Current Hypertension Reviews最新文献

Introduction: Hypertension is a worldwide problem that affects people of all ethnicities and social groups. Its mortality rate has been steadily increasing. However, several pharmacological compounds have been used to manage hypertension and related issues. Calcium Channel Blockers (CCBs) based on Dihydropyridine (DHP) are used as first-line therapy. It is well established that simple adjustments to an existing medicine's fundamental structure can considerably improve its efficacy.

Materials and methods: The purpose of this research study was to create potential antihypertensive drugs utilizing a 1,4-DHP scaffold and analyze their binding processes with different calcium channel proteins for comparative analysis, with PDB IDs 3LV3, 1T0J, and 6DAF. This study used molecular docking and ADMET (Absorption, Distribution, Metabolism, Excretion, Toxicity) profiling to predict the binding efficacy of newly produced potential drugs, such as CCBs.

Results: The binding energy of the protein with the newly created compounds ranged between -2.6 and -7.26 kcal/mol (3LV3), -7.42 to -10.36 kcal/mol (1T0J), and -6.63 to -11.98 kcal/mol (6DAF).

Discussion: The predicted ADMET profiling yielded significant results, indicating that among the virtually prepared ligands, apart from the standard drugs amlodipine and nifedipine, ligand numbers 60 and 13 showed a favorable ADMET profile.

Conclusion: In this study, drug development efforts focused on modifying existing hypertension medications through in silico analysis. From hundreds of synthesized ligands, 19 showed optimal docking scores. ADMET profiling of these 19 ligands revealed ligands 60 and 13 to have favorable profiles. The Swiss ADME and ADMET lab 2.0 tools confirmed these findings, highlighting their potential for further development.

Introduction/ Objective: Blood pressure variability (BPV) is a potential predictor of vascular events and triggers target organ damage. This study aimed to determine the BPV in stroke and coronary heart disease (CHD) in the Bogor Cohort Study in Indonesia.

Methods: Over six years of monitoring, a prospective cohort study was conducted on 1649 respondents aged ≥ 31 years from the Bogor Non-communicable Diseases Risk Factors Cohort Study. The dependent variable was vascular events (stroke or CHD), which were new cases (incidents) that appeared during the 6-year monitoring period (2011 - 2017 and 2012-2018).

Result: During the six years of monitoring, the incidence of vascular events was 12.4 percent. The dose-response of systolic and diastolic BPV in vascular events, stroke, and coronary heart disease showed an increased risk (quintiles Q2, Q3, and Q4) compared to quintile 1 (Q1). Systolic BPV of ≥12,10 mmHg and diastolic BPV of ≥ 7,31 mmHg had a risk of 2.3 and 1.7 (95% Confidence Intervals (CI)), respectively, for vascular events during the period of 6-year observation, after controlling for age, hypertension status, and lipid profile.

Conclusion: BPV is an independent predictor of vascular events, stroke, and coronary heart disease. The public and clinicians must pay attention to controlling BPV as a risk factor for vascular events, stroke, and CHD.

Introduction: According to current clinical practice guidelines, Ambulatory Blood Pressure Measurement (ABPM) is recommended to confirm diagnoses of hypertension. It remains unclear as to which method is superior in predicting mortality outcomes.

Methods: Prospective observational studies, comparing ABPM with Clinical Blood Pressure Measurements (CBPM), were included with outcomes of the study being all-cause and cardiovascular mortality.

Results: Nine studies with a total of 23,140 participants were included. Each 10-mmHg increase in 24-hour mean systolic blood pressure (SBP) was linked to a higher risk of all-cause mortality (HR: 1.13, 95% CI: 1.09-1.18), while Clinic Blood Pressure Measurement (CBPM) was not a significant predictor (HR: 1.02, 95% CI: 0.90-1.13). Nighttime SBP increases of 10 mmHg were associated with a higher all-cause mortality risk than daytime SBP (HR: 1.16, 95% CI: 1.11-1.21 versus HR: 1.08, 95% CI: 1.05-1.12). For cardiovascular mortality, a 10 mmHg increase in SBP yielded an HR of 1.21 (95% CI: 1.16-1.27) for 24-hour ABPM compared to 1.08 (95% CI: 1.04- 1.11) for CBPM. Similarly, for a 5 mmHg increase in Diastolic Blood Pressure (DBP), the HR was 1.14 (95% CI: 1.07-1.20) for 24 hour ABPM versus 1.04 (95% CI: 1.01-1.07) for clinical DBP, highlighting 24-hour monitoring as a stronger predictor for cardiovascular mortality.

Conclusion: The findings of this study support the superiority of ABPM measurements in predicting both all-cause and cardiovascular mortality.

A significant proportion of hypertensive patients are both smokers and obese. Several pathophysiological mechanisms are involved in the combined effect of smoking and obesity on hypertension onset and maintenance. These include increased sympathetic nervous system activity, endothelial dysfunction, inflammation, oxidative stress, and insulin resistance. The presence of these major cardiovascular risk factors may lead to difficult-to-control hypertension as well as substantially increase the risk for an adverse cardiovascular outcome. It is, therefore, imperative that healthcare providers embrace a comprehensive, multifaceted approach in the management of obese hypertensive patients with smoking habits. This review delves into the complex interplay of these risk factors, providing a comprehensive overview of the current literature to aid the deployment of effective clinical management strategies toward reducing the risk profile of affected individuals.

