International Journal Of Hypertension[JOURNAL]
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200 papers
Divergent Blood Pressure Thresholds in Hypertensive Disorders of Pregnancy: A Narrative Review of Global Guideline Discordance and Clinical Implications.
Akankwasa P, Kakooza J, Namutosi E … +7 more , Katongole J, Theoneste H, Onaba E, Muse FA, Cedeño CAB, Lewis CR, Okurut E
Int J Hypertens · 2026 · PMID 42404690 · Full text
Hypertensive disorders of pregnancy (HDP) remain a leading cause of preventable maternal and perinatal morbidity and mortality. Although blood pressure (BP) thresholds guide diagnosis, treatment, and delivery, internatio...
Hypertensive disorders of pregnancy (HDP) remain a leading cause of preventable maternal and perinatal morbidity and mortality. Although blood pressure (BP) thresholds guide diagnosis, treatment, and delivery, international and national guidelines differ, resulting in inconsistent management. This narrative review synthesizes contemporary evidence to map divergences in BP thresholds across global guidelines and evaluate their implications for clinical decision-making and maternal and fetal outcomes, particularly in low- and middle-income countries (LMICs). Comprehensive searches of PubMed, Scopus, Web of Science, and Lens.org were performed. Twenty-five eligible sources, including 12 major international and national guidelines and 13 supporting peer-reviewed sources, were synthesized following SANRA principles. Additional contextual references were cited where necessary but were not counted as included sources in the threshold-synthesis dataset. Diagnostic thresholds, hypertension criteria, treatment initiation thresholds, target BP goals, and magnesium sulfate indications were reviewed. All 12 guidelines uniformly diagnosed hypertension at ≥ 140/90 mmHg. Near-consensus exists for defining severe hypertension at ≥ 160/110 mmHg, though several LMIC guidelines adopt lower thresholds (≥ 150/100-110 mmHg). The most clinically impactful divergence concerns antihypertensive treatment initiation, which varies from ≥ 140/90 mmHg to ≥ 160/110 mmHg, with intermediate thresholds (≥ 150/100 mmHg) used in several LMICs. Additional differences such as the inclusion of fetal growth restriction in some diagnostic frameworks further contribute to misclassification. These inconsistencies create a 20 mmHg "treatment gap," leading to guideline-dependent over- or under-treatment and widening disparities in resource-limited settings. Marked threshold discord across the 12 major HDP guidelines results in systematic misclassification and divergent management pathways. Harmonization initiatives, transparent communication of evidence limitations, and context-specific implementation research, particularly in LMICs, are urgently needed to support equitable, evidence-based maternal care.
Prevalence of Hypertensive Disorders of Pregnancy and Associated Birth Outcomes Among Adolescent Mothers at a Tertiary Hospital in Zambia: A Retrospective Cross-Sectional Study.
Chakulya M, Chisompola D, Hatwiko H … +5 more , Siame L, Povia JP, Chishala N, Kirabo A, Masenga SK
Int J Hypertens · 2026 · PMID 42404689 · Full text
BACKGROUND: Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal and perinatal morbidity, yet data on their burden among adolescent mothers in Sub-Saharan Africa are limited. This study aimed to dete...
BACKGROUND: Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal and perinatal morbidity, yet data on their burden among adolescent mothers in Sub-Saharan Africa are limited. This study aimed to determine the prevalence of HDP and their association with birth outcomes among adolescent mothers at Livingstone University Teaching Hospital (LUTH) in Zambia. METHODS: We conducted a retrospective cross-sectional study of 405 medical records of adolescent pregnancies (aged 10-19 years) at LUTH from January 2023 to December 2024. HDP was defined as systolic/diastolic blood pressure ≥ 140/90 mmHg after 20 weeks of gestation. Data were abstracted using REDCap and analyzed with StatCrunch. Univariable and multivariable logistic regression identified factors associated with HDP. Bivariate analyses examined associations with birth outcomes. Statistical significance was set at < 0.05. RESULTS: The prevalence of HDP was 16.8% (68/405). In multivariable analysis, increasing age (AOR = 1.31 per year, 95% CI: 1.06-1.63, = 0.012), a previous history of hypertension (AOR = 1.77, 95% CI: 1.19-2.62, = 0.005), and a positive family history of chronic hypertension (AOR = 3.89, 95% CI: 1.03-14.61, = 0.044) were independent predictors. HDP was significantly associated with adverse birth outcomes ( = 0.014), particularly fetal death (46.2% vs. 16.1% among normotensive). Hypertensive adolescents had higher rates of preeclampsia (86.4% vs. 12.8%, < 0.001), eclampsia (100% vs. 16%, < 0.001), and fetal complications, including asphyxia (34.5% vs. 14.6%, = 0.013) and prematurity (23.5% vs. 14.6%). CONCLUSIONS: HDP affect nearly one in six adolescent mothers at a Zambian tertiary hospital and are strongly associated with adverse birth outcomes. Older age, prior hypertension, and family history of chronic hypertension are independent predictors. Enhanced antenatal risk assessment, including detailed personal and family history, age-stratified monitoring, and routine proteinuria screening, is urgently needed to improve maternal and neonatal outcomes in this high-risk population.
RETRACTION: Apo A1 Mimetic Rescues the Diabetic Phenotype of HO-2 Knockout Mice via an Increase in HO-1 Adiponectin and LKBI Signaling Pathway.
