Current Hypertension Reviews最新文献

Gestational hypertension and preeclampsia are frequently encountered conditions in pregnancy, often occurring around the time of delivery. Mild cases of these conditions in the near term typically result in few complications for both the mother and the newborn. However, women diagnosed with gestational hypertension or preeclampsia need careful monitoring of both maternal and fetal well-being throughout pregnancy, and those with severe symptoms should receive hospital- based management. Preeclampsia is associated with endothelial dysfunction in the mother, prolonged immunological activation, fetal development limitation, hypertension with or without proteinuria, and endothelial dysfunction after week twenty of pregnancy. Pregnancy-related hypertension raises concerns, although the main issues are related to the progression of the condition to pre-eclampsia or eclampsia and HELLP syndrome. In this review, the cross-sectional study of gestational hypertension is evaluated, and the treatment approaches are highlighted.

Background: Adding olive oil (OO) and flaxseed oil (FLO) to the diet has been reported to improve endothelial function and reduce inflammation. However, the efficacy of supplementing OO and FLO on blood pressure (BP) in normo-, pre-, and hypertensive stage 1 adults is uncertain.

Objective: This study aimed to systematically review the literature on OO and FLO supplementation on BP and select inflammatory markers in healthy adults and adults at risk of hypertension.

Methods: Four databases, PubMed, CINHAL, Web of Science, and Medline (Ovid), were searched from inception until October 2023 for randomized control trials (RCTs) comparing OO and FLO supplementation in normotensive or adults at risk of hypertension. The outcomes included were systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) and at least one inflammatory marker, C-reactive protein (CRP), interleukin6 (IL6), or tumor necrosis factor alpha (TNFα). The risk of bias was assessed using version 2 of the Cochrane risk of bias tool for RCTs, publication bias visualization was performed using funnel plots, and meta-analysis was completed to generate average estimates of effects in 2024.

Results: Seventeen RCTs, comprising 14 studies on OO and 3 on FLO, met the inclusion criteria. Meta-analysis using a random-effects model reported no significant effect on SBP n=17 mean difference (MD) -0.48; 95% CI: -1.76, 0.80; p=0.65, I2=0%) and DBP (n=16, MD -0.47; 95% CI: -1.33, 0.39; p=0.65, I2=0%) or inflammatory markers, CRP (n=8, MD 0.11; 95% CI: -1.18, 0.40; p=0.98, I2=0%), IL6 (n=3, MD -0.15; 95% CI: -0.57, 0.27; p=0.87, I2=0%), and TNFα (n=3, MD-0.08; 95% CI: -0.12, -0.03; p=0.98, I2=0%).

Conclusion: Longer-duration, higher-dose, and larger-scale RCTs are needed to better understand the efficacy of OO and FLO supplementation on BP. Further insight will better inform dietary supplement use for preventing hypertension.

Introduction: The role of Angiotensin-converting enzyme (ACE and ACE2) phenotypes and polymorphisms in modulating severe acute respiratory syndrome coronavirus (SARS-- CoV2) infection in hypertensive patients remains unclear. Our objective was to determine the distribution of ACE and ACE2 receptor phenotypes by patient demographics and correlate ACE and ACE2 levels of activity with SARS-CoV-2 outcomes.

Methods: Hypertensive patients treated for SARS-CoV-2 at an urban emergency department (ED) were prospectively enrolled in a cohort study between August 2020 and April 2021. Blood samples were collected during ED visits or hospitalization. Outcome measures including hospitalization, intensive care unit (ICU) admission, and 30-day mortality were obtained from electronic health records. Multivariable logistic regression was used.

Results: Of the 150 patients enrolled, 60% were Black, 32% Hispanic/Latinx, 4% Non-Hispanic Whites, and 4% others. The mean age was 59 (+/-14) years. The rate of hospitalization was high (86%) and Hispanic/Latinx had a higher likelihood of ICU admission. Patients harboring the rs2285666 genotype TT, AA, and GC alleles were more likely to be admitted to ICU, and those with TT and AA had higher mortality. The ACE level was a significant predictor of hospitalization with a protective effect in both unadjusted and adjusted results. Hispanics/Latinx had a four times higher likelihood of ICU admission compared to all others, and age was significantly associated with 30-day mortality.

Conclusion: Our results show that even after adjusting for age, race, and sex, ACE levels remained a predictor of hospitalization. ACE/ACE2 phenotypes and genotypes potentially play an important role in disease progression in SARS-CoV-2 patients.

