 mmHg). GLP-1RAs show modest SBP reductions (1.8-5.1 mmHg) and minimal DBP effects (~ 0.5 mmHg), though tirzepatide shows greater efficacy (~ 10.6 mmHg) in select populations. Both classes have demonstrated cardio-renal benefits, favorable safety profiles, and reduced polypharmacy. SGLT2-i exert more consistent BP-lowering effects than GLP-1RA, largely due to their diuretic-like action. While not first-line therapies, both drug classes show promise as adjuncts in high-risk populations. Future research should further define their role in comprehensive hypertension management.
The Clinical Significance of Ambulatory Blood Pressure on Cerebral Small Vessel disease. A Systematic Review and meta-analysis of the Literature.
Antza C, Kakaletsis N, Palaska S … +3 more , Anyfanti P, Triantis D, Kotsis V
Curr Hypertens Rep · 2025 Dec · PMID 41324713 · Publisher ↗
PURPOSE OF REVIEW: Blood pressure (BP) is involved in the pathogenesis of cerebral small vessel disease (CSVD) and clinical research confirms this strong correlation. Data showing whether daytime or nighttime BP is the m...
PURPOSE OF REVIEW: Blood pressure (BP) is involved in the pathogenesis of cerebral small vessel disease (CSVD) and clinical research confirms this strong correlation. Data showing whether daytime or nighttime BP is the most important variable of CSVD are conflicting. Therefore, the purpose of this meta-analysis is to evaluate the impact daytime and nighttime BP in terms of CSVD correlation. Additionally, we evaluated the role of nocturnal BP variation for the same purpose. RECENT FINDINGS: We systematically searched PubMed and Scopus databases to extract data evaluating the association between different ABPM components (24 h, day- and nighttime BP, dipping patterns) and imaging features of CSVD (white matter hypersensitivies, lacunes, cerebral microbleeds). Study quality was evaluated with the Newcastle-Ottawa scale. In the qualitative synthesis, 24 studies with 6822 patients were included. The pooled analysis of 19 studies showed that increased 24 h SBP is associated with 41% increased risk of CSVD, and this is consistently observed for both daytime and nighttime SBP. this effect is largely driven by the impact of 24 h, day- and night-time SBP on CMBs. Impaired nocturnal BP patterns are strongly associated with CSVD, specifically non-dipping profile with an OR of 2.24 (95% CI: 1.31-3.16) compared to dipping pattern. Reverse dipping was associated with CMBs with an increased OR of 3.02 (95% CI: 1.61, 4.42). Obtaining information on different components of ABPM (24 h, day- and night-time BP, dipping profile) may allow identification of patients at higher risk for CSVD including its specific subtypes, specifically CMBs.
Impact of Adverse Childhood Experiences on Cardiovascular Health across the Lifespan.
Mukundan A, Brady TM
Curr Hypertens Rep · 2025 Oct · PMID 41128949 · Publisher ↗
PURPOSE OF REVIEW: Pediatric hypertension is an increasingly recognized public health issue and represents a key target for preventing long-term cardiovascular morbidity and mortality. Adverse childhood experiences-traum...
PURPOSE OF REVIEW: Pediatric hypertension is an increasingly recognized public health issue and represents a key target for preventing long-term cardiovascular morbidity and mortality. Adverse childhood experiences-traumatic events related to abuse, neglect, and household dysfunction occurring before age 18-are emerging as significant risk factors for both pediatric and adult hypertension and cardiovascular disease (CVD). FINDINGS: While some studies report direct links between childhood adversity and cardiovascular outcomes, others suggest these associations may be mediated by the development of intermediate CVD risk factors such as obesity and mood disorders. Regardless of pathway, evidence indicates that even exposure to a single form of adversity can negatively impact cardiovascular health, with some studies demonstrating threshold and cumulative effects. Early identification of children exposed to adversity may offer a valuable opportunity to guide targeted interventions aimed at the primary prevention of CVD.
Methods for Assessment of Sleep and Circadian Rhythms in Cardiovascular Research.
Williams R, Gloston G, Ward KC … +8 more , Jain S, Hays K, Ensor A, Patel S, Patel N, Hogue M, Thomas SJ, Polanka BM
Curr Hypertens Rep · 2025 Oct · PMID 41118090 · Full text
Sleep is recognized in Life's Essential 8™ as an important behavioral factor for improving and maintaining cardiovascular health. While sleep duration is currently the focus in Life's Essential 8™, sleep health is multid...