Hypertension IJO
Int J Hypertens · 2026 · PMID 42389162 · Full text
[This retracts the article DOI: 10.1155/2012/628147.].
[This retracts the article DOI: 10.1155/2012/628147.].
RETRACTION: Reciprocal Effects of Oxidative Stress on Heme Oxygenase Expression and Activity Contributes to Reno-Vascular Abnormalities in EC-SOD Knockout Mice.
Hypertension IJO
Int J Hypertens · 2026 · PMID 42389161 · Full text
[This retracts the article DOI: 10.1155/2012/740203.].
[This retracts the article DOI: 10.1155/2012/740203.].
Prevalence and Determinants of Abnormal Ambulatory Blood Pressure and Circadian Patterns Among Adults in Ido Ekiti, Nigeria: A Community-Based Study.
Ajayi EA, Ogah OS, Fadare JO
Int J Hypertens · 2026 · PMID 42376251 · Full text
BACKGROUND: Hypertension is the leading cause of global cardiovascular diseases and deaths, but its management remains poor in sub-Saharan Africa. Ambulatory blood pressure monitoring (ABPM) provides more detailed inform...
BACKGROUND: Hypertension is the leading cause of global cardiovascular diseases and deaths, but its management remains poor in sub-Saharan Africa. Ambulatory blood pressure monitoring (ABPM) provides more detailed information on variations in blood pressure during the day and circadian patterns than office measurements. Unfortunately, there is a paucity of information regarding ABPM patterns among Nigerian adults. OBJECTIVE: To determine the prevalence and circadian patterns of abnormal ambulatory blood pressure, as well as to identify sociodemographic, anthropometric and lifestyle predictors of systolic and diastolic dipping status in the adult population of Ido Ekiti, Nigeria. METHODS: A community-based cross-sectional study involving 352 adults aged ≥ 18 years was conducted using a multistage sampling method. Office blood pressure and 24-h ABPM were recorded with validated automated devices. Dipping patterns were classified as dipper (10%-20%), nondipper (< 10%), reverse dipper (no decrease or increase) or extreme dipper (≥ 20%). Logistic regression was used to identify predictors of nondipping patterns. RESULTS: The mean age was 48.6 ± 17.9 years, and 55.7% of the participants were females. Thirty-nine-point-eight percentage of the subjects had abnormal 24-h blood pressure (≥ 130/80 mmHg). Only 22.2% and 36.9% showed normal systolic and diastolic dipping, respectively. Nondipping was associated with higher income (₦70,000-₦500,000; adjusted odds ratio [AOR] 7.91-104.0; < 0.05) and central obesity (AOR 1.67 × 10-1.95 × 10; < 0.05). Elevated 24-h systolic blood pressure increased the likelihood of nondipping (AOR 6.35-7.63), whereas abnormal diastolic blood pressure appeared to have a protective effect (AOR 0.09-0.84). Following WHO physical activity recommendations resulted in a reduction of systolic nondipping (AOR 0.23; = 0.010), whereas it was associated with an increase in diastolic nondipping (AOR 3.97; = 0.004). Being male and having a higher office diastolic blood pressure level were protective against systolic nondipping. CONCLUSION: Abnormal circadian blood pressure patterns are frequent among Nigerian adults, and nondipping is the predominant pattern. Socioeconomic status, central adiposity and 24-h BP load are the most influential factors. The promotion of ABPM in primary care is a vital step in detecting hypertension early and managing it in a personalised way.
Clinical Study on the Multidimensional Efficacy of Mindfulness-Based Stress Reduction Combined With Ear Triple Therapy in Young and Middle-Aged Patients With Hypertension.
Li J, Sun Q, Wu Y
Int J Hypertens · 2026 · PMID 42338493 · Full text
OBJECTIVE: This study aims to explore the clinical efficacy of mindfulness-based stress reduction (MBSR) combined with ear triple therapy in improving blood pressure, symptoms, emotions, and other multidimensional condit...
OBJECTIVE: This study aims to explore the clinical efficacy of mindfulness-based stress reduction (MBSR) combined with ear triple therapy in improving blood pressure, symptoms, emotions, and other multidimensional conditions of young and middle-aged patients with hypertension. METHODS: Using convenient sampling, young and middle-aged patients with hypertension who visited Jiangsu Provincial Hospital of Chinese Medicine from January 2024 to January 2025 were selected as participants. They were divided into an intervention group and a control group using a random number table, with 115 cases in each group. The control group received standard treatment and nursing, while the intervention group was additionally given MBSR combined with ear triple therapy on the basis of the control group's intervention, with an intervention cycle of 8 weeks. Before the intervention and after 8 weeks, the therapeutic effect, immediate blood pressure-lowering effect, improvement of TCM symptoms, psychological status, and mindfulness level were compared between the two groups. RESULTS: There were no significant differences in baseline characteristics and medication use between the 2 groups. After 8 weeks, the intervention group showed superior performance to the control group in terms of therapeutic effect, immediate blood pressure-lowering effect, TCM syndrome score, SAS score, and MAAS score, with statistically significant differences ( < 0.05). CONCLUSION: MBSR combined with ear triple therapy can improve hypertension conditions in young and middle-aged patients with hypertension, alleviate symptoms, reduce negative emotions, and enhance mindfulness level, thereby improving medication compliance and self-management ability.
