Studies suggest that asthma and hypertension may be comorbid conditions. Most of these studies are epidemiological research. However, data on the relationship between asthma and hypertension in childhood are limited. We aimed to evaluate ambulatory blood pressure profiles of children with asthma.

Children aged 5-18 with asthma were evaluated using ABPM. The control group included healthy age- and sex-matched volunteers. A total of 26 patients with asthma and 20 controls were enrolled.

Children with asthma had higher mean 24-h systolic blood pressure (SBP) SDS (standard deviation score) compared to controls (mean difference: 0.84, 0.19 ± 1.14 vs. - 0.65 ± 1.09, p = 0.015). Daytime SBP SDS was higher in those with asthma (mean difference: 0.83, 0.009 ± 1.22 vs. - 0.82 ± 1.09, p = 0.021), as was nighttime SBP SDS (mean difference: 0.74, 0.64 ± 1.09 vs. - 0.10 ± 0.79, p = 0.013). Median nighttime SBP load was higher in those with asthma (p = 0.006). Nondipping status was found in 23.1% of patients with asthma (none in controls, p = 0.021). One patient (3.8%) had ambulatory hypertension and six (23.1%) had masked hypertension (none in controls, p = 0.042). Extended use of inhaled corticosteroids was associated with a 2% increase in the odds of developing hypertension (OR 1.02, p = 0.025).

Children with asthma may be at greater risk for developing hypertension compared to healthy counterparts. Ambulatory blood pressure tends to be higher in children with asthma than healthy peers. Inhaled steroids potentially contribute to elevated BP levels in children with asthma.

Sodium reduction is a cost-effective measure to prevent noncommunicable diseases. The World Health Organization (WHO) established a target of a 30% relative reduction in mean population intake of sodium by 2025. The Pan American Health Organization (PAHO) published sodium reduction targets (SRTs) for packaged foods in 2015, expanding and updating the targets in 2021 to help Member States with its efforts in reducing population sodium intake.

This study examined the current sodium levels in packaged foods among five countries in the Americas and monitored cross-sectional and longitudinal compliance with the sodium targets from 2015 to 2022.

Food labels were systematically collected from the main supermarkets in five countries in the Americas region in 2022. Sodium levels per 100g and per kcal for collected food labels in 16 PAHO categories and 75 subcategories were analyzed and compared against the updated SRTs. Further analysis of three countries that have longitudinal data for 2015-2016, 2017-2018 and 2022 was conducted to compare sodium per 100 g against the 2015 SRTs.

A total of 25,569 food items were analyzed. Overall, 'processed meat and poultry' had the highest sodium levels, although there were large variations within categories. 47% and 45% of products met the sodium per 100g and per kcal 2022 SRTs, respectively. Peru had the highest compliance, whereas Panama had the lowest for both targets. Among Argentina, Costa Rica and Peru, the proportion of foods meeting the 2015 PAHO lower targets were 48, 53 and 61% for 2015-2016, 2017-2018 and 2022, respectively (p < 0.001).

This study showed that around half of the examined foods met their respective SRTs and there have been small improvements in compliance over time. Further efforts are required to reach the WHO's global sodium reduction goal by 2025, such as implementation of mandatory SRTs and front-of-pack labelling regulations.

Evidence on which hypertensive intervention is cost-effective is essential to inform strategy, policy development, practice, implementation, and resource allocation. Value-Based Care (VBC) is a healthcare delivery model that emphasizes improving patient outcomes while optimizing costs. It shifts the focus from the volume of services provided to the value delivered to patients. We hypothesize that innovative VBC intervention would be more cost-effective compared to standard care among individuals with poorly controlled hypertension.

This study in Ghana will employ a mixed-methods evaluation design, a comprehensive and thorough approach that combines quantitative and qualitative methods. The quantitative component will involve a quasi-experimental study to measure the impact of the VBC intervention on quality of life, improved clinical outcomes, patient satisfaction, and enhanced financial protection among hypertensive patients registered with the National Health Insurance Authority. We will use a difference-in-difference analytic approach and a generalized estimation equation model with cluster-robust standard errors to quantify the impact of VBC, accounting for potential confounding variables. The qualitative component will involve in-depth interviews and focus group discussions to gather insights into the experiences and perceptions of the patients, caregivers, and policymakers involved in the VBC intervention and the benefits, barriers, costs of treatment, and challenges associated with the VBC intervention.

Despite the availability of safe treatment options for hypertension, most people with hypertension in LMICs do not have it controlled. There is currently a paucity of knowledge about the cost-effectiveness of VBC interventions in developing countries. This study aims to fill this knowledge gap and pave the way for more cost-effective hypertension treatment worldwide. The Ghana VBC intervention described in this paper is a pioneering approach to achieving safer, more consistent, and cost-effective care for hypertensive patients.

Cardiovascular illnesses are multifactorial disorders and represent the primary reasons for death worldwide, according to the World Health Organization. As a signaling molecule, nitric oxide (NO) is extremely permeable across cellular membranes owing to its unique molecular features, like its small molecular size, lipophilicity, and free radical properties. Some of the biological effects of NO are vasodilation, inhibition in the growth of vascular smooth muscle cells, and functional regulation of cardiac cells. Several therapeutic approaches have been tested to increase the production of NO or some downstream NO signaling pathways. The health benefits of red wine are typically attributed to the polyphenolic phytoalexin, resveratrol (3,5,4'-trihydroxy-trans-stilbene), which is found in several plant species. Resveratrol has beneficial cardiovascular properties, some of which are mediated through endothelial nitric oxide synthase production (eNOS). Resveratrol promotes NO generation from eNOS through various methods, including upregulation of eNOS expression, activation in the enzymatic activity of eNOS, and reversal of eNOS uncoupling. Additionally, by reducing of oxidative stress, resveratrol inhibits the formation of superoxide and inactivation NO, increasing NO bioavailability. This review discusses the scientific literature on resveratrol's beneficial impact on NO signaling and how this effect improves the function of vascular endothelium.

Hypertension is the leading preventable cause of cardiovascular morbidity and mortality globally, with a disproportionate impact on low-income and middle-income countries like Sri Lanka. Effective blood pressure (BP) control improves outcomes in patients with hypertension. This study aimed to assess the prevalence of uncontrolled hypertension, and its correlates among Sri Lankan patients with hypertension in clinic settings.

A cross-sectional study was done at the largest tertiary care hospital in Sri Lanka and patients with hypertension presenting to its medical clinics over a 6-month period were recruited. An interviewer-administered questionnaire captured sociodemographic, morbidity, and medication details from records. BP measurements were taken following standard guidelines with OMRON-X7 BP monitors. Multivariate logistic regression was used to identify significant associations ( P  < 0.05).