Sleep is recognized in Life's Essential 8™ as an important behavioral factor for improving and maintaining cardiovascular health. While sleep duration is currently the focus in Life's Essential 8™, sleep health is multidimensional and encompasses regularity, satisfaction, next-day alertness, timing, efficiency, and duration. In addition to sleep, circadian factors have also been implicated in cardiovascular health. For example, shift work, which results in significant circadian misalignment, is associated with poor cardiovascular health. This review will describe methods for measuring, analyzing, and interpreting sleep and circadian rhythms in humans. Subjective and objective measurements of sleep are not always concordant and may reflect distinct constructs. Therefore, both subjective and objective sleep measurements are discussed. Assessment of the circadian system in humans typically relies on the measurement of circadian biomarkers (i.e., melatonin, core body temperature, and/or cortisol) during rigorous and burdensome research protocols. However, novel approaches are being developed to estimate circadian parameters with lower cost and participant burden. This review aims to inform cardiovascular scientists and clinicians of common practices in the assessment of sleep and circadian rhythms.
Which Systolic Blood Pressure Measure Is Most Important for Determining Cardiovascular Risk: Seated or Supine Blood Pressure?
Bothe TL, Melloy AE, Patzak A … +1 more , Pilz N
Curr Hypertens Rep · 2025 Oct · PMID 41118028 · Full text
PURPOSE OF REVIEW: In clinical practice, the diagnosis of hypertension is based on non-invasive upper-arm cuff blood pressure (BP) measurement. Most measurements are performed seated, although evidence indicates that sup...
PURPOSE OF REVIEW: In clinical practice, the diagnosis of hypertension is based on non-invasive upper-arm cuff blood pressure (BP) measurement. Most measurements are performed seated, although evidence indicates that supine BP may provide additional information. This review summarises recent findings on the influence of body posture on BP readings and cardiovascular (CV) risk prediction across office, ambulatory, and home BP monitoring (OBPM, ABPM, HBPM), their clinical implications and future research directions. RECENT FINDINGS: In OBPM, patients with supine-only hypertension demonstrated CV risk comparable to patients with hypertensive BP in both positions, and a higher risk than seated-only hypertensives. Supine hypertension was particularly predictive in individuals under 65 years of age. In ABPM, the strongest predictors of CV events are nocturnal hypertension and abnormal dipping patterns, particularly when patients are truly asleep, whereas supine nocturnal HBPM has been less extensively investigated. Current clinical practice remains primarily based on seated BP measurements. Recent trials have highlighted that supine OBPM may provide additional predictive power in the assessment of CV risk. These findings offer a partial explanation for the residual high predictive value of nocturnal BP values which can be derived from ABPM or specialised HBPM devices that goes beyond the correlation of breathing related sleep disorders Research should focus on homogenising supine risk data into composite risk scores combining seated and supine BP while new outcome studies should consider including supine BP measurement. Future guideline committees should consider recommending the structured clinical application of supine BP, given its demonstrated prognostic benefits.
Obesity, Hypertension and Brain Health.
Qureshi K, Schick J, Anderson TR … +2 more , Farooq MU, Gorelick PB
Curr Hypertens Rep · 2025 Oct · PMID 41099969 · Publisher ↗
PURPOSE OF REVIEW: This brief review provides background information about brain health and its definition and public health importance. Within the context of brain health, we focus on two important modifiable cardiovasc...
PURPOSE OF REVIEW: This brief review provides background information about brain health and its definition and public health importance. Within the context of brain health, we focus on two important modifiable cardiovascular risks, obesity and hypertension, and discuss mechanisms by which these factors affect brain health and recent advances in our understanding of trajectories of these risks across the lifespan. RECENT FINDINGS: Our understanding of obesity, hypertension and brain health has advanced beyond the categorization of these factors as binary (present, absent) variables. The study of trajectories of obesity and hypertension have taught us that the presence of these factors as early as childhood and adolescence may be a signal of brain injury and eventual cognitive impairment as early as one's late 20s or early 30s. Over time each factor may show variability in measures and begin to decline prior to the onset of a clinical diagnosis of cognitive impairment (e.g., 5-10 years earlier). Both obesity and hypertension are key modifiable vascular factors affecting brain health via a complex relationship that exceeds a simple binary association. Primary care clinicians and public health officials are uniquely positioned to influence these factors during periods of susceptibility during the individual lifespan.
Hypertensive Disorders of Pregnancy: Reaching the Rural Population After Delivery.
Freiha M, Sosso JL, Kattah AG
Curr Hypertens Rep · 2025 Aug · PMID 40833554 · Full text
PURPOSE OF REVIEW: Hypertensive disorders of pregnancy are associated with maternal morbidity, mortality, hospital readmissions, and significant costs to healthcare systems. RECENT FINDINGS: The incidence of hypertensive...
