Hypertension Research最新文献

Cardiovascular diseases (CVDs) have been a major cause of global morbidity and mortality, necessitating continuous innovation in diagnostic methods, better mechanistic understanding, and the development of risk stratification strategies. This review summarizes significant updates in vascular and cardiovascular health from 2024 to 2025, focusing on novel non-invasive assessment technologies, deeper insights into molecular and cellular pathophysiology, and effective approaches to clinical risk assessment. Key advancements include the development and validation of artificial intelligence-driven models for vascular age assessment, plethysmographic methods for endothelial function evaluation, and refined pulse wave velocity measurements for proximal aortic stiffness. Mechanistic studies have further investigated the roles of long noncoding RNAs, mitochondrial dynamics, and Piezo ion channels in various CVD pathologies. Clinically, new evidence supports the importance of central arterial stiffness in atrial myopathy, the association of pulse wave velocity with cerebral microbleeds, and the prognostic value of supine hypertension and combined vascular biomarkers, such as the cardio-ankle vascular index and ankle-brachial index. Furthermore, these updates will improve our understanding of vascular health and provide novel approaches to early detection, personalized intervention, and improving patient outcomes in the management of CVD.

This study investigated the associations of twin pregnancies with early-onset (EO)- and late-onset (LO)-hypertensive disorders of pregnancy (HDP). Totally, 86,717 pregnant women were included in a prospective birth cohort study. The associations of dichorionic diamniotic (DD)- and monochorionic diamniotic (MD)-twin pregnancies with EO-HDP (Diagnosed from 20 to <34 weeks of gestation) and LO-HDP (Diagnosed at ≥34 weeks of gestation) were analyzed using a multinomial logistic regression model. Compared with singleton pregnancies, both DD- and MD-twin pregnancies had significantly higher odds for EO- and LO-HDP. The adjusted odds ratios (aORs) for EO-HDP were 2.05 (95% confidence interval [Cl]: 1.51-2.78) in DD-twin pregnancies and 2.80 (95% Cl: 2.01-3.90) in MD-twin pregnancies, respectively. Also, the aORs for LO-HDP were 1.32 (95% CI: 1.03-1.69) in DD-twin pregnancies and 1.64 (95% Cl: 1.24-2.17) in MD-twin pregnancies, respectively. Although no statistically significant differences were observed, MD-twin pregnancies tended to have higher odds for both EO- and LO-onset HDP compared with DD-twin pregnancies. In conclusion, both DD- and MD-twin pregnancies are risk factors for the development of EO- and LO-HDP. We showed that both dichorionic diamniotic and monochorionic diamniotic twin pregnancies are risk factors for the development of early-onset and late-onset hypertensive disorders of pregnancy.

Hypertension is the primary modifiable risk factor for both ischemic stroke and intracerebral hemorrhage (ICH), yet recommendations for blood pressure (BP) management vary across contemporary guidelines. This narrative review compares BP targets and therapeutic strategies in the 2025 American Heart Association (AHA), 2024 European Society of Cardiology (ESC), 2023 European Society of Hypertension (ESH), and 2025 Japanese Society of Hypertension (JSH) guidelines, with emphasis on acute and chronic phases of ischemic stroke and ICH. In acute ischemic stroke without reperfusion therapy, all four guidelines discourage routine BP lowering unless systolic BP (SBP) is ≥220 mmHg or diastolic BP ≥ 120 (110) mmHg, and then recommend only modest reductions of about 15% within 24 hours. For patients receiving IV thrombolysis or mechanical thrombectomy, the guidelines converge on pre-treatment BP<185/110 mmHg and maintenance <180/105 mmHg during the first 24 hours, with JSH specifying micro-infusion calcium channel blockers as preferred agents. In chronic ischemic stroke, AHA, ESH, and JSH generally endorse BP<130/80 mmHg, whereas ESC prioritizes an SBP range of 120-9 mmHg. For acute ICH, all guidelines support rapid but carefully titrated SBP reduction toward approximately 140 mmHg, while emphasizing avoidance of overshoot, large variability, and excessive early declines, particularly when baseline SBP exceeds 220 mmHg in the AHA and ESC guidelines. Long-term after ICH, targets of <130/80 mmHg are widely recommended. Thiazide diuretics, ACE inhibitors, and angiotensin receptor blockers remain foundational for secondary prevention, with calcium channel blockers central to acute parenteral therapy and β-blockers reserved for specific indications. Despite regional nuances, the guidelines converge on conservative acute management in ischemic stroke, proactive early lowering in ICH, and intensive long-term BP control as the global benchmark for secondary cerebrovascular prevention.

The measurement of an individual's blood pressure (BP) while he or she is in a seated position is the standard BP measurement method. The significance of BP measurements obtained from an individual while he or she is in the supine position has also been described. Supine BP values are usually lower than seated BP values, and thus the condition of high supine BP is abnormal and called 'supine hypertension.' Although the mechanisms that underlie supine hypertension are not completely understood, it has been speculated that fluid retention and abnormal sympathetic nervous activity can lead to supine hypertension. Hypertension-mediated organ damage and cardiovascular events have been shown to be associated with supine hypertension; not only supine hypertension with neurogenic orthostatic hypotension but also supine hypertension without it. The treatment of supine hypertension has not been established. Considering the pathophysiological background of this condition, the use of antihypertensive drugs and bedtime dosing may be effective. Further research is necessary to clarify the significance of supine hypertension and to establish the optimal treatment for this condition.

Chronological age is a well-established risk factor for Hypertension (HTN), yet while biological ageing markers such as epigenetic age acceleration (EAA), have been associated with HTN, findings are inconsistent. This study aimed to conduct a systematic review and meta-analysis to evaluate the association between EAA, HTN and blood pressure (BP) to provide an understanding of the role of EAA in HTN development and progression. Six databases were searched, and studies which reported associations between DNA and HTN, and/or BP were included. Functional enrichment analysis was conducted using DAVID and STRING to elucidate underlying molecular pathways. From 4334 studies, 165 met the inclusion criteria. Qualitative analysis indicated that 17.0% of studies reporting global methylation and 49.1% of studies reporting gene-specific methylation demonstrated significant associations with HTN and/or BP. A random effects meta-analysis of 16,136 participants from 8 studies using three epigenetic clock algorithms demonstrated that HTN was associated with increased EAA (β: 0.29, 95%Cl: 0.15-0.43; P < 0.0001). All three individual epigenetic clocks demonstrated a positive association between clinically measured HTN and EAA (Horvath β: 0.33, 95%Cl: 0.08-0.58, P = 0.010; Hannum β: 0.64, 95%Cl: 0.09-1.20; PhenoAge β: 1.21, 95%Cl: 0.56-1.86), whereas this relationship was not clear when using self-reported HTN. This study is the first to systematically demonstrate that HTN is associated with EAA. We recommend the use of clinically measured over self-reported HTN in appropriately powered studies of epigenetic age to obtain an accurate understanding of BP regulation/HTN on the epigenome, supporting pathways to translation and development of novel therapeutic targets for HTN.