Short- and Long-Term Clinical Outcomes of Preeclampsia in Women and Their Neonates in Pregnancies With and Without HIV Infection.
Ramdass C, Moodley J, Ngene NC … +1 more , Govender N
Int J Hypertens · 2026 · PMID 42338492 · Full text
Preeclampsia (PE) is characterized by new-onset hypertension at or after 20 weeks of pregnancy, associated with either uteroplacental dysfunction and/or maternal organ dysfunction that involves any of the hematological,...
Preeclampsia (PE) is characterized by new-onset hypertension at or after 20 weeks of pregnancy, associated with either uteroplacental dysfunction and/or maternal organ dysfunction that involves any of the hematological, renal, hepatic, cardiovascular, and central nervous systems. It complicates 2%-8% of pregnancies worldwide and is a significant contributor to maternal and perinatal morbidity and mortality. The multiorgan involvement in PE may extend beyond the immediate puerperium period and significantly impact the health of both affected women and their children in later life. In sub-Saharan Africa, long-term data on PE remain limited, irrespective of the substantial HIV burden in the region and the probable interaction between hypertensive disorders of pregnancy, HIV infection, and antiretroviral therapy. Therefore, this narrative review provides an update on the short- and long-term clinical outcomes of PE in the context of HIV infection, for both the mother and affected child. For instance, there is an increased risk of long-term cardiovascular disease development and renal impairment in the mother. Neonates born from such pregnancies are also at increased risk of low birth weight and the sequelae of prematurity.
Mapping the Burden of Hypertension in Türkiye (2008-2022): A National Cross-Sectional Study of Nearly 100000 Adults.
Sakir R, Yahya D, Kocak M
Int J Hypertens · 2026 · PMID 42325241 · Full text
BACKGROUND: Hypertension (HTN) remains one of the most common and modifiable risk factors for cardiovascular diseases worldwide. While several studies have explored its risk factors, updated national data covering long-t...
BACKGROUND: Hypertension (HTN) remains one of the most common and modifiable risk factors for cardiovascular diseases worldwide. While several studies have explored its risk factors, updated national data covering long-term trends in Türkiye has been limited. METHODS: We conducted a cross-sectional study using data from seven national health surveys carried out in Türkiye between 2008 and 2022, including a total of 97562 participants aged 19 and older. We calculated HTN prevalence across years and performed univariable and multivariable logistic regression analyses to examine associations with demographic, socioeconomic, and lifestyle factors. RESULTS: Overall, 18.9% of participants reported to have HTN. Prevalence increased modestly from 2008 to 2016 and then stabilized by 2022 (18.4%). HTN was significantly associated with older age, female gender, higher BMI, larger waist circumference, lower education level, unemployment, physical inactivity, and having a spouse or parent with HTN. Notably, individuals with graduate-level education had a higher prevalence of HTN than those without a high school education, and regular smokers showed a slightly lower prevalence compared to nonsmokers. There was also a significant regional difference in HTN diagnoses. CONCLUSION: Our findings offer an updated picture of HTN in Türkiye and highlight the influence of age, gender, lifestyle, geographical region, and family context on its prevalence. These results can guide future public health strategies of risk reduction at the individual, household, and regional levels.
Association Between Neutrophil-Percentage-To-Albumin Ratio Level and Heart Failure in Hypertensive Population.
Sun M, Li Z, Zhou Z … +2 more , Chen J, Jia W
Int J Hypertens · 2026 · PMID 42325240 · Full text
The neutrophil-to-albumin ratio (NPAR), which represents a surrogate sign of systemic inflammation, has recently garnered interest as a novel prognostic biomarker in cardiovascular pathology, with a particular focus on h...
The neutrophil-to-albumin ratio (NPAR), which represents a surrogate sign of systemic inflammation, has recently garnered interest as a novel prognostic biomarker in cardiovascular pathology, with a particular focus on heart failure (HF) in patients diagnosed with hypertension. The present analysis explored the relationship between NPAR and HF prevalence based on cross-sectional data derived from the 2017-2020 cycle of the National Health and Nutrition Examination Survey (NHANES). A total of 3045 hypertensive adults were analyzed, and multivariable logistic regression was employed with sequential adjustment for a comprehensive range of demographic, lifestyle, and clinical variables, including age, sex, ethnicity, body mass index, smoking status, alcohol consumption, diabetes, coronary artery disease, previous myocardial infarction, and history of stroke. The overall weighted prevalence of HF in this hypertensive cohort was 6.27%, and participants with HF had significantly higher NPAR levels than those without HF. After comprehensive adjustment for potential confounders, elevated NPAR remained independently associated with greater odds of HF (OR = 1.17, 95% CI: 1.09-1.25, < 0.001). Additional quartile, blood pressure-adjusted sensitivity, and spline analyses further supported the robustness and approximately linear nature of this association. ROC analysis indicated that NPAR had acceptable discriminatory ability for HF, with an AUC of 0.649 and an optimal cutoff value of 14.24. Subgroup analyses further identified notable interaction effects for alcohol use and stroke history (interaction < 0.05), indicating potential effect modification. These findings suggest that NPAR may serve as an accessible and cost-effective marker for HF risk stratification in hypertensive individuals.
Medication Adherence Among Hypertensive Patients in Bangladesh: A Nationwide Analysis of Gender and Urban-Rural Disparities.