Among 600 patients (mean age 64 ± 9 years, 43% men), 55% had uncontrolled hypertension. Most (62%) were on 1 or 2 antihypertensives, primarily renin-angiotensin blockers (91%), with minimal (<10%) thiazide use. Uncontrolled hypertension was less common among furosemide (10.5%) and spironolactone (21.5%) users but frequent among those on alpha-blockers (16.3%). Coronary artery disease (58%), heart failure (9%), and stroke (17%) were more common in men and those with longstanding hypertension. Beta-blockers were favoured in those with cardiac comorbidities, and dihydropyridines in those with stroke. Potential treatment resistance, seen in 11%, was associated with increased cardiac morbidity, while sociodemographic factors and family history had no significant impact on BP control or cardiovascular morbidity.

Uncontrolled hypertension and cardiovascular morbidity were highly prevalent. The data suggest the need for optimized antihypertensive regimens, with reduced use of alpha-blockers and early and prioritized incorporation of diuretics.

The risk of hypertension varies based on ethnicity, environmental factors, and genetic predispositions. Studies have reported a higher risk of cardiovascular diseases (CVD) and hypertension among the Newar ethnic groups in Nepal. However, the genetic analysis for Methylenetetrahydrofolate reductase (MTHFR C677T) gene mutations, serum homocysteine, and high-sensitivity C-reactive protein (hs-CRP) levels across different ethnicities remains unexplored.

Sociodemographic information and baseline data of 489 participants were obtained from the first phase of the Dhulikhel Heart Study. Preserved blood samples were analyzed for MTHFR C677T polymorphism using real-time polymerase chain reaction (TaqMan assay), and serum homocysteine was measured through immunoassay techniques. Descriptive analysis, the Hardy-Weinberg equilibrium test, and multinomial regression were performed.

The prevalence of homozygous mutation (TT) was 19.8% in the Newar group and 12.5% in the Brahmin/Chhetri ethnicity. The highest mean value of homocysteine (19.4 µmol/L) was observed in homozygous participants, followed by the heterozygous mutant group (17.4 µmol/L). A statistically significant association (P = < 0.001) was found between homocysteine levels and blood pressure.

The Dhulikhel Heart Study reveals a significant prevalence of the MTHFR C677T gene mutation among the Newar ethnicity compared to other groups. Elevated levels of homocysteine and high-sensitivity C-reactive protein (hs-CRP) were associated with increased blood pressure.

Not applicable.

Chronic kidney disease (CKD) is a growing health concern worldwide. It is crucial to prevent CKD to mitigate its impact and enhance health results. Recognizing and managing the risk factors of chronic kidney disease at an early stage can aid in stopping its advancement. A cross-sectional study was carried out at a hospital from March 1 to April 30, 2023, involving 422 hypertensive patients. The participants were chosen using systematic random sampling. Data on socio-demographic and clinical factors, as well as knowledge and practices, were gathered through interviews, medical record reviews using structured questionnaires. Descriptive statistics were used to determine the frequency and percentage of variables. The data was entered into Epi-data version 4.6 and analyzed using SPSS version 23 (Chicago). Variables with P-values < .25 were considered for multivariable analysis, and those with P-values < .05 were deemed to be factors associated with knowledge and practices. The study found that 42.2% (178) of hypertensive patients had good knowledge about chronic kidney disease, and 43.6% (184) had good practices. Living in urban areas (with an adjusted odds ratio [AOR] of 3.94 at a 95% confidence interval [CI] of 2.42-6.42) and having a family history of kidney disease (AOR 5.59 at a 95% CI of 3.21-9.75) were factors associated with good knowledge. Being a government employee (AOR 7.29, at 95% CI 1.79-29.58) and maintaining a normal body mass index (AOR 8.03, at 95% CI 3.54-18.19) were linked to good practices. Less than half of the study participants had good knowledge and practices toward prevention of chronic kidney disease. Identifying factors that affect knowledge and practices towards the prevention of chronic kidney disease can offer healthcare providers, governmental and nongovernmental organizations (NGOs), and policymakers' valuable insights for developing strategic interventions and education programs to promote better management of hypertension and CKD.

This study aims to examine the association between single nucleotide gene polymorphisms (SNPs) of GAB1, GAB2, and GAB3 and the genetic susceptibility to essential hypertension in the Chinese Han population. The findings of this research will contribute to understanding the underlying causes of hypertension.

A community-based sampling survey was conducted in two towns in the south of Jiangsu Province to investigate the correlation between gene polymorphisms and essential hypertension. The study included a total of 2119 cases of hypertension and 2317 healthy controls, with an average follow-up period of 10.75 years. The genotypes of seven tagging SNPs (GAB1 rs300893 and rs11936966, GAB2 rs7107174, rs2450135, and rs3740677, GAB3 rs3813455 and rs5987015) were analyzed.

Regression analysis showed that after multifactor correction, only GAB1 rs300893 dominant model was statistically associated with the risk of hypertension among 7 SNPs locis before Bonferroni correction. Subgroup analysis showed that there were associations between specific SNPS and the risk of hypertension in different subgroups, but after Bonferroni correction, these associations were no longer statistically significant. In the follow-up study, Cox proportional hazard regression analysis showed that there was no significant association between the seven SNPs locis and the risk of hypertension. However, subgroup analyses suggest that some gene variants are associated with a reduced or increased risk of hypertension in specific populations. After Bonferroni correction, the addition model of GAB2 rs7107174 was still statistically significant in the specific stratified analysis. Plasma GAB1, GAB2, and GAB3 mRNA expression showed no significant difference between the hypertensive group and the control group.

These findings provide additional support for the genetic role of GAB1, GAB2 and GAB3 in hypertension and blood pressure regulation.

This study aimed to evaluate the association between hypertension (HT) onset age and later risks of chronic kidney diseases (CKD) and mortality. Adult patients without CKD from 2008 to 2013 were identified using electronic medical records from United Kingdom (UK) and Hong Kong (HK). Patients newly diagnosed with HT and those without were included in the HT and control groups, respectively. All subjects were stratified into six age groups (18-39, 40-49, 50-59, 60-69, 70-79, ≥80). Multivariable Cox proportional hazard regression, adjusted with baseline characteristics and fine stratification weights, was conducted to investigate the association between HT onset and risks of CKD, renal decline, end-stage renal disease (ESRD), and all-cause mortality. Subjects were followed up from baseline until an outcome event, death, or administrative end of the cohort, whichever occurred first. A total of 4,413,551 and 3,132,951 subjects were included in the UK and HK cohorts, respectively. HT was significantly associated with increased risks of outcome, but the hazard ratios (HRs) decreased with increasing onset age. In the UK cohort, the HRs (95% confidence intervals) for subjects aged 18-39 and ≥80 were 3.69 (3.53, 3.86) and 2.01 (1.96, 2.06) for CKD, 3.83 (3.60, 4.07) and 3.17 (2.97, 3.38) for renal decline, 17.26 (14.34, 20.77) and 2.55 (2.12, 3.07) for ESRD, 2.88 (2.66, 3.11) and 1.09 (1.07, 1.12) for mortality. The HK cohort exhibited a similar pattern. Our study concluded that early onset of HT significantly affects renal health later in life, while the contribution decreases with the onset age of HT.