Background: Suppression of the body's immune system can cause high blood pressure. Also, many people with COVID-19 have underlying diseases, including high blood pressure.

Aim: This study was conducted to investigate the effect of COVID-19 infection on blood pressure caused by pregnancy in women referred to Kashani Hospital in Jiroft City.

Methods: This study was a case-control study with a census sampling method on 266 pregnant women referring to Kashani Hospital in Jiroft City in 2021-2022. Pregnant women were divided into two control groups (pregnant women without COVID-19) and intervention (pregnant women with COVID-19). SPSS software version 22 was analyzed.

Results: 266 pregnant women participating in the study were divided into two equal control (133) and intervention (133) groups. The average age of pregnant women was 29 ± 6.8 years. The average systolic and diastolic blood pressure in the intervention group was 112.6 and 70, and in the control group, it was 107.8 and 66.6, which was not statistically significant (P_Value>0.05). Also, the results showed that there was a difference between home blood pressure during pregnancy and there is a statistically significant relationship between the age of pregnant women (P_Value< 0.05).. while there is no significant statistical relationship between gestational age and body mass index (P_Value>0.05).

Conclusion: According to the results of this study, COVID-19 affects blood pressure caused by pregnancy, and gestational age is an important factor in the prevalence of high blood pressure in women with COVID-19.

Hypertension (HTN) is a leading risk factor for cardiovascular diseases (CVDs) and a major contributor to global morbidity and mortality. Conventional pharmacological treatments have been effective but are often accompanied by side effects and do not address all pathological aspects of the disease. Recent advances in molecular biology have identified non-coding RNAs (ncRNAs), including microRNAs (miRNAs) and long non-coding RNAs (lncRNAs), as key regulators in the pathogenesis of hypertension. These ncRNAs influence various cellular processes, such as gene expression, vascular tone, and inflammation, making them promising targets for therapeutic intervention. This review explores the potential of polyphenols, a diverse group of phytochemicals with potent antioxidant and anti-inflammatory properties, in modulating ncRNA expression and function. We discuss how polyphenols, such as epigallocatechin-3-gallate (EGCG), resveratrol, curcumin, and quercetin impact the regulation of ncRNAs, particularly focusing on their roles in reducing oxidative stress, improving endothelial function, and ameliorating vascular remodeling associated with hypertension. The review synthesizes current evidence from both in vitro and in vivo studies, highlighting significant findings and the mechanisms by which polyphenols exert their effects on ncRNA-mediated pathways. Moreover, we address the challenges of translating these findings into clinical applications, including issues related to bioavailability, dosing, and the complex interactions of polyphenols with other cellular components. Future directions for research are suggested, with an emphasis on the need for comprehensive clinical trials to establish the efficacy of polyphenol-based therapies targeting ncRNAs in hypertension management. By targeting ncRNAs, polyphenols offer a novel therapeutic strategy that could enhance the treatment landscape for hypertension and potentially other cardiovascular conditions.

Introduction: There is a recognised association between white coat hypertension (WCH) and adverse cardiovascular outcomes in older adults. However, there is no consensus on the management of WCH in this group. The objective of the Hypertension in the Very Elderly Trial (HYVET-2) study was to assess the feasibility of randomising 100 patients > 75years with WCH from General Practice in the UK to treatment or usual care. The study did not randomise any patients. In this follow-up study, we sought to explore the reasons for not recruiting.

Methods: Furthermore, using a mixed-methods study design, staff from 29 General Practice (GP) sites and the Clinical Research Network (CRN) in Kent, Surrey, and Sussex (KSS), UK, were sent an online questionnaire about local research facilities and infrastructure, and HYVET-2 study methodology and target population demographics.

Results: Nineteen (19) individuals responded to the online questionnaires (15 primary care staff, 4 CRN staff). Moreover, using a framework approach, we identified six themes summarising challenges to HYVET-2 recruitment. These themes are established approaches of primary care towards managing WCH in older people, target patient demographics, study design complexity, patient- facing study documents, limited research resources in primary care, and identification of eligible patients using existing coding.

Conclusion: Our experience showed that recruiting older people from primary care to a WCH study was not feasible. A national scoping survey amongst primary care physicians in the UK, as well as robust patient and public involvement (PPI) targeting older people with WCH, might improve recruitment in future studies addressing the management of WCH in older people.

Background: Declined kidney function associated with hypertension is a danger for cognitive deficits, dementia, and brain injury. Cognitive decline and vascular dementia (VaD) are serious public health concerns, which highlights the urgent need for study on the risk factors for cognitive decline. Cysteinyl leukotriene (CysLT₁) receptors are concerned with regulating cognition, motivation, inflammatory processes, and neurogenesis.