PURPOSE OF REVIEW: Hypertensive disorders of pregnancy are associated with maternal morbidity, mortality, hospital readmissions, and significant costs to healthcare systems. RECENT FINDINGS: The incidence of hypertensive disorders of pregnancy (HDP) and maternal morbidity is higher in rural areas than in urban areas. The interaction of rural residence, race, and non-medical drivers of health can create significant barriers to post-partum care in rural communities. Novel models of care, including remote blood pressure monitoring, telehealth, and application-based approaches, may offer ways to reach rural patients after hypertensive pregnancy. There are significant opportunities to create novel multi-modal and multi-disciplinary approaches to post-partum care of HDP. Tailoring and evaluating the approach in rural communities is an important next step to improve care.
Introduction: A Renewed Focus on Disparities in Hypertension Identification, Treatment, and Control.
Reddy TK, Ferdinand KC
Curr Hypertens Rep · 2025 Jul · PMID 40705143 · Publisher ↗
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Sympathetic Responses to Antihypertensive Treatment Strategies : Implications for the Residual Cardiovascular Risk.
Dell'Oro R, Quarti-Trevano F, Ambrosino P … +1 more , Grassi G
Curr Hypertens Rep · 2025 Jul · PMID 40699460 · Full text
PURPOSE OF REVIEW: To examine whether and to what extent lifestyle, pharmacological and device-based therapeutic blood pressure lowering interventions are capable to restore a normal sympathetic cardiovascular function i...
PURPOSE OF REVIEW: To examine whether and to what extent lifestyle, pharmacological and device-based therapeutic blood pressure lowering interventions are capable to restore a normal sympathetic cardiovascular function in hypertensive patients. RECENT FINDINGS: Data collected by examining the results of more than 50 studies published during the past years by directly quantifying, via microneurography, the sympathetic nerve traffic responses to non-pharmacological and pharmacological antihypertensive treatment have shown that no normalization of the sympathetic cardiovascular function is achieved. Recently, a study by our group carried out in 219 hypertensive patients under monotherapy or combination drug treatment confirmed these results, by showing that, despite achieving an optimal blood pressure control, antihypertensive treatment fails to restore the normal sympathetic neural function detected in the normotensive healthy subjects. The sympathetic nervous system plays a key role in blood pressure regulation and hypertension pathophysiology. Recent findings document its involvement also in determining the blood pressure lowering effects of antihypertensive agents. However, the available data show the inability to achieve during treatment a full sympathetic normalization, a finding which may represent one of the mechanisms responsible for the residual cardiovascular risk of the treated hypertensive patient.
Sympathetic Nervous System in Heart Failure: Targets for Treatments.
Arshad MS, Kittipibul V, Fudim M
Curr Hypertens Rep · 2025 Jul · PMID 40691427 · Publisher ↗
PURPOSE OF REVIEW: Heart failure (HF) is characterized by a significant imbalance of the autonomic nervous system (ANS), with chronic sympathetic nervous system (SNS) overactivity leading to maladaptive cardiac remodelin...
PURPOSE OF REVIEW: Heart failure (HF) is characterized by a significant imbalance of the autonomic nervous system (ANS), with chronic sympathetic nervous system (SNS) overactivity leading to maladaptive cardiac remodeling, arrhythmia, and hemodynamic instability. In this review, we aim to discuss current and emerging therapies and the potential path forward for developing future novel neuromodulatory therapies in HF. RECENT FINDINGS: Neuromodulatory therapies including splanchnic nerve modulation (SNM), vagal nerve stimulation (VNS), baroreflex activation therapy (BAT), and renal denervation (RDN) reduce sympathetic output in individuals with HF, leading to improved cardiac function, neurohormonal regulation, and vascular resistance. However, implementation of these strategies in clinical practice is limited owing to variability in response, patient selection criteria, and insufficient long-term efficacy data. Gene therapy targeting Gαi2 proteins, and adenylyl cyclase isoforms have demonstrated potential in reducing sympathetic overactivation. Endovascular BAT such as the Mobius HD has shown early indications of improvements in symptoms, left ventricular function, and biomarkers in patients with HF. These emerging therapies warrant further investigation. Neuromodulation is a characteristic method for reducing disease progression and improving outcomes in individuals with autonomic dysfunction-driven HF. Although initial studies demonstrate benefits, long-term impact of neuromodulation on HF development, symptom load, and survival has not yet been thoroughly demonstrated. Future studies should prioritize deep phenotyping using genetic and biomarker profiles to improve patient selection. Comparative trials are required to assess the efficacy and safety of neuromodulatory therapies relative to conventional approaches. Large-scale trials are needed to optimize procedural procedures, and assess the long-term efficacy of treatment interventions.
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