To accommodate the fast-paced nature of modern life, the "Weekend Warriors (WW)" has emerged as a novel physical activity (PA) indicator. This study aims to investigate the relationship between WW and other PA patterns with hypertension, thereby addressing a significant research gap. Data from 30,697 participants in the National Health and Nutrition Examination Survey conducted between 2007 and 2018 were analyzed. We employed multiple regression analyses to examine the relationships among WW, other PA patterns, PA duration, PA intensity, and hypertension, with data stratified by various characteristics. Results showed that compared to the inactive group, the insufficiently PA pattern (OR = 0.9, 95% CI 0.8, 1.0), the WW group (OR = 0.9, 95% CI 0.7, 1.1), and the regularly active group (OR = 0.8, 95% CI 0.8, 0.9) were all negatively associated with hypertension, with the WW group showing a trend towards a reduced prevalence of hypertension (P for trend < 0.01). This association was particularly evident among middle-aged and older adults aged 41-80 years. Additionally, total moderate-to-vigorous physical activity (MVPA) time, as well as moderate and vigorous PA intensity, showed "L"-shaped and "U"-shaped relationships with hypertension, with inflection points at 2640 MET minutes, 45%, and 62%, respectively. Our study provides insights for selecting suitable PA patterns but indicates the need for further research.

This study examines the risk factors associated with non-communicable diseases (NCDs), specifically diabetes mellitus (DM) and hypertension (HTN), among adults in Bangladesh, a lower-middle-income country. Given the rising prevalence of DM and HTN and their significant public health burden, this research aims to identify key socioeconomic, demographic and lifestyle-related determinants to inform targeted interventions.

The study used nationally representative cross-sectional data extracted from the Bangladesh Demographic and Health Survey conducted in 2017-2018.

Bangladesh.

The study included 8013 women and 6691 men aged 18 and older who were eligible for blood pressure and blood glucose measurements.

Type 2 DM, HTN.

HTN was significantly associated with higher odds of diabetes (adjusted OR (AOR)=1.28, 95% CI: 1.14 to 1.43), while diabetes was associated with increased odds of HTN (AOR=1.24, 95% CI: 1.11 to 1.39). Individuals aged 40 years and older had 74.8% higher odds of diabetes (AOR=1.748, 95% CI: 1.58 to 1.993) and were 3.21 times more likely to have HTN (AOR=4.208, 95% CI: 3.781 to 4.685). Overweight individuals had 2.15 times higher odds of HTN compared with those with normal weight (AOR=2.154, 95% CI: 1.98 to 2.34). Wealthier individuals also showed significantly higher odds of both DM and HTN.

This study highlights the strong association between DM and HTN and identifies age, overweight status and higher socioeconomic class as key risk factors. These findings underscore the need for integrated public health strategies targeting NCD prevention and management in Bangladesh. Further research should explore longitudinal trends and the impact of targeted interventions on reducing the burden of NCDs.

This study aimed to investigate the relationship between body mass index (BMI) during adolescence and the future risk of developing hypertension, with a particular focus on potential sex differences.

This study was a secondary analysis based on a cohort study involving 2,020 adolescents aged 10-15 years who underwent health check-ups at the MJ Health Screening Center between 1999 and 2008. Cox proportional hazards regression models were used to evaluate the association between BMI and hypertension risk, with stratification by gender. Cox proportional hazards regression with cubic spline functions was employed to explore potential nonlinear relationships, and sensitivity analyses were conducted to ensure robustness.

The multivariate Cox proportional hazards regression model showed a significant positive association between BMI and hypertension risk in the overall adolescent population and particularly in males, with hazard ratios (HRs) of 1.204 (95% CI: 1.038-1.396) and 1.181 (95% CI: 1.013-1.377), respectively. In females, a nonlinear relationship with a threshold effect was identified, with an inflection point at a BMI of 24.11 kg/m². Beyond this threshold, each 1 kg/m² increase in BMI was associated with a 3.491-fold higher risk of hypertension (HR = 4.491, 95% CI: 1.185-17.020).

Among Chinese adolescent males, there was a positive dose-response relationship between BMI and future hypertension risk. In adolescent females, a specific nonlinear association with a threshold effect (inflection point: 24.11 kg/m²) was observed. Maintaining a BMI below 24.11 kg/m² in adolescent females may reduce their future risk of developing hypertension.

The Horoscope trial aimed to assess the efficacy of home blood pressure (BP) telemonitoring (TLM) in controlling BP reduction in hypertensive patients compared with usual care. This is a multi-center, prospective randomized, parallel-group trial comparing TLM with usual care during a period of 6 months in patients with hypertension. We included 525 patients randomly assigned in a 1-1 ratio to telemonitoring (TLM group; n = 260) or usual care (control group; n = 265). After 6 months of follow up, mean values of 24-h systolic and diastolic blood pressure decreased in both TLM and control groups. The mean decrease was significantly greater in the TLM group vs control group (-3.29 mmHg Vs -1.19; p = 0.009) and (-2.9 mmHg Vs, -0.07; p = 0.002) for systolic and diastolic blood pressure, respectively. This study shows that TLM results in significant BP reduction compared to usual care in a Tunisian population of patients with hypertension. Our findings highlight the importance of integrating telemedicine in the management of hypertensive patients; it has the potential to improve the quality of the delivered care and to prevent cardiovascular consequences of uncontrolled BP.

High Na+ intake has been linked to elevations in blood pressure, whereas K+ has the opposite effect. The underlying mechanisms involve complex interactions among renal function, fluid volume, fluid-regulatory hormones, vasculature, cardiac function, and the autonomic nervous system. These mechanisms are likely modulated by sex, given the known sex differences in blood pressure regulation and the higher prevalence of hypertension in men. The source of these observed sex differences may be traced to organ and tissue levels, given that kidney function, intrarenal renin-angiotensin system components, renal sympathetic nervous activity, and nitric oxide bioavailability all exhibit sex differences. To assess the functional impact of each of these sex differences, we developed sex-specific computational models to simulate whole-body Na+, K+, and fluid homeostasis, and the effects on blood pressure. The models describe the interactions among the renal system, cardiovascular system, gastrointestinal system, renal sympathetic nervous system, and renin-angiotensin-aldosterone system. Model simulations suggest that women's attenuated blood pressure response to hypertensive stimuli, including high Na+ intake, may be largely attributable to the female renal transporter abundance pattern. In addition, we investigated the causal link between high K+ intake and blood pressure reduction. The models simulate renal response to high K+ intake, including the immediate gastrointestinal feedforward signals to the kidneys to increase K+ excretion, and the longer-term response to decrease proximal fractional Na+ reabsorption and distal K+ reabsorption. With these assumptions, simulations of high K+ intake yielded kaliuresis, natriuresis, and a substantial reduction in blood pressure, even when combined with high Na+ intake.NEW & NOTEWORTHY Excessive dietary Na+ raises blood pressure, whereas a high K+ diet has the opposite effect. The underlying mechanisms are moderated by sex and involve multiple organs and tissues. How do high K+-induced alternations in kidney function lower blood pressure, and how do those mechanisms differ between men and women? To answer these questions, we conducted computer simulations to simulate whole-body fluid and electrolyte homeostasis, and the effects of Na+ and K+ intake on blood pressure.