Objective: This research aims to examine the consequence of montelukast (specific CysLT₁ antagonist) in renovascular hypertension 2-kidney-1-clip-2K1C model-triggered VaD in experimental animals.

Methods: 2K1C tactics were made to prompt renovascular hypertension in mature male rats. Morris water maze was employed to measure cognition. Mean arterial pressure (MAP), serum nitrite levels, aortic superoxide content, vascular endothelial activity, brain's oxidative stress (diminished glutathione, raised lipid peroxides), inflammatory markers (IL-10, IL-6, TNF-α), cholinergic activity (raised acetylcholinesterase), and cerebral injury (staining of 2, 3, 5- triphenylterazolium chloride) were also examined.

Results: Montelukast in doses of 5.0 and 10.0 mg kg^-1 was used intraperitoneally as the treatment drug. Along with cognitive deficits, 2K1C-operated rats showed elevated MAP, endothelial dysfunction, brain oxidative stress, inflammation, and cerebral damage with diminished serum nitrite/nitrate. Montelukast therapy significantly and dose-dependently mitigated the 2K1Chypertension- provoked impaired behaviors, biochemistry, endothelial functions, and cerebral infarction.

Conclusion: The 2K1C tactic caused renovascular hypertension and associated VaD, which was mitigated via targeted regulation of CysLT₁ receptors by montelukast administration. Therefore, montelukast may be taken into consideration for the evaluation of its complete potential in renovascular-hypertension-induced VaD.

Background: The representatives of mathematical concepts and indices allied to the Golden Ratio (GR) have been shown in the human body in superimposed human hands, phalangeal lengths of the digits, human ears, and the cardiovascular system. Recently, it has been demonstrated that the systolic blood pressure (SBP) to diastolic blood pressure (DBP) ratio measured by ambulatory blood pressure monitoring (ABPM) is close to GR. Accordingly, we aimed to evaluate the ratios between the SBP, DBP, and PP in normotensive and hypertensive patients who were on medical treatment or not, to assess the existence of golden proportions in 24-hour ambulatory blood pressure monitoring results.

Material and method: Five hundred and twenty-nine patients who underwent ABPM were retrospectively enrolled in the study population. The ABPM was programmed to measure blood pressure every 30 min during the daytime and 60 min night time. Based on the ABPM results, patients were classified as hypertensive (SBP/DBP≥130/80 mmHg) and normotensive (SBP/DBP<130/80 mmHg), depending on ESC/ESH 2018 guidelines. They were also divided into two subgroups: medicated and nonmedicated. Systolic to diastolic blood pressure ratio (SBP/DBP) and diastolic blood pressure to pulse pressure (DBP/PP) were calculated in the usual fashion in all study populations and subgroups.

Results: After the exclusion of 133 patients who did not fulfill the inclusion criteria, 396 patients were included in the statistical analysis. Mean SBP/DBP ratios were 1.66±0.15 in all the study population, 1.63±0.11 in normotensive without medication, 1.66±0.13 in normotensive with medications, 1.62±0.15 in hypertensive without medication, and 1.76±0.20 with medications.

Conclusion: We have documented that SBP to DBP ratios of untreated patients, irrespective of having normal or high blood pressure, run close around the GR. However, SBP to DBP ratios of patients having antihypertensive treatment are far from the GR.

Arterial hypertension is a multifactorial clinical condition characterized by higher blood pressure levels. The main treatment for controlling high blood pressure consists of drug therapy, but the scientific literature has been pointing to the efficiency of aerobic and resistance exercises acting in a therapeutic and/or preventive way to reduce and control the blood pressure levels. Resistance training is characterized by sets and repetitions on a given muscle segment that uses overload, such as machine weights, bars, and dumbbells. As it successfully affects a number of variables associated to practitioners' functional and physiological features as well as emotional and social variables, resistance training has been a crucial part of physical exercise programs. Several reports highlight the various adaptive responses it provides, with a focus on the improvement in strength, balance, and muscular endurance that enables a more active and healthy lifestyle. Resistance training programs that are acute, sub-chronic, or chronic can help people with varying ages, conditions, and pathologies reduce their arterial hypertension. However, molecular mechanisms associated with resistance training to reduce blood pressure still need to be better understood. Thus, we aimed to understand the main effects of resistance training on blood pressure as well as the associated molecular mechanisms.