Mim MS, Akib MMH, Pal B … +1 more , Rahaman ML
Int J Hypertens · 2026 · PMID 42257108 · Full text
Hypertension remains a major public health concern in Bangladesh, yet comprehensive nationwide studies examining prescription-based medication adherence are limited. To address this gap and understand adherence patterns...
Hypertension remains a major public health concern in Bangladesh, yet comprehensive nationwide studies examining prescription-based medication adherence are limited. To address this gap and understand adherence patterns for effective hypertension management, this study utilized secondary data from the Bangladesh Demographic and Health Survey (BDHS) 2022. A total of 1597 hypertensive individuals aged 18 years or older (670 urban, 927 rural) were included after excluding cases with missing values. Medication adherence was defined by self-reported use of prescribed antihypertensive drugs among those identified with hypertension (SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg or currently taking medication). Univariate, bivariate, and multilevel binary logistic regression analyses were conducted to identify key factors influencing adherence. Findings revealed that 83.2% of participants were adherent to medication. Adherence varied significantly by gender, wealth status, and diabetes comorbidity. In urban males, those from middle and rich households were 90.4% and 86.8% less likely to be adherent than poor counterparts, while nondiabetic men were over four times more likely to be adherent (AOR: 4.459, 95% CI = (1.371, 13.224), value = 0.013). Among rural females, higher wealth status increased adherence (AOR: 1.998, 95% CI = (1.221, 3.268), value = 0.006), but those with primary or secondary education showed lower odds of adherence. Urban females from rich households had significantly higher odds of adherence (AOR: 4.759, 95% CI = (1.838, 12.335), value = 0.002). These findings highlight the substantial gender and urban-rural disparities in hypertension medication adherence in Bangladesh. Targeted policies, such as educational outreach for rural women, expanded diabetes screening in urban men, and subsidized medication access in rural areas, are urgently needed to improve hypertension management.
Prevalence and Factors Associated With Hypertension Among Type 2 Diabetic Patients in Private Health Facilities, Kampala, Uganda.
Ninsiima LR, Bulafu D, Okade T … +4 more , Nakuya E, Baguma JN, Musiitwa R, Musoke D
Int J Hypertens · 2026 · PMID 42158264 · Full text
INTRODUCTION: Noncommunicable diseases (NCDs) such as Type 2 diabetes mellitus (T2D) and hypertension (HTN) are the leading causes of mortality worldwide, particularly in low- and middle-income countries (LMICs). In Ugan...
INTRODUCTION: Noncommunicable diseases (NCDs) such as Type 2 diabetes mellitus (T2D) and hypertension (HTN) are the leading causes of mortality worldwide, particularly in low- and middle-income countries (LMICs). In Uganda, while private health facilities in urban areas are preferred for managing these conditions, there is limited information on the prevalence of HTN and associated risk factors among T2D patients in these settings. This study assessed the prevalence of HTN and associated factors among T2D patients in private health facilities, Kampala, Uganda. METHODS: A health facility-based cross-sectional study using quantitative methods was employed, which included obtaining information from the patient records and a structured questionnaire. The study recruited 295 participants at the diabetes clinics in selected private health facilities. The collected data were analysed using STATA 15.0 statistical software. Bivariate and multivariable analyses were conducted using a generalised linear model of modified Poisson regression. RESULTS: Almost a third, 28.9% (85/295) of the participants had lived with T2D for more than 10 years. The prevalence of HTN among participants was 63.7%. Knowledge of HTN was low, with only 44.1% of the participants knowing about blood pressure, and 56.3% had a low level of knowledge overall. Participants who smoked (APR = 2.15, 95% Cl: 1.34-3.46), consumed an alcoholic drink in the past 30 days (APR = 1.56, 95% Cl: 1.10-2.20) and had a high level of knowledge on HTN (APR = 2.16, 95% Cl: 1.56-2.99) were more likely to have HTN. CONCLUSIONS: Our study found a worrying high burden of uncontrolled HTN among T2D patients, which could be due to risky behaviours including smoking and alcohol use. The generated evidence will inform feasible HTN risk reduction measures among T2D patients, which will improve awareness and existing controls set up by the different stakeholders. Therefore, there is a need for consolidated efforts aimed at addressing the identified gaps through community health education and lifestyle adjustments at facilities they attend to, especially for high-risk behaviours such as smoking and alcohol use, to effectively reduce HTN prevalence in similar populations.
Correlation of Systolic and Diastolic Blood Pressure in Measuring Blood Pressure Using Validated Digital Wrist Monitor Versus Validated Digital Arm Monitor: Study in a Real-World Setting.
Mina AB, Co M, Diaz AF … +3 more , Balmores BA, Bonzon D, Mercado-Asis LB
Int J Hypertens · 2026 · PMID 42109898 · Full text
Wrist-cuff blood pressure (wBP) monitors in the market have gained popularity due to their cost, portability, acceptability, and accessibility. Although wide variability in wrist versus the standard arm BP (aBP) monitor...