Renal denervation (RDN) lowers blood pressure (BP) in patients with uncontrolled hypertension. Current guidelines recommend RDN for patients with uncontrolled BP despite the use of antihypertensive (AH) medications. Durability of BP reductions and assessment of which patient baseline characteristics correlate with subsequent BP reductions are scarce.

The authors leveraged patient data from the entire SYMPLICITY Clinical program to model long-term BP reductions and assess patient characteristics associated with future BP reductions.

Repeated BP measurements from each patient were analyzed using linear mixed models. Models were fitted with office systolic BP (SBP), 24-h ambulatory SBP, office diastolic BP (DBP), and 24-h ambulatory DBP as outcome variables. Baseline BP, baseline number of AH medications, AH medications over time, and other variables were included as fixed effects.

The mixed model included data from 4,155 patients treated with the Symplicity RDN system. The mean age was 60 ± 12 years, 40.4% of whom were female. Estimated, longitudinal office and 24-h ambulatory SBP changes through 36 months, after adjusting for AH medication effects, were biphasic, with a steep reduction after RDN through the first 6 months followed by continuous and steady reductions in office and 24-h SBP and DBP afterward through 36 months. Higher baseline office systolic or 24-h ambulatory SBP were correlated with greater reductions through follow-up in office and 24-h SBP, respectively. Patient characteristics consistent with high sympathetic nerve activity, such as atrial fibrillation and type 2 diabetes, emerged as statistically significant covariates associated with greater office systolic and office and 24-h diastolic BP reductions, respectively.

Modeling suggested patients have durable BP reductions following RDN, with a steep immediate reduction followed by a steady reduction through 3 years.

Hypertension is a major cause of cardiovascular (CVS) diseases. Statins exhibit a blood pressure-lowering effect independent of cholesterol. This study investigates whether combining statins with the phosphodiesterase-III inhibitor cilostazol enhances antihypertensive and cardioprotective effects.

Hypertension was induced in rats via implanted mini-osmotic pumps releasing angiotensin II at 120 ng.kg-1.min-1 for 11 days. Hypertensive rats were treated with cilostazol (50 mg.kg-1.day-1), rosuvastatin (20 mg.kg-1.day-1), atorvastatin (50 mg.kg-1.day-1), or their combinations for seven days. Cardiovascular parameters, baroreflex sensitivity, histopathology, myocardial injury markers (creatine kinase-MB "CK-MB" and cardiac troponin I "cTnI"), and oxidative stress (catalase and malondialdehyde "MDA") were evaluated.

Cilostazol reduced systolic blood pressure, improved left ventricular (LV) function, and mitigated baroreflex dysfunction. Co-administration of atorvastatin enhanced these effects, with rosuvastatin showing greater improvements. The rosuvastatin/cilostazol combination significantly reduced myocardial injury, oxidative stress, and histopathological damage in the heart and aorta.

Statins, particularly rosuvastatin, enhanced cilostazol's antihypertensive and cardioprotective effects, highlighting the potential of this combination in managing hypertension and CVS diseases.

The management of hypertension is one of the most important public health issues. Many patients with untreated hypertension in Japan require urgent treatment. This retrospective cohort study in Hiratsuka city aimed to evaluate the proportion of participants achieving target blood pressure and identify modifiable factors affecting the achievement. We retrospectively analyzed data from a merged database of claims, specific health checkup (SHC), and national health insurance data in Hiratsuka City, Japan, from June 2016 to March 2023. The study participants were adults aged 40-74 years without a history of hypertension treatment and with blood pressure ≥140/90 mmHg at SHC. The primary outcome was the achievement of target blood pressure <140/90 mmHg at the next SHC. Furthermore, multivariable logistic regression was performed to explore factors influencing the achievement. Of 5428 participants, 43.6% were female. The median age was 69 years, and 58.4% (95% confidence interval 57.1-59.7) achieved target blood pressure <140/90 mmHg. Multivariable logistic regression results showed that achievement of target blood pressure was associated with younger age (50-69 years), mild hypertension (grade I), no hypertension at the previous SHC, no record of SHC in the previous year, and willingness to improve lifestyle. One-third of people reported that their hypertension at SHCs failed to achieve target blood pressure. For community-level hypertension management, people who have the influencing factors must be educated by public health nurses, which might be effective for lifestyle improvement. Additionally, the elderly and people with persistent hypertension or severe hypertension should seek medical advice.

The "Life's Essential 8" (LE8) score is an assessment of cardiovascular health recently introduced by the American Heart Association. This study aimed to explore the correlation of the total LE8 score and its individual metrics with all-cause and cardiovascular disease (CVD) mortality in patients with hypertension. Data from 10,556 hypertension adults were retrieved from National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. After a median follow-up of 6.75 years, patients with high LE8 scores (≥ 75 points) showed significantly lower mortality rates from all causes and CVD (P < 0.001). Cox regression analysis indicated that high LE8 scores were associated with a 40% lower risk of all-cause [0.60(0.50-0.73)] and CVD mortality [0.60(0.43-0.83)] compared to low scores. As the total LE8 score increased linearly, the likelihood of all-cause and CVD mortality decreased, with a potential threshold at 60 points. Subgroup analyses revealed that diet, sleep, nicotine exposure, physical activity, and blood glucose control affected both types of mortality. The LE8 score was negatively correlated with the risks of all-cause and CVD mortality in hypertensive patients. Life interventions and management of physical indicators based on the LE8 score may be an effective way to improve mortality in hypertensive patients.

Chronic coronary syndrome (CCS) leads to high morbidity and mortality despite therapeutic advances in recent decades. Several modifiable risk factors, including increased blood pressure (BP), significantly contribute to cardiovascular risk in CCS. Therefore, optimal secondary prevention includes managing BP through lifestyle changes and pharmacological therapy. The CHANGE study aimed to provide evidence for optimizing secondary prevention in CCS patients using a smartphone application.

The CHANGE-Study is a prospective, randomized, controlled trial performed in 9 centers in Germany. Patients with CCS were randomly allocated to either a control or an intervention group. The intervention group received the "Vantis | KHK und Herzinfarkt" digital health application and standard care. The control group received standard care alone. From the original cohort, subgroups of patients with systolic BP ≥140 mmHg (n = 44), ≥130 mmHg (n = 89) and diastolic BP ≥90 mmHg (n = 28) were analyzed for BP reduction after 12 weeks.

In patients with systolic BP ≥140 mmHg, the intervention group showed a reduction in systolic BP by 15.5 mmHg (± 16.7 mmHg, p = 0.0001), which was greater compared to the control group (6.0 ± 13.0 mmHg, p = 0.058). This observation was consistent in patients with systolic BP ≥130 mmHg at baseline. No significant differences between both groups were observed in diastolic BP reduction in patients with diastolic BP ≥90 mmHg.