Hypertension, a condition affecting 1.28 billion adults globally, poses significant health risks, including damage to the heart, kidneys, and brain. Factors such as unhealthy lifestyles, poor dietary habits, obesity, and diabetes contribute to its prevalence. While pharmaceutical interventions are effective in controlling blood pressure, their adverse effects have led to growing interest in alternative therapies such as Ayurveda and Yoga. This review explores the potential of these traditional practices, individually and in combination, for managing hypertension. A thorough literature review was conducted using databases like PubMed and Google Scholar to analyze peerreviewed studies up to 2024. Ayurvedic treatments, including therapies like Basti and Shirodhara and herbal formulations such as Raktadabashamak Ghana Vati and Sarpagandha Vati, have shown promise in reducing blood pressure. Similarly, Yoga practices, including OM chanting and Yoga Nidra, have demonstrated stress-reducing and blood pressure-lowering effects. Despite evidence supporting their efficacy, research on their integrated use remains limited. This review underscores the importance of combining Ayurveda and Yoga for holistic hypertension management. Further scientific studies are necessary to validate this integrative approach, which has the potential to offer a safer, non-pharmacological alternative for managing hypertension and improving overall wellbeing.

Introduction: Type 2 diabetes is a metabolic disorder that is becoming more prevalent over time. Research has shown that the Mediterranean diet (MD) and intermittent fasting (IF) can improve the metabolic parameters of patients with type 2 diabetes. However, there has yet to be a study comparing the effectiveness of these two diets in diabetic patients. This review aims to compare the impact of the Mediterranean diet and intermittent fasting on glycemic, lipid, and anthropometric indices in patients with type 2 diabetes.

Methods: We selected clinical trial studies published between 2013 and 2023 that examined the impact of the MD and the IF diet on glycemic, lipid, and anthropometric indices in patients with type 2 diabetes, in the PubMed and Scopus databases on November 23, 2023, and were included in our study following the PRISMA guidelines.

Results: A total of 22 clinical trials meeting the inclusion criteria were chosen. Out of these, 13 clinical trials focused on the impact of the Mediterranean diet, while the remaining trials examined the effects of the IF diet on type 2 diabetes. The age range of participants in all studies was above 18 years, with the number of individuals investigated ranging from 9 to 557. The duration of the interventions varied from 1 week to 8 years. The MD and IF have both have been shown to effectively improve glycemic control, lipid profiles, and anthropometric measurements in patients with type 2 diabetes. However, the MD tends to offer more consistent and sustainable long-term benefits. This can be attributed to its rich composition of antioxidants, healthy fats, and dietary fiber. IF has demonstrated potential benefits for improving blood sugar levels and lipid profiles over short periods. However, its effectiveness may be compromised by the risk of hypoglycemia and the inconsistent commitment of patients.

Conclusion: These findings suggest that the MD is preferable for long-term, while IF may serve as a complementary short-term strategy. Further research in this area is necessary to provide a definitive opinion.

Hypertension is a chronic medical state and a major determining factor for cardiovascular and renal diseases. Both genetic and non-genetic factors contribute to hypertensive conditions among individuals. The Renin-Angiotensin-Aldosterone System (RAAS) is a major genetic target for the anti-hypertension approach. The majority of classical antihypertensive drugs were mainly focused on the RAAS signaling pathways. Though these antihypertensive drugs control Blood Pressure (BP), they have mild to severe life-threatening effects. Unrevealing effective hypertensive targets for BP management is essential. The effective targets could emerge either from RAAS-dependent or RAAS-independent pathways and/or through the cross-talks among them. Analyzing the physiopathological mechanisms of hypertension has the benefit of understanding the interactions between these systems which helps in better understanding of drug targets and the importance of emergence of novel therapeutics. This review is about the signaling pathways involved in hypertension pathogenesis and their cross-talks and it contributes to a better understanding of the etiology of hypertension.

Hypertension, commonly known as high blood pressure, is a chronic condition characterized by elevated arterial pressure. It occupies a unique position in population health. It is the leading cause of cardiovascular disease and the most common non-communicable condition affecting millions worldwide and is a major public health challenge. The etiology of hypertension involves a complex interplay of environmental and pathophysiological factors alongside genetics, diet, lifestyle, and other coexisting medical conditions. Treatment typically involves medication and lifestyle adjustments such as dietary changes, regular exercise, weight management, and stress reduction to pharmacological interventions involving drugs like diuretics, beta-blockers & ACE inhibitors to lower blood pressure. The pathogenesis of hypertension is linked to endothelial dysfunction, vascular remodelling, sympathetic nervous system activation, and the renin-angiotensin-aldosterone system. Diagnosis is made by measuring blood pressure using a sphygmomanometer, with stages including prehypertension, stage 1 hypertension, and stage 2 hypertension. Effective management of hypertension requires lifestyle modifications such as dietary changes, regular exercise, weight control, and reduced alcohol consumption, alongside pharmacological interventions. As hypertension continues to be a leading cause of death and disability globally, understanding and addressing these factors are crucial for mitigating the widespread impact of hypertension on public health.