International Journal of Hypertension最新文献

Background: The Mediterranean diet (MedDiet) is a well-established cardioprotective dietary pattern with demonstrated efficacy in managing hypertension (HTN) and cardiovascular disease (CVD). Its rich array of bioactive compounds, including omega-3 polyunsaturated fatty acids, polyphenols and organosulfur compounds, targets multiple molecular pathways implicated in endothelial dysfunction, oxidative stress, inflammation and metabolic dysregulation.

Methods: This review employed a structured, integrative methodology following preferred reporting items for systematic reviews and meta-analyses, guidelines to analyze literature from PubMed, Scopus, Web of Science and Google Scholar (2000-2025). The population, intervention, comparator and outcomes (PICO) framework guided the research question, focusing on mechanistic, physiological and clinical evidence linking MedDiet components to HTN and vascular health. Inclusion criteria prioritized studies on the MedDiet -specific pathways, such as short-chain fatty acid (SCFA)-G-protein-coupled receptors 41/43 signaling, endothelial nitric oxide synthase (eNOS) activation, nuclear factor erythroid 2-related factor 2-antioxidant response element modulation and renin-angiotensin-aldosterone system regulation. Data were qualitatively synthesized to rank mechanisms by translational relevance and clinical tractability.

Mechanisms: The MedDiet exerts its antihypertensive effects through synergistic pathways: endothelial function enhancement via eNOS activation and nitric oxide bioavailability, oxidative stress reduction through nuclear factor erythroid 2-related factor 2-antioxidant response element pathway upregulation and nicotinamide adenine dinucleotide phosphate oxidase 4 inhibition. The third mechanism is anti-inflammatory actions via nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing-3 inflammasome suppression and cytokine modulation. The fourth is the renin-angiotensin-aldosterone system regulation through angiotensin-converting enzyme inhibition and angiotensin-converting enzyme 2 upregulation. Gut microbiota-derived SCFAs further amplify these effects by activating G-protein coupled 41/43 receptors, improving vasodilation and attenuating systemic inflammation.

Conclusion: Compelling evidence supports the MedDiet as a first-line strategy for HTN and CVD, but research must address adherence, implementation and precision-nutrition gaps to translate proven cardioprotection into personalized, scalable therapies across diverse and resource-limited populations.

Backgrounds: Obstructive sleep apnea (OSA) and hypertension both had significant impacts on human health. Whether OSA increases the risk of hypertension in relation to heredity remains unclear. We sought to clarify this issue using bidirectional Mendelian randomization (MR) analysis in large cohorts.

Methods: A bidirectional two-sample MR was conducted to evaluate the potential causality between OSA and hypertension by selecting single-nucleotide polymorphisms (SNPs) as instrumental variables (IVs) from meta genome-wide association studies (mGWAS). The inverse-variance weighted (IVW) method was the main approach for data analysis to estimate the possible causal effects. Alternative methods such as MR-Egger, the MR pleiotropy residual sum and outlier (MR-PRESSO), and leave-one-out analysis methods were also performed as sensitivity analysis approaches. In order to adjust the confounding factors, a multivariable MR (MVMR) was also performed.

Results: In the forward analysis, the IVW analysis demonstrated a significant association of OSA on increased hypertension risk (OR, 1.044; 95% CI, 1.012-1.076; and p=0.006), DBP value (β, 0.041; 95% CI, 0.012-0.071; and p=0.005), and hypertension of siblings risk (OR, 1.025; 95% CI, 1.003-1.049; and p=0.028), but after adjusting the confounding factors (BMI, smoking, and alcohol consumption), the association disappeared. The reverse analysis demonstrated the causal effect of hypertension of father on elevated OSA risk (OR, 3.803; 95% CI, 1.135-12.726; and p=0.030).

Conclusions: Our forward analysis found the association between OSA and increased hypertension risk, DBP, and hypertension risk of siblings, but after adjusting the confounding factors, the association disappeared; on the reverse analysis, we found the causal effect of hypertension of father on elevated OSA risk.

Background: Hypertension is a global health issue that affects millions of people in the world and is a significant risk factor for cardiovascular diseases, stroke, and kidney failure. Among the many lifestyle factors influencing hypertension, dietary salt consumption has emerged as a key determinant of blood pressure regulation. This study aimed to investigate the relationship between daily salt intake and blood pressure in a group of Cameroonian subjects living in Yaoundé.