Wrist-cuff blood pressure (wBP) monitors in the market have gained popularity due to their cost, portability, acceptability, and accessibility. Although wide variability in wrist versus the standard arm BP (aBP) monitor values has been reported, comparative investigations in a real-world setting has not been fully elucidated. This study was undertaken to correlate systolic and diastolic BP using wBP versus the standard aBP monitors, to determine discrepancies, if any, and to formulate recommendations for its use. Adult subjects with normal, mild, or moderate hypertension randomly recruited in the investigators' clinics were included. Complete medical history and physical examination were done, and standard positioning for BP measurements was followed. Validated wrist BP (Omron, HEM6161) and validated aBP (Omron, HEM7156) monitors were used. The statistical data were analyzed with (ver 4.3.2) and MedCalc Statistical Software (Version 22.021). Correlation between wBP and aBP was determined using Passing-Bablok regression and Lin's concordance correlation coefficient. Bland-Altman analysis was applied to determine if the wBP values were according to the predetermined clinical significance for systolic and diastolic BP. Statistical significance was defined as a value of less than 0.05 for all tests. Two-hundred ninety-nine (299) patients participated in the study, with a mean (SD) age of 44.2 years ± 15.1. Majority of the hypertensive subjects were on medications. There were 45 (15%) participants with aBP in the hypertensive level (BP > 140 mm Hg and diastolic BP > of 90 mm Hg). The median systolic wBP was 127 mmHg (range, 115-138) while aBP was 129 mmHg (range, 116-140). The median diastolic wBP and aBP were 80 mmHg (range, 74-88) and 82 mmHg (range, 75-88), respectively. A statistically significant correlation ( = 0.002 and = 0.003) was obtained between the systolic and diastolic measurements using wBP and aBP apps. However, diastolic wBP was systematically lower by 10 mmHg. In conclusion, there is a correlation between the systolic and diastolic BP values taken through a validated digital wrist BP monitor and a validated aBP monitor. However, caution must be observed when interpreting the diastolic BP results. Clinical correlation is imperative.
Prevalence of Prehypertension Among Adults in Baghdad/Iraq.
Alogaili MH, Alsallami AA, Fadhil MS … +1 more , Khaleel SH
Int J Hypertens · 2026 · PMID 42058636 · Full text
INTRODUCTION/OBJECTIVE: Prehypertension (defined as systolic pressure of 120-139 mmHg or diastolic pressure of 80-89 mmHg) may impose a substantial burden and future public health challenge. Prehypertension is associated...
INTRODUCTION/OBJECTIVE: Prehypertension (defined as systolic pressure of 120-139 mmHg or diastolic pressure of 80-89 mmHg) may impose a substantial burden and future public health challenge. Prehypertension is associated with a high risk of progression to hypertension and subsequent cardiovascular complications, with a 40% five-years progression rate. In those people, lowering blood pressure helps prevent progression to frank hypertension and subsequent target organ damage. In Iraq, the prevalence of hypertension is about 35.6%, and the blood pressure in one-third was uncontrolled. To our knowledge, there are no studies addressing prehypertension in Iraq. This study aimed to assess the prevalence of prehypertension among adults in Baghdad/Iraq. METHODS: This cross-sectional study enrolled 424 adults (18 years old and above) recruited from randomly selected primary healthcare centers distributed throughout the city of Baghdad (capital of Iraq) using a multistage sampling technique. Blood pressure was measured (two readings were taken 10-min apart, and the mean value for both systolic and diastolic readings was calculated in millimeters of mercury). Those with a history of hypertension, on antihypertensive treatment or pregnant women were excluded from the study. RESULTS: The prevalence of prehypertension was 31.0%. There was a significant difference in the preHTN group between normal and high waist circumference (32.1% vs. 49.0%, = 0.04). Predicted mean blood pressure was significantly correlated with both body mass index and waist circumference ( < 0.001, R-squared = 0.03). The adjusted multiple logistic regression model shows a significant association of prehypertension with male sex (OR = 2.72, CI = 1.65 to 6.41), high fasting glucose, and high cholesterol level. CONCLUSIONS: Prehypertension (as well as risk factors) is highly prevalent among Iraqi adults. Targeted screening programs, lifestyle modifications, and more focus are needed.
IFN-γ and IL-17A Exhibit Opposing Roles in Age-Related Blood Pressure Dysregulation.
Muchaili L, Sinamwenda EN, Hamooya BM … +3 more , Povia JP, Kirabo A, Masenga SK
Int J Hypertens · 2026 · PMID 42052421 · Full text
BACKGROUND: The inflammatory pathophysiology of hypertension involves interactions between innate and adaptive immune pathways. While interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) have established roles, t...