The CHANGE study documents that a smartphone-guided digital health application positively affects systolic BP in CCS patients. This study underlines the potential of digital interventions in cardiology to improve secondary prevention.

One of the major causes of hypertension (HT) is the transition of normal weight (NW) status to overweight (OW) status and obesity in a population, which leads to cardiovascular disease (CVD) and other disorders. A variety of factors/variables are involved in the development of HT and OW-related hypertension (OHT). However, we planned to investigate the pathophysiological role of serum leptin (Lep), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), total cholesterol (TC) and serum testosterone (ST) in OHT in middle-aged men.

We consulted three groups of middle-aged men (age: 51-60 years)-an HT group (n: 97, high normal weight (HNW), body mass index (BMI): 23-24.9 kg/m2); an OHT group (n: 97, high overweight (HOW), BMI: 28-29.9 kg/m2) and a normal control group (NC, n: 98, HNW)-to investigate the variations in and correlations of Lep, IL-6, TNF-α, ST, TC and other variables.

Significant variations were obtained for the comparisons of TNF-α, Lep, ST and TC for the patient groups. OHT vs. NC showed a significant difference for ST. OHT vs. NC and OHT vs. HT had significant variations for IL-6. Significant changes were obtained for the serum levels of TNF-α, Lep, IL-6, ST and TC among groups. Significant and positive linear associations were obtained for TNF-α, Lep, TC and IL-6. Significant and negative linear associations were found for ST plotted against Lep, TNF-α and IL-6.

The current report provides pathophysiological evidence of the interactive role of serum Lep, TNF-α, ST, TC and IL-6 in middle-aged men with HT and OHT. We suggest that the changes we noted in the present study would be helpful for further BMI-based studies in various subcategories of NW, OW and obese subjects with/without HT.

Hypertension is a leading preventable and controllable risk factor for cardiovascular and cerebrovascular diseases and the leading preventable risk for death globally. With a prevalence of nearly 50% and 93% of cases uncontrolled, very little progress has been made in detecting, treating, and controlling hypertension in Africa over the past thirty years. We propose the African Control of Hypertension through Innovative Epidemiology and a Vibrant Ecosystem (ACHIEVE) to implement the HEARTS package for improved surveillance, prevention, treatment/acute care of hypertension, and rehabilitation of those with hypertension complications across the life course. The ecosystem will apply the principles of an iterative implementation cycle by developing and deploying pragmatic solutions through the contextualization of interventions tailored to navigate barriers and enhance facilitators to deliver maximum impact through effective communication and active participation of all stakeholders in the implementation environment. Ten key strategic actions are proposed for implementation to reduce the burden of hypertension in Africa.

To investigate the sex differences in the efficacy of renal denervation (RDN) in patients with resistant hypertension (RHT) concerning the size of abdominal fat depots, changes in biomarkers of sympathetic activity, and renal function.

24 men (56.5 ± 7.8 years) and 33 women (59.5 ± 8.4 years) with RHT were enrolled in the study and underwent RDN. 24-h ambulatory blood pressure (BP) [systolic/diastolic (SBP/DBP)], serum creatinine (with eGFR calculation), serum adipocytokines (leptin, adiponectin, resistin), serum metanephrines and normetanephrines were measured baseline and 12 months after RDN. The size of subcutaneous, visceral, and perirenal adipose tissue (SAT, VAT, and PRAT) was assessed using MRI.

After RDN, BP decreased, leptin increased, and adiponectin, resistin, and metanephrine levels did not change in both sexes. There was a decrease in normetanephrine levels in women and a similar trend in men. In men, the eGFR did not change. In women, the eGFR remained unchanged only in those with chronic kidney disease (CKD) (n = 10) and decreased in the absence of CKD (n = 23) from 79.7 ± 14.1 to 72.1 ± 12.0 ml/min/1.73 m2 (p = 0.011). Men had larger visceral fat depots, and women had larger subcutaneous fat depots. After RDN, the size of adipose tissue in men remained unchanged, and in women, the PRAT thickness decreased from 2.36 ± 1.23 to 2.10 ± 1.17 cm (p = 0.002). Lowering BP in women was associated with increased leptin levels after RDN (r = -0.47 for SBP, r = -0.48 for DBP). Dependence of BP reduction on baseline eGFR was observed in men only [r = 0.44 for SBP, r = 0.48 for pulse pressure (PP)]. Additionally, in men, the decrease in SBP and PP depended on VAT areas (r = -0.44 and r = -0.58, respectively). In women, the SBP reduction showed an inverse correlation between baseline weight (r = -0.35) and waist circumference (r = -0.38).

The magnitude of the antihypertensive effect of RDN depends on signs of visceral obesity and, in men, also on the presence of CKD. Renoprotective effects of RDN in men are obtained regardless of the initial kidney function, while in women, it was observed only in individuals with CKD. Additional beneficial effects of RDN in women include a decrease in normetanephrine levels and a reduction in PRAT size.

Excessive dietary sodium intake is a major risk factor for hypertension, prompting interest in potassium chloride (KCl) as a sodium chloride (NaCl) alternative. While KCl preserves saltiness, its neural processing compared to NaCl remains underexplored. This study investigates the neural correlates of taste perception for NaCl, KCl, and their mixture using gustatory event-related potentials (ERPs) in a sample of 28 healthy young adults. Participants rated the intensity, saltiness, and pleasantness of the stimuli, which were matched for iso-intensity and iso-pleasantness. High-density EEG data revealed distinct microstate patterns associated with each condition, particularly in the later stages of processing, which align with the endogenous phases of taste perception. Source localization identified the insula and opercular regions as primary sites for gustatory processing, with specific differences in activation patterns between NaCl and KCl. These findings suggest that while KCl elicits comparable behavioral responses to NaCl, its neural representation involves unique processes that may reflect its distinct chemical properties. This study advances our understanding of the neural dynamics of salt taste perception, providing insights into the potential use of KCl as a potentially healthier alternative in dietary interventions.

Hypertension (HTN) is a global public health concern and a major risk factor for cardiovascular disease (CVD) and mortality. Insulin resistance (IR) plays a crucial role in HTN-related metabolic dysfunction, but its assessment remains challenging. The triglyceride-glucose (TyG) index and its derivatives (TyG-BMI, TyG-WC, and TyG-WHtR) have emerged as reliable IR markers. In this study, we evaluated their associations with all-cause and cardiovascular mortality in hypertensive patients using machine learning techniques.

Data from 9432 hypertensive participants in the National Health and Nutrition Examination Survey (NHANES) 1999-2018 were analysed. Cox proportional hazards models and restricted cubic splines were employed to explore mortality risk and potential nonlinear relationships. Machine learning models were utilized to assess the predictive value of the TyG index and its derivatives for mortality outcomes.