Methods: We conducted a cross-sectional analytical study, with prospective data collection conducted from March to May 2024. We included people aged 21 and over with known or unknown hypertension, residing in the Biyem-Assi Health District and having given their free and informed consent. Pregnant women, people with chronic kidney disease, people who had recently taken diuretics, and people with secondary hypertension were excluded from the study. We used a stratified random sampling method. The measurement of the association between salt consumption and blood pressure was studied using Pearson's correlation test with a significance threshold of p < 0.05.

Result: Of the 203 participants included in our study, the median age was 36 [25-55] years. They were predominantly female (51.2%), overweight/obese (50.2%), living a sedentary lifestyle (90.6%), and had normal blood pressure (MAP: 97.79 ± 7.71 mmHg). All participants had a high salt intake (5067.23 ± 1195.23 mg), with extremes of 2005.94 mg and 8222.11 mg, the majority (80.8%) having more than double the recommended value, and the majority of family meals (75%) had a sodium content ≥ 0.6 g/100 g. There was a positive linear relationship between salt intake and mean daily blood pressure (r = 0.452, p < 0.001).

Conclusion: This study highlights the importance of reducing salt intake in the strategy for preventing and managing hypertension in Cameroon. Reducing salt intake through education, awareness, and policy changes could contribute to significantly reduce the burden of hypertension in Cameroon.

Background: Aortic dissection (AD) is the most dangerous disease in acute aortic syndrome and is associated with serious complications. Current studies have shown that sphingosine-1-phosphate (S1P) has a certain effect on AD. Therefore, this study focuses on exploring biomarkers related to S1P in AD.

Methods: Differentially expressed genes (DEGs) between AD and normal samples were identified from the GSE153434 dataset. Key module genes associated with the S1P score were then obtained using weighted gene coexpression network analysis (WGCNA). The DEGs were intersected with these key module genes to derive a set of intersection genes. Subsequently, a protein-protein interaction (PPI) network was constructed and screened to identify candidate genes. Further biomarker mining was performed through machine learning approaches followed by validation. Following this, gene set enrichment analysis (GSEA), immune infiltration analysis, investigation of regulatory mechanisms, and drug prediction were conducted. Finally, we quantified S1P concentration in human plasma using an ELISA kit, established an AD rat model, and validated gene expression levels using quantitative real-time polymerase chain reaction (qRT-PCR).

Results: A total of 651 intersection genes were identified from the overlap between the 702 DEGs and 7108 key module genes. Subsequently, 20 candidate genes were screened, yielding two biomarkers: CXCL5 and ITGA5. Both biomarkers were enriched in the p53 signaling pathway, porphyrin and chlorophyll metabolism, and the NOD-like receptor signaling pathway. Furthermore, eight types of immune cells, including central memory CD4 T cells and natural killer T cells, were significantly elevated in the AD group compared with controls. ELISA quantification confirmed elevated S1P levels in human plasma. Additionally, utilizing an established AD rat model, we provided the first experimental validation that ITGA5 is highly expressed in dissected aortic tissue. Notably, CXCL5 exhibited the strongest significant positive correlation with central memory CD4 T cells. Regulatory network analysis revealed a relatively complex lncRNA-miRNA-mRNA interaction network. Finally, seven potential small-molecule drugs targeting ITGA5 were predicted, including cilmostim, cilengitide, and dimethyl sulfoxide.

Conclusion: This study identifies ITGA5 as a novel biomarker for S1P-associated AD and reveals its potential underlying mechanisms and therapeutic candidates, providing a theoretical foundation for AD diagnosis and treatment.

This study investigated hypertension management in young adults in Korea using data from the 2023 Korean Community Health Survey. We examined treatment patterns and identified factors associated with untreated cases among adults aged 20-39 years diagnosed with hypertension. Among young adults, 21.2% were receiving both drug treatment and lifestyle modification, while 28.6% were neither receiving drug treatment nor lifestyle modification. In addition, 35.5% were receiving only drug treatment, and 14.8% were practicing only lifestyle modification. The percentage of young adults who were not practicing both drug treatment and lifestyle modification was higher than that of adults aged 40 or older. These were associated with male sex (OR: 1.427, 95% CI: 1.12-1.82), BMI (OR: 0.932, 95% CI: 0.91-0.95), current smoking (OR: 1.366, 95% CI: 1.06-1.77), alcohol consumption (≤ once/week, OR: 1.654, 95% CI: 1.14-2.39; ≥ twice/week, OR: 2.484, 95% CI: 1.59-3.87), awareness of one's own blood pressure (OR: 0.194, 95% CI: 0.15-0.26), knowledge of myocardial infarction symptoms (OR: 0.779, 95% CI: 0.71-0.86), education about hypertension management (OR: 0.648, 95% CI: 0.52-0.80), and social network level (OR: 0.934, 95% CI: 0.91-0.96). These findings highlight the need for tailored interventions to improve hypertension awareness and management in young adults.