BACKGROUND: The inflammatory pathophysiology of hypertension involves interactions between innate and adaptive immune pathways. While interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) have established roles, the contributions of specific T cell-derived cytokines, especially interferon-γ (IFN-γ), interleukin-17A (IL-17A), and interleukin-1 (IL-1), remain less defined in age-stratified human populations. The aging immune system undergoes characteristic shifts that may differentially engage these pathways in regulating blood pressure, with this immune senescence being notably accelerated in people living with HIV (PLWH). Therefore, this study aimed to investigate age-stratified associations between key cytokines and systolic blood pressure (SBP) and to determine how these relationships interact with metabolic factors in both PLWH and non-PLWH. METHODS: We conducted a cross-sectional analysis of 332 adults, stratified into two age groups: < 45 years ( = 121) and ≥ 45 years ( = 211). Of the participants, 241 were living with HIV (PLWH) and 91 were HIV-negative. Multiple linear regression models, adjusted for demographics, HIV status, LDL cholesterol, and smoking, assessed associations between SBP and plasma levels of IFN-γ, IL-17A, IL-6, IL-1, and TNF-α. Analyses were performed separately for each age group. In secondary analysis, we evaluated the cytokine-SBP associations using multilinear regression within the HIV + subgroup and in a pooled model including both PLWH and HIV-negative participants to assess consistency across HIV serostatus. RESULTS: The older cohort had significantly higher median SBP, BMI, and LDL cholesterol (all < 0.001). Regression models revealed distinct, age-dependent drivers of SBP. In adults < 45 years, only IFN-γ ( = 0.00107, = 0.018) and chronological age ( = 0.487, = 0.047) showed significant positive associations with SBP. In contrast, for adults ≥ 45 years, body mass index (BMI) was the dominant and consistent predictor across all models ( range: 1.95-2.08, all < 0.001). In this older group, IL-17A was additionally significant in its specific model ( = 0.00322, = 0.0448). Systemic levels of IL-6, IL-1, and TNF-α were not significantly associated with SBP in either cohort. Secondary analysis showed consistent cytokine-SBP relationships by HIV status, with a slight reduction in effect size seen in IL-17A after adding HIV-negative participants: HIV+ ( = 0.0029, = 0.035) to the combined cohort ( = 0.0027, = 0.048). IFN-γ remained stable with near-identical effect sizes (HIV+: = 0.0010, = 0.011; combined: = 0.0010, = 0.010). CONCLUSION: The regulation of blood pressure appears to undergo a fundamental pathophysiological transition with advancing age. In younger adults (< 45 years), SBP is associated with adaptive immune activity, mainly the Th1-associated IFN-γ. After midlife (≥ 45 years), this relationship is superseded by a model dominated by adiposity, within which the Th17-associated IL-17A acts as a contributing inflammatory mediator. These age-stratified cytokine-blood pressure relationships were consistent across PLWH and HIV-negative individuals, suggesting that this pathophysiological succession operates independently of HIV serostatus. Collectively, these findings advocate for age-tailored, mechanism-based approaches to the understanding and managing blood pressure-related risk.
The Promoter as a Molecular Nexus for Antihypertensive Therapy Resistance and Enhanced Malaria Susceptibility.
Ameke SL, Fosu K, Amenga-Etego L … +2 more , Sarpong KAN, Kwofie SK
Int J Hypertens · 2026 · PMID 42027996 · Full text
BACKGROUND: In Sub-Saharan Africa, the escalating burden of hypertension converges with persistent malaria endemicity, creating a complex clinical challenge marked by increasing rates of resistance to first-line antihype...
BACKGROUND: In Sub-Saharan Africa, the escalating burden of hypertension converges with persistent malaria endemicity, creating a complex clinical challenge marked by increasing rates of resistance to first-line antihypertensive therapies, particularly angiotensin-converting enzyme inhibitors (ACEIs) and Angiotensin II receptor blockers (ARBs). The molecular mechanisms underpinning this therapeutic failure remain elusive. , a Rho GTPase regulating both cardiovascular function and erythrocyte biology, presents a compelling molecular link between these comorbidities, yet its regulatory architecture in this context is uncharacterized. METHODS: We conducted a comprehensive analysis of the human promoter region (-2000 to +500 bp relative to the transcription start site) using biomaRt, BSgenome, and the JASPAR2022 database, anchored to the GRCh38/hg38 reference genome. African ancestry variants from resources such as gnomAD were considered to enhance population-specific relevance. Transcription factor binding sites were predicted using position weight matrices with an 80% relative score threshold to balance sensitivity and specificity. CpG island analysis was performed, including calculation of the observed/expected (o/e) ratio. RESULTS: The 2501 bp promoter is notably GC-rich (57.34%) and contains 164 CpG sites with an o/e ratio of 0.75, defining a canonical CpG island. Analysis revealed a complex regulatory landscape featuring binding motifs for the mineralocorticoid receptor (MR), suggesting a potential pathway for bypassing RAAS blockade and contributing to ACEI/ARB resistance. Binding sites for hypoxia-inducible factors, inflammatory mediators, and the erythroid-specific factor GATA-1 were also identified. Spatial analysis showed nonrandom clustering of these elements, suggesting integrated response capabilities. CONCLUSION: The regulatory architecture of the promoter suggests a potential molecular basis for MR-mediated resistance to ACEI/ARB therapies while simultaneously providing a predictive link to enhanced malaria susceptibility through erythrocyte remodeling pathways. These findings offer a novel framework for understanding treatment-resistant hypertension in malaria-endemic regions and identify the promoter as a candidate nexus for developing dual-disease therapeutic strategies tailored to high-burden populations.
Postprandial Antihypertensive Evaluation of Microencapsulated Pomegranate Juice in Women With Mild Hypertension: A Randomized Pilot Study.
Betanzos-Cabrera G, Cabrera-García P, Fabella-Illescas HE … +6 more , Valle-Mondragón LD, Talamantes-Gómez JM, Sánchez-Ortiz NA, Ariza-Ortega JA, Ojeda-Ramírez D, Ahlgren-Beckendorf JA
Int J Hypertens · 2026 · PMID 41938572 · Full text
INTRODUCTION: Hypertension is a risk factor for cardiovascular disease (CVD). Pomegranates are fruits with a high phenol content that have an antihypertensive effect. OBJECTIVE: This randomized postprandial pilot study e...