The TyG index and its derivatives were independent predictors of both all-cause and cardiovascular mortality in hypertensive patients. The TyG-WHtR exhibited the strongest association, with each 1-unit increase linked to a 41.7% and 48.1% higher risk of all-cause and cardiovascular mortality, respectively. L-shaped relationships were observed between TyG-related indices and mortality. The incorporation of the TyG index or its derivatives into predictive models modestly improved the prediction performance for mortality outcomes.

The TyG index and its derivatives are significant predictors of mortality in hypertensive patients. Their inclusion in predictive models enhances risk stratification and may aid in the early identification of high-risk individuals in this population. Further studies are needed to validate these findings in external hypertensive cohorts.

Hypertension (HTN) is well-known as a major risk factor for various noncommunicable diseases. Evidence indicates a link between socioeconomic status and the likelihood of developing HTN. A thorough comprehension of the inequalities in HTN is crucial for implementing evidence-based interventions. This study aimed to assess the socioeconomic disparities in HTN among people aged 60 and older in Fasa County, located in southern Iran.

A total of 1,632 seniors, aged 60 and above, were included in the analysis, with data obtained from the Fasa Adults Cohort Study (FACS). Initially, we utilized both simple and multiple logistic regression models to investigate the associations between HTN and the determinant variables. The Blinder‒Oaxaca decomposition method was used to decompose the disparity between the impoverished and the wealthy.

The research indicated that elderly individuals with a higher risk of developing HTN were notably linked to factors such as socioeconomic status, education level, a history of coronary artery disease, employment status, smoking habits, body mass index (BMI), waist‒hip ratio (WHR), and physical activity (p < 0.05). The decomposition model revealed a significant gap in HTN rate between rich and poor individuals, with those in the lower income bracket having a 7.59% higher rate of HTN (p = 0.001). Additionally, the leading factors contributing to the greatest disparities in HTN among older adults from different socioeconomic backgrounds include education level (33.07%), employment status (12.78%), BMI (12.25%), physical activity (-15.02%), and WHR (-9.22%).

The decomposition model illustrated a significant disparity in HTN rates among various socioeconomic groups, with a higher rate observed in the lower-income demographic. The analysis revealed that a substantial part of the explained gap can be attributed to factors including education level, employment status, WHR, BMI, and level of physical activity. Nonetheless, a considerable portion of HTN inequality among older adults remains unexplained by the model, highlighting the necessity for additional research that includes a wider variety of factors and variables to gain a deeper insight into the root causes of these disparities.

Primary hypertension (PH) affects over one billion individuals globally, yet less than 30% achieve controlled blood pressure (BP) with medication. Many patients require a combination of multiple medications to reach targets, but adverse effects and financial burdens undermine adherence. Additionally, prehypertension affects 25%-50% of adults, increasing the risk of cardiovascular complications. Early detection and management of prehypertension are crucial for delaying the need for pharmacological interventions. In recent years, clinical guidelines have increasingly emphasised non-pharmacological interventions for PH management. However, the diversity of non-pharmacological therapies and the inconsistencies in efficacy challenge clinical decision-making. This study aims to use network meta-analysis (NMA) to synthesise existing evidence on non-pharmacological interventions for PH, offering updated clinical insights and evidence-based support to optimise treatment strategies. It will also provide recommendations for integrating these interventions into community-based chronic disease management.

To identify potentially relevant randomised controlled trials, a reverse search strategy will be employed to ascertain all non-pharmacological interventions for PH. A well-constructed search strategy will be applied across nine academic databases (Web of Science, Embase, PubMed, PsycINFO, CENTRAL, AMED, CNKI, WF and VIP database) and three clinical trial registries (WHO ICTRP, ClinicalTrials.gov and ChiCTR) for studies conducted between 1 January 2014 and 1 August 2024. Two investigators will independently extract information from eligible articles and document reasons for exclusions. The primary outcomes will encompass changes in systolic and diastolic BP. Pairwise and Bayesian NMA will be conducted using 'meta' and 'GeMTC' package (R 4.4.1). Risk of bias will be assessed using the Risk of Bias 2 tool, and the quality of evidence will be evaluated according to the Grading of Recommendations, Assessment, Development and Evaluation approach.

As this review involves secondary analysis of previously published data, ethical approval is not required. The results will be published in peer-reviewed journals.

CRD42023451073.

Hypertension, a common chronic disease, often leads to serious complications. While conventional management relies on antihypertensive drugs, which can cause side effects and adherence issues, alternative treatments like herbal medicine are gaining attention. This study examines the efficacy and safety of modified Saengmaeksan, an East Asian herbal remedy, in treating hypertension.

This single-arm, prospective, observational study will be conducted at Kyunghee Bichedam Korean Medicine Clinic from October 23, 2023 to August 30, 2024, enrolling 30 hypertensive patients. Over 12 weeks, participants will undergo 4 visits, receiving modified Saengmaeksan twice daily for 8 weeks, with a subsequent 4-week follow-up. Primary outcome is the change in systolic blood pressure from the baseline to week 8. Secondary outcomes include diastolic blood pressure changes, radial artery tonometry, and quality of life evaluations. Safety assessments will include monitoring hematologic parameters and adverse events. Data will be analyzed using an ANCOVA model for adjusting confounders.

Modified Saengmaeksan has shown potential for lowering blood pressure in clinical settings, supported by animal and cell studies. However, human studies are scarce. This research will employ radial artery tonometry to analyze blood pressure comprehensively, exploring Saengmaeksan's hemodynamic effects. The study's goal is to support the approval of modified Saengmaeksan as a hypertension treatment by the South Korean Food and Drug Administration and to promote the industrialization of traditional herbal medicine in managing hypertension. The findings will provide essential data for future clinical research, aiding in feasibility assessments and sample size determinations for randomized controlled trials.

Nociceptors contribute to the cardiovascular responses during a cold pressor test (CPT). While these responses are lower in females, data suggest that they perceive the CPT as more painful. Thus, we examined sex differences in associations between pain and cardiovascular responses to a CPT (Aim 1) as well as differences between females using (OC), and not using (NC), an oral contraceptive (Aim 2). 25 males (23 ± 5 years) and 25 females (21 ± 3 years; 11OC and 14NC) were studied. Cardiovascular data and pain levels (0-10 scale) were recorded at baseline then during a two-minute CPT; changes from baseline to peak response were analyzed. Systolic blood pressure (SBP, p = 0.57), mean arterial pressure (MAP, p = 0.22), heart rate (HR, p = 0.58), and pain (p = 0.71) responses did not differ between sexes; diastolic blood pressure (DBP) increased more in males (17 ± 8 vs. 13 ± 6 mmHg, p < 0.05). Pain was associated with HR in males (r = 0.42, p < 0.05) but not females (r = -0.16, p = 0.44); no other associations were observed in either sex (p = 0.48-0.92). SBP (27 ± 12 vs. 15 ± 6 mmHg), DBP (16 ± 6 vs. 9 ± 5 mmHg), MAP (20 ± 7 vs. 14 ± 5 mmHg), and HR (8 ± 5 vs. 2 ± 5 beats/min) were greater in NC than OC (p < 0.05 for all); pain was similar (p = 0.38). In NC, pain was associated with DBP (r = 0.65, p = 0.01) and MAP (r = 0.65, p = 0.01), but not HR (r = -0.43, p = 0.13), and tended to be associated with SBP (r = 0.46, p = 0.09). In OC, pain was inversely associated with SBP (r = -0.62, p < 0.05) but no other outcome (p = 0.40-0.65). We report a sexual dimorphism in the HR-pain association during a CPT and underscore the impact of oral contraceptives.