Background: Whether constipation serves as a risk factor for mortality in hypertensive patients remains an open question. The purpose of the study was to investigate the association of constipation in hypertensive patients with the prognosis for mortality. Methods: The study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted in 2009-2010 involving hypertensive individuals. Constipation was self-reported over the past 12 months. Cox regression analyses, adjusted for age, sex, and race/ethnicity, were employed to assess the association between constipation and all-cause mortality, as well as cardiovascular mortality. Subgroup and sensitivity analyses were conducted to explore variations in the relationship across different demographic and comorbidity groups. Results: Of the 5199 individuals, 1285 had constipation. Hypertensive patients with constipation exhibited an increased risk of all-cause mortality (HR, 1.40, 95% CI, 0.99 to 1.97, p=0.06) and cardiovascular mortality (HR, 1.83, 95% CI, 1.09 to 3.07, p=0.02) compared to nonconstipated patients. The Kaplan-Meier survival curves also reflected higher rates of all-cause mortality (92.71% vs. 89.18%, p < 0.001) and cardiovascular mortality (97.87% vs. 96.44%, p=0.004) in the constipation group. Among hypertensive patients with a PIR ≤ 100, those with constipation exhibited significantly higher all-cause mortality risk than those without (HR 1.95; 95% CI 1.14-2.67; p < 0.001). These patients also demonstrated increased cardiovascular mortality risk (HR 1.93; 95% CI 1.12-3.40; p=0.019). Conclusion: Constipation shows a significant association with increased cardiovascular mortality risk in hypertensive patients.

Background: The Dietary Approaches to Stop Hypertension (DASH) diet is an internationally recognized anti-hypertensive dietary model. This systematic scoping review examines the effectiveness of digital-based interventions utilizing the DASH dietary pattern. Methods: A search was conducted using 14 databases to include relevant studies from 1997 to January 2025 using PRISMA guidelines for scoping reviews. Results: The review included 24 studies with almost 7000 participants, including randomized controlled trials and cohort studies conducted in several countries. Interventions using the DASH dietary pattern positively affected blood pressure (BP), nutrition behavior, and weight. Some studies also reported secondary outcomes such as reduced healthcare cost savings. Conclusion: Technology-based DASH diet interventions yielded favorable health outcomes, particularly in reducing BP and dietary salt intake, as well as improved diet quality. This systematic scoping review supports the potential of digital-based interventions utilizing the DASH dietary pattern to improve nutrition and health outcomes, particularly those related to hypertension management. The findings emphasize the importance of using evidence-based approaches, which are grounded in theoretical frameworks and models to develop effective interventions, and thoughtful program design to maximize group effectiveness. Other factors that influenced the effectiveness of the intervention included the type of technology used, as well as participant comfort with using technology. Further research and development are needed to optimize these interventions for widespread impact and long-term sustainability.

Background: Hypertension or elevated blood pressure is a serious medical condition that significantly increases the risk of diseases of the heart, brain, kidneys, and other organs. Antihypertensive drug adherence is key to controlling blood pressure. This study aimed to assess factors associated with antihypertensive drug adherence and blood pressure control among hypertensive patients in selected public hospitals under the Addis Ababa City Administration. Method: A hospital-based cross-sectional study was conducted among hypertensive patients on follow-up in randomly selected public hospitals under the Addis Ababa City Administration from November 1, 2022, to February 28, 2023. The study population included 393 patients who fulfilled the eligibility criteria and were selected by systematic random sampling. Data collection was conducted from the electronic medical records and by interviewing patients with a structured questionnaire. The data were entered into Epi-Info 7.2.1 and exported to SPSS version 25 software for analysis. Logistic regression analysis was performed to determine the associations between the dependent and independent variables. Results: The rates of antihypertensive drug adherence and blood pressure control were 72.5% and 23.4%, respectively. Participants with uncontrolled blood pressure were 41.7% less adherent than those with controlled blood pressure (AOR = 0.59; 95% CI, 0.36-0.97). Nonadherence to dietary restriction (AOR, 3.31; 95% CI, 1.84-5.96) and chronic kidney disease (AOR = 3.85; 95% CI, 1.41-10.52) were associated with good adherence, whereas the use of a single antihypertensive drug (AOR = 0.53; 95% CI, 0.30-0.94) and nonadherence to moderate physical exercise (AOR = 0.30; 95% CI, 0.20-0.65) were associated with poor adherence to antihypertensive medications. Male sex (AOR = 1.95; 95% CI, 1.04-3.28) and blood pressure measured at home (AOR = 0.59; 95% CI, 0.36-0.99) were found to be independent predictors of controlled blood pressure. Drinking alcohol (AOR = 1.92; 95% CI, 1.05-3.49) was inversely associated with blood pressure control. Conclusion: Although adherence to antihypertensive medications was relatively good, blood pressure control remained low, indicating that medication adherence alone is insufficient. Public health policies should focus on strengthening primary care systems to deliver integrated hypertension management, including lifestyle counseling, dietary support, and improved access to medications and monitoring tools.