INTRODUCTION: Hypertension is a risk factor for cardiovascular disease (CVD). Pomegranates are fruits with a high phenol content that have an antihypertensive effect. OBJECTIVE: This randomized postprandial pilot study evaluated microencapsulated pomegranate juice (MPJ) as a natural antihypertensive agent in patients with mild hypertension. MATERIALS AND METHODS: The content of phenols, flavonoids, anthocyanins, and antioxidant activity in fresh pomegranate juice (FPJ) and MPJ was determined. Subsequently, the postprandial antihypertensive effect was evaluated in recruited participants who consumed approximately a 480 kcal breakfast. Four experimental groups with five participants each were evaluated: FPJ, 150 mL fresh juice; MPJ, 20 g MPJ; the participant's usual drug (AH); and 150 mL water (W) with breakfast. Each participant's blood pressure (BP) was measured before and after breakfast at 30, 60, 90, and 120 min. Changes in BP values were evaluated as a function of time using generalized linear models. RESULTS: MPJ contained the highest content of phenols (14.84 ± 0.03 mg gallic acid equivalent/g lyophilized FPJ) and flavonoids (9.20 ± 0.50 mg quercetin equivalent/g lyophilized FPJ) compared to FPJ; the latter contained a higher content of anthocyanins (3.06 ± 0.009 mg cyanidin 3-glucoside/g lyophilized FPJ) and had higher antioxidant capacity. In systolic BP, AH showed significant reductions at 60-120 min. Several statistically significant differences in diastolic pressure were observed: MPJ at 30-120 min and FPJ and AH groups at 60-120 min. FPJ exerted an effect similar to AH at 90 min. CONCLUSIONS: The results suggest a moderate postprandial antihypertensive effect of MPJ when used as an adjunct to pharmacological treatment. However, the findings do not support its use as a replacement for antihypertensive therapy. ClinicalTrials.gov identifier: NCT07017296.
The Prevalence and Correlates of Arterial Stiffness in Patients With Treated Hypertension: Oscillometric Pulse Wave Analysis During 24-h Ambulatory Blood Pressure Monitoring.
Tufekci D, Sahutoglu T, Kara E
Int J Hypertens · 2026 · PMID 41685267 · Full text
BACKGROUND: We investigated the prevalence and correlates of arterial stiffness in treated hypertension using oscillometric pulse wave analysis during 24-h ambulatory blood pressure monitoring (ABPM). METHODS: In this si...
BACKGROUND: We investigated the prevalence and correlates of arterial stiffness in treated hypertension using oscillometric pulse wave analysis during 24-h ambulatory blood pressure monitoring (ABPM). METHODS: In this single-center cross-sectional study, 131 patients (median age 51.0 years, range 17.0-86.0; 54.2% female) underwent 24-h ABPM. Measurements included 24-h, daytime, and night-time SBP, DBP, MAP, pulse pressure, dipping status, and estimated pulse wave velocity (ePWV) derived by the Mobil-O-Graph (ARCSolver; age/SBP-dependent). RESULTS: High ePWV (> 9 m/s) was present in 16.8% of patients. Compared with low/moderate ePWV, the high-ePWV subgroup was older ( < 0.001) and had higher FPG ( < 0.001), higher creatinine and lower eGFR (both < 0.001), greater proteinuria ( = 0.006), and a lower frequency of systolic dipper status ( = 0.033). In simple correlations, 24-h ePWV was correlated positively with 24-h, daytime, and night-time values of DBP, MAP, and pulse pressure, BMI, FPG, creatinine, uric acid, and proteinuria, and negatively with systolic dipping, diastolic dipping, albumin, and eGFR. However, after adjusting for age, age, and 24-h SBP, the partial correlation analysis revealed that ePWV was negatively correlated only with FPG ( = -0.216, = 0.014) and hsCRP ( = -0.220, = 0.031) and positively correlated only with total cholesterol ( = 0.243, = 0.043) and LDL ( = 0.359, = 0.004). CONCLUSION: Elevated ePWV identifies a high-risk phenotype in treated hypertension, characterized by advanced age and renal impairment. However, these associations appear intrinsic to the algorithm's reliance on age and SBP. After adjusting for these inputs, ePWV did not exhibit independent associations with clinical parameters, suggesting it should be viewed as an integrated derivative of age and blood pressure rather than a separate physiological measure. ePWV values should be interpreted with caution, recognizing their inherent dependence on algorithmic inputs.
Lifestyle and Anthropometric Predictors of Hypertension Among Adults Attending Debark General Hospital, Northwest Ethiopia: An Unmatched Case-Control Study.
Tegegne KT, Tegegne ET, Tessema MK … +7 more , Teshome SE, Chalachew AA, Wudu TK, Workneh AZ, Abebe MT, Kelkay JM, Adugna DM
Int J Hypertens · 2026 · PMID 41669273 · Full text
BACKGROUND: Hypertension is a growing public health concern in Ethiopia, contributing substantially to cardiovascular morbidity and mortality. Identifying predictors of hypertension is crucial for effective prevention an...