Hypertension is a global health concern, particularly among middle-aged and older adults. This study aims to fill this gap by examining hypertension prevalence and risk factors using data from the Longitudinal Ageing Study in India (LASI).

This study used data from the LASI, which is a nationally representative Longitudinal Ageing Study in India (LASI), wave-1 (2017-2018). Our study included a sample of 12,920 individuals from tribal communities who were aged 45 and above. A binary logistic regression analysis was performed to investigate the factors associated with hypertension in middle-aged and elderly tribal adults using STATA software.

The study revealed that the prevalence of hypertension among middle-aged and older tribal adults was 34.35%, with 31.97% among males and 36.29% among females. The prevalence of hypertension among middle-aged tribal adults was observed to be 28.67%, while among older tribal adults, it was found to be 46.13%. Age is a prominent factor, showing a marked increase in hypertension risk with advancing age. Individuals aged 51-55 have a cOR of 1.35 (1.03-1.75) and an aOR of 1.37 (1.01-1.86). Gender analysis reveals that females exhibit a higher crude risk with a cOR of 1.21 (1.02-1.42).

Hypertension is associated to factors such as increasing age, BMI, physical inactivity, tobacco use, and diabetes. Sociodemographic factors like education and socioeconomic status also contribute to the prevalence of hypertension. Targeted public health interventions, including lifestyle modifications, early diagnosis, and management, particularly in tribal communities, can significantly reduce hypertension prevalence and impact. Culturally tailored health promotion programs could further address these risk factors.

Human populations are experiencing unprecedented growth and longevity with lingering knowledge gaps of the characteristics, mechanisms, and pathologies of senescence. Invasive measurements and long-term control conditions for longitudinal studies are infeasible, necessitating the need for surrogate animal models. Rats have short lifespans (2-3 years) with translatable cardiovascular systems, and Sprague Dawley microcirculatory preparations are key to studying the oxygen transport mechanisms critical to the loss of skeletal muscle function in aging. Here we present baseline physiological data of 61 male, Sprague Dawley rats at 3, 6, 12, 18, and 24 months of age. Anesthetized animals were surgically prepared for femoral arterial and venous cannulations, tracheal intubation, and exteriorization of the spinotrapezius muscle. Measurements included cardiovascular function, blood gases, and peripheral tissue interstitial oxygen tension (PISFO2) using phosphorescence quenching microscopy. Intrinsic heart rates decreased with age without significant changes to blood pressure. Arterial oxygen tension declined 17% by 18 and 24 Months (p < 0.05) while pACO2 and PISFO2 were unchanged. Lactate was elevated at 12 and 18 Months along with an alkaline shift in blood pH. Heart rate and decreased pAO2 decoupled from pACO2 are conserved phenomena in human aging. The continuity of resting PISFO2 despite an anaerobic shift in metabolism may be due to declining mitochondrial function and dysregulation of the vascular response to hypoxemia, which are also present in aged humans. These physiological and microcirculatory data offer a useful experimental model for investigating the detailed changes in oxygen supply and demand that affect senescing skeletal muscles in rats and humans.

This study aimed to examine the causal effect between perceived social support and self-management in rural patients with hypertension and to provide a basis for improving self-management.

A cross-sectional study of 1,091 rural hypertensive patients in Shanxi Province was conducted from March through June 2022 to analyze the factors influencing social support as well as the causal effects of social support and self-management using generalized propensity score matching.

Rural hypertensive patients had a low level of social support (social support score = 0.632 ± 0.178). Social support had a significant and inverted U-shaped relationship with self-management; with increasing social support levels, the levels of self-management first rose and then declined, with an inflexion point of 0.774. Social support had significant negative correlations with sex, age, number of child, living status (i.e., living alone or living with others), disease duration, family economic status, and decision-making power, and positive correlations with having a spouse and having medical insurance.

Greater emphasis should be placed on the older adult, individuals living alone, those without spouses, only children, economically disadvantaged populations, and uninsured individuals to enhance the social support they received and ultimately improve their self-management of hypertension. Furthermore, establishing social support systems that are congruent with rural relational networks is crucial for promoting effective hypertension self-management.

Few studies have examined the relationship between nutritional status, as assessed by the Prognostic Nutrition Index (PNI), and incident cardiovascular mortality and all-cause mortality, particularly in hypertensive patients. This study aimed to examine the association between PNI and cardiovascular mortality and all-cause mortality in Americans with hypertension.

Data from this retrospective cohort study were obtained from the National Health and Nutrition Examination (NHANES) 1999-2016. Using data of The NHANES Public-Use Linked Mortality Files to assess all-cause mortality (ACM) and cardiovascular mortality (CVM). After excluding participants younger than 18 years, without hypertension, and with missing follow-up data, a total of 18,189 cases were included in this study. Persons with hypertension were divided by PNI into 4 groups: Q1 (PNI < 49.0), Q2 (PNI: 49.0-52.5), Q3 (PNI: 52.5-55.5), and Q4 (PNI > 55.5). We used the Cox proportional hazard regression model to explore the predictive role of PNI on ACM and CVM in American adults with hypertension. Restricted cubic spline (RCS) curves to investigate the existence of a dose-response linear relationship between them.

During a median follow-up period of 89 months, a total of 1,444 (7.94%) cardiovascular deaths occurred and 5,171 (28.43%) all-cause deaths occurred. Multifactorial COX regression analysis showed all-cause mortality [hazard ratio (HR): 0.584, 95% CI: 0.523-0.652, p < 0.001] and cardiovascular mortality (HR: 0.435, 95% CI: 0.349-0.541, p < 0.001) associated with Q4 group risk of malnutrition in PNI compared to Q1 group. RCS curves showed a nonlinear relationship between PNI and all-cause mortality and cardiovascular mortality (both non-linear p < 0.001).

Lower PNI levels are associated with mortality in patients with hypertension. PNI may be a predictor of all-cause mortality and cardiovascular mortality risk in patients with hypertension.