Background: As frontline healthcare workers, emergency department nurses face high levels of urgency in their work and are exposed to a high risk of contingencies. Their blood pressure status and influencing factors require close attention. Methods: This study employed a census method and conducted a cross-sectional survey in 11 cities in Hebei Province from November 2016 to July 2018, measuring blood pressure and collecting questionnaires on influencing factors. Binary logistic regression and multiple linear regression were used to analyze the factors influencing blood pressure. Multivariate analysis of variance was used to examine the interaction effects between monthly night shift frequency and other influencing factors on the blood pressure of emergency department nurses. Results: A total of 7218 emergency department nurses in Hebei Province were included (median [IQR] age, 29 [8] years; 6038 [83.65%] women). The prevalence of hypertension was 9.43%. The median SBP (M [IQR]) was 112.0 (13) mmHg, and the median DBP was 70.0 (14) mmHg. Analysis showed that gender, age, BMI, marital status, hospital location, monthly night shift frequency, hyperlipidemia, and antihypertensive medication were influencing factors for the blood pressure (p < 0.05). Significant interactions existed between monthly night shift frequency and marital status, monthly night shift frequency and hospital grade, and monthly night shift frequency and hyperlipidemia (p < 0.05). The systolic blood pressure of emergency department nurses who were divorced or widowed or in Class I hospitals or hyperlipidemia increased to a high degree with the increase of night shifts. The diastolic blood pressure of those combined with hyperlipidemia increased higher with the rise of night shifts. Conclusion: The blood pressure of emergency department nurses requires attention. Nursing managers should pay particular attention to nurses in the emergency department who are prone to hypertension and take proactive measures to prevent and manage hypertension.

Background: In the modern age, the problem of heart disease is increasing day by day which cause even more deaths than cancer. The study was designed to evaluate the polymorphism and expressional analysis of genes CDKN2B and ADIPOQ in cardiovascular patients. Methodology: Blood samples of 300 cardiovascular patients and 300 controls were collected from Gannan and other hospitals of Pakistan. For polymorphism analysis, DNA was extracted followed, by conventional PCR to amplify the variants rs4977574, rs2383206, and rs2241766 of genes CDKN2B and ADIPOQ, respectively. For expressional analysis, mRNA was extracted from whole blood and converted into cDNA, followed by qPCR. Results: The results show that heterozygous (AG) of rs4977574 of the CDKN2B gene showed highly significant association with 2-folds increased risk of cardiovascular disease (CVD) (OR = 2.03; 95% Cl = 1.26-3.25; p < 0.0033) while heterozygous (AG) of rs2383206 of the gene CDKN2B exhibited significant association but with decreased risk of CVD (OR = 0.47; 95% Cl = 0.29-0.75; p < 0.0017). The results of ADIPOQ polymorphism rs2241766 show that the heterozygous genotype (TG) showed a significant association with a decreased risk of CVD (OR = 0.63; 95% CI = 0.39-1.01; p < 0.05) while the homozygous mutant genotype (GG) of rs2241766 again showed a highly significant association with CVD which increased the risk of CVD by 2-folds (OR = 1.77; 95% CI = 1.11-2.80; p < 0.0150). The results of expressional analysis show that CDKN2B is significantly overexpressed in cardiovascular patients, while the gene ADIPOQ showed significant downregulation. Conclusion: The findings show that the CDKN2B and ADIPOQ gene polymorphisms significantly raise the risk for CVD, while their expression shows a significant correlation with CVD.