BACKGROUND: Hypertension is a growing public health concern in Ethiopia, contributing substantially to cardiovascular morbidity and mortality. Identifying predictors of hypertension is crucial for effective prevention and control. OBJECTIVE: To identify the lifestyle and anthropometric predictors of hypertension among adults attending Debark General Hospital, Northwest Ethiopia. METHODS: An unmatched case-control study was conducted from January to March 2025, including 640 participants (128 hypertensive cases and 512 normotensive controls) with a 1:4 case-to-control ratio. Cases were adults diagnosed with hypertension (SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg or on antihypertensive treatment). Controls were normotensive adults attending the hospital for other health issues. Data were collected using a structured questionnaire and anthropometric measurements. Multivariable logistic regression was performed using Stata to identify independent predictors of hypertension. RESULTS: The multivariable analysis identified age ≥ 45 years (AOR = 3.62; 95% CI: 2.11-6.20), obesity (BMI ≥ 30 kg/m) (AOR = 2.95; 95% CI: 1.78-4.89), low physical activity (AOR = 2.47; 95% CI: 1.45-4.19), high dietary salt intake (AOR = 2.33; 95% CI: 1.32-4.11), family history of hypertension (AOR = 3.14; 95% CI: 1.89-5.22), alcohol consumption (AOR = 2.01; 95% CI: 1.17-3.44), and low fruit intake (< 5 servings/week) (AOR = 1.89; 95% CI: 1.08-3.29) as significant predictors of hypertension (all < 0.05). CONCLUSION: The study identified key modifiable predictors of hypertension, including obesity, physical inactivity, high salt intake, alcohol use, and low fruit consumption, along with nonmodifiable factors such as older age and family history among adults in Northwest Ethiopia. These findings highlight the need for integrated preventive interventions targeting lifestyle modification and early screening in the Ethiopian healthcare system.
Various Antihypertensive Drug Compliance Models and Cardiovascular Prognosis of People With Incidentally Detected High Blood Pressure During Health Check-Up in Korea.
Park JK, Chun S, Kim J … +7 more , Lee H, Jang JY, Chun KH, Kim H, Oh SJ, Park G, Yoon SJ
Int J Hypertens · 2025 · PMID 41479876 · Full text
BACKGROUND: A health check-up system (HCS) is one of the best ways to prevent complications and maintain health by diagnosing diseases and screening risk factors early. Here, we investigated how many people who detected...
BACKGROUND: A health check-up system (HCS) is one of the best ways to prevent complications and maintain health by diagnosing diseases and screening risk factors early. Here, we investigated how many people who detected elevated blood pressure through the HCS were finally diagnosed with "hypertension" and continuously treated. We also analyzed their cardiovascular risk and prognostic significance according to the multiple drug compliance patterns. METHODS: A total of 38,100 subjects without cardiovascular disease who were newly detected with elevated blood pressure in HCS between 2006 and 2011 were analyzed and followed up until 2019 using the Korean National Health Insurance Database. They were divided into five subgroups through subsequent prescription history and compared for epidemiological, laboratory performance and cardiovascular events. RESULTS: Of the total 38,100 subjects, 6981 (18.3%) cases were diagnosed with hypertension and started medication within 12 months. Of those cases, 3021 (7.9%) cases continued taking their medication, 2184 (5.7%) cases persistently discontinued medication, and 485 (1.3%) cases restarted medication again within 12 months of discontinuation. As a result of follow-up until 2019, the "drug-free group" showed the significantly lowest cardiovascular complication incidences (angina, heart failure, ischemic heart disease, CKD, and PAOD), and the highest were seen in the "re-initiation group" (cerebral infarct and atrial fibrillation) compared with the "continuous medication group." CONCLUSIONS: A considerable proportion of individuals with high blood pressure detected in HCS were diagnosed with hypertension and at high cardiovascular risk. The group that needed to restart medication within 12 months after discontinuation showed a higher cardiovascular risk among them.
Development and Validation of a Diagnostic Nomogram for Predicting Hypertension in Patients With Obstructive Sleep Apnea at High Altitude.
Shi W, Wang R, Liu D … +6 more , Sun H, Qin Y, Du B, Zhang R, Tang H, Chu A
Int J Hypertens · 2025 · PMID 41477189 · Full text
Obstructive sleep apnea (OSA) has been established as one of the independent risk factors for hypertension, and its coexistence substantially raises the risk of cardiovascular incidents. However, existing clinical predic...
Obstructive sleep apnea (OSA) has been established as one of the independent risk factors for hypertension, and its coexistence substantially raises the risk of cardiovascular incidents. However, existing clinical predictive models mainly focus on populations in plain areas and fail to take altitude-specific factors into account. The objective of this study was straightforward: to develop and validate a nomogram that can predict hypertension in patients with OSA syndrome living at mid- to high altitudes. We carried out a detailed retrospective review of 1505 patient records from January 2021 to February 2024, all newly diagnosed with OSA through polysomnography (PSG). After applying the inclusion and exclusion criteria, 694 patients were included in the training cohort, and 358 patients were included in the validation cohort. Candidate predictors were selected using LASSO logistic regression, and a nomogram was subsequently established through multivariable logistic regression. The area under the receiver operating characteristic curve, calibrated curves, and decision curve analysis were employed to comprehensively evaluate the model's discriminative capacity, calibration, and clinical applicability. Six variables were identified as risk factors for OSA patients with hypertension, including age, BMI, tonsillar hypertrophy, IVSd, LVPWD, and T90. The nomogram was developed using these variables. The training and validation sequences demonstrate their effectiveness. The AUC of the training and validation cohort was 0.78 (95% CI: 0.74-0.81) and 0.72 (95% CI: 0.66-0.77), respectively. The development of this nomogram can help identify individuals with a higher likelihood of hypertensive conditions among OSA patients in mid- to high-altitude regions, thereby providing a basis for early clinical identification and intervention.
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