The relationship between nontraditional lipid profiles and type 2 diabetes mellitus (T2DM) remains ambiguous within the hypertension population. The objective of this study is to examine the association between nontraditional lipid profiles and T2DM in Chinese adults with hypertension. The current investigation encompassed 13 728 participants with hypertension from the China Hypertension Registry Study. Logistic regression analysis and smooth curve fitting were employed to evaluate the association between nontraditional lipid profiles and T2DM. The prevalence of T2DM was found to be 17.8%. In the fully adjusted model, atherogenic index of plasma (AIP) exhibited the highest odds ratios (ORs) for T2DM (OR: 2.71, 95% confidence interval [CI]: 2.26-3.26). Conversely, the fully adjusted ORs (95% CI) for total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)/HDL-C, and non-high-density lipoprotein cholesterol (Non-HDL-C) were 1.33 (1.25-1.41), 1.40 (1.29-1.51), and 1.41 (1.34-1.49), respectively. Additionally, the study demonstrated that AIP had a superior ability to identify T2DM. Subgroup analyses indicated that the relationship between AIP and Non-HDL-C with T2DM was more significant in the lighter weight population. In addition, the association of TC/HDL-C with LDL-C/HDL-C with T2DM was stronger in the lower homocysteine level population. Among the southern Chinese population with hypertension, all nontraditional lipid indices positively correlated with the risk of T2DM. Among these lipid indices, AIP exhibited superior discriminatory power in identifying T2DM compared to TC/HDL-C, LDL-C/HDL-C. Trial Registration: ChiCTR1800017274.

The causal relationship between visceral adipose tissue (VAT) and hypertension remains unclear. We aimed to examine the potential association between them using observational and two-sample Mendelian randomization (MR) analyses. Data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 were used, applying multivariable logistic regression analysis to investigate the association between VAT mass and hypertension risk. Independent genetic variants related to VAT mass were derived from genome-wide association studies (GWAS) in 325 153 UK Biobank participants. The primary analysis employed the random-effects inverse-variance weighted (IVW) method, with MR-Egger, weighted median, simple mode, and weighted mode as sensitivity analyses. A total of 7661 participants were included. After adjusting for confounding factors, increased VAT mass was associated with a higher risk of hypertension (quartile 4 vs. quartile 1: OR:1.85, 95% confidence intervals [CI]: 1.31-2.63). Furthermore, VAT mass exhibited greater accuracy than body mass index (BMI) in predicting hypertension (areas under the curve [AUC]: 0.701 vs. 0.676, p for comparison < 0.001). The MR analyses demonstrated a causal relationship between increased VAT mass and the risk of hypertension in primary analyses (odds ratio [OR]:1.768, 95% CI: 1.594-1.861). Consistent findings across various MR models substantiate the robustness and strength of this causal relationship. These analyses provide additional support for both the positive association and causal relationship between elevated VAT and the risk of developing hypertension, suggesting that targeted interventions for VAT may be beneficial in preventing hypertension.

Hypertension and dyslipidemia are major cardiovascular risk factors that often coexist. Hyperlipidemia is a crucial modifiable risk factor in preventing cardiovascular disease.

We aimed to explore the relationship between lipid levels and the grading of hypertension in a community-based adult population.

A total of 63,091 non-employed individuals were included in this study. Measurements included systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), fasting plasma glucose (FPG), alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (STB), serum creatinine (SCr), blood urea nitrogen (BUN), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), and high-density lipoprotein cholesterol (HDL-c). Chi-square and t-tests were used to obtain basic population characteristics. Multivariate logistic regression was used to evaluate the association between the prevalence of hypertension and lipid profiles, as well as to identify influencing factors. A P-value < 0.05 was considered statistically significant. Statistical charts were utilized to analyze the relationship between lipid parameters and hypertension grades.

A total of 30,588 men and 32,503 women with an average age of 64.57 ± 12.5 years participated in this study. After adjusting STB and TC, every 1 mmol/L increase in TG and LDL-c was associated with a 6.0% and 6.5% increase in the prevalence of hypertension, respectively. Conversely, for every 1 mmol/L increase in HDL-c, the prevalence of hypertension decreased by 4.1%. Increases in TG and LDL-c levels were observed across all grades of hypertension, while very high HDL-c was significantly associated in grade III hypertension (1.54→1.66 mmol/L). Additionally, age, BMI, FPG, ALT, AST, SCr, and BUN significantly influenced the association between hypertension and lipid levels.

Hyperlipidemia and hypertension often coexist in health examination populations. Elevated levels of TG and LDL-C are associated with all grades of hypertension, while extremely high HDL-C level is linked to more severe hypertension.

Hypertension is a prevalent health issue in Bangladesh, impacting a significant portion of the population. This meta-analysis explored how social status inequalities impact hypertension risk in Bangladesh. We systematically searched various electronic databases and rigorously selected 12 studies for inclusion in the analyses. The I2 statistic measured between study heterogeneity, and pooled effect estimates were obtained using the DerSimonian and Laird random effects model to address this variability. Publication bias was assessed through a funnel plot and Egger's test. Sensitivity analysis was conducted to evaluate the robustness of the findings. All analyses were performed using STATA 17. The analyses indicated that females had a significantly higher risk of developing hypertension compared to males, with a pooled odds ratio (OR) of 1.15 (95% confidence interval [CI]: 1.02-1.27). Urban residents showed a pooled OR of 1.11 (95% CI: 1.03-1.19) compared to rural residents. The pooled ORs for hypertension were 1.02 (95% CI: 0.89-1.14) for primary education, 1.07 (95% CI: 0.94-1.21) for secondary education, and 1.25 (95% CI: 1.03-1.47) for higher secondary education, suggesting an increasing risk with higher education levels. Wealth status showed a pooled OR of 1.08 (95% CI: 0.87-1.29) for the poorer class, 1.13 (95% CI: 1.04-1.22) for the middle class, 1.38 (95% CI: 0.68-2.07) for the richer class, and 1.49 (95% CI: 0.97-2.00) for the richest class, indicating a greater risk of hypertension among wealthier individuals. Working individuals had a 39% lower risk of hypertension (OR = 0.61, 95% CI: 0.43-0.80) compared to nonworking individuals.

Observational studies have indicated that there is an association between rheumatoid arthritis (RA) and an elevated risk of hypertension. However, a definitive causal relationship between the two conditions has not been established. The objective of this study was to investigate the causal link between RA and hypertension, as well as the potential mediating role of circulating inflammatory proteins in this relationship. We utilized Mendelian randomization (MR) to examine the causal relationship between RA and hypertension. The study data were obtained from publicly accessible genome-wide association study (GWAS) databases and meta-aggregates of large GWAS studies. The primary statistical method for determining causal effects was the inverse variance weighted (IVW) method, which was supplemented by a variety of sensitivity analyses. The results of the IVW method suggest a causal relationship between RA and an increased risk of hypertension (OR = 1.03, 95% CI = 1.01-1.04, p = 3.32 × 10-5). This association remained statistically significant even after adjusting for multiple confounding factors. Furthermore, MR analyses also revealed causal links between 10 circulating inflammatory proteins and the risk of hypertension, with TNF-related activation-induced cytokine partially mediating RA-induced hypertension at a mediator ratio of 11.17% (0.27%-22.08%). Our study identifies causal relationships between several genetically determined inflammatory proteins and hypertension, establishing that RA increases hypertension risk, with inflammation partially mediating this effect. These findings provide new evidence supporting the inflammatory hypothesis in the mechanism of hypertension. Inflammatory factors may serve as potential targets for antihypertensive therapy.