Current Hypertension Reviews最新文献

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.

Substantial evidence indicates that breastfeeding reduces mortality and morbidity in infants. However, social changes in the 20th century resulted in a considerable decline in breastfeeding rates in many countries. Breast milk is crucial because of its nutritional, immunological, and emotional benefits and economic value. Approximately 10% of pregnancies are complicated by hypertensive syndromes, which are the most commonly diagnosed conditions during pregnancy. This perspective aims to explore how hypertension may interfere with the quality of human breast milk. While numerous studies have investigated the composition of breast milk and its numerous benefits for both infants and mothers, limited research examines the relationship between colostrum, breast milk, and hypertension. Given the diverse nutritional and immunological components of breast milk, many questions remain about this complex interaction.

Introduction: Hypertension, characterized by chronically elevated blood pressure, poses a significant global health burden. Its prevalence, a critical public health concern, necessitates accurate prediction models for timely intervention and management.

Aim: The proposed approach leverages the capability of an artificial neural network to capture complex patterns and non-linear relationships within the time series data, allowing for the development of a robust forecasting model to predict Hypertension. The study population consisted of known hypertensives. In this study, historical time series data related to Hypertension, including patient demographics, lifestyle factors, and medical records, were collected from a Rural primary health center associated with the medical college in coastal Karnataka, India, which is employed to train and validate the model.

Methods: The performance of the Artificial Neural Network (ANN) is evaluated using metrics such as MAE (Mean Absolute Error) and RMSE (Root Mean Squared Error) on a separate test dataset. This research explores the potential of ANN in time series forecasting of Hypertension.

Results: ANN performs well for this data and has been chosen as the best algorithm for this data set, as it has the lowest MAP (0.20) and MAE (0.45) and the highest R-Square (0.89), making it the most accurate and reliable model for the given data. If these algorithms prove beneficial, they can be used in the primary prevention of Hypertension. Individuals, institutions, and even government bodies can use it to save treatment costs and lives.

Conclusion: The ANN model demonstrated reasonably accurate predictions despite the lower overall fit. It has shown the potential to be used as a primary healthcare tool by helping physicians predict and warn about the dangers of elevated blood pressure to patients. These algorithms, deployed using a web application, will enable people to evaluate themselves in the comfort of their homes. This would make us inch closer to the WHO's broader goal of making health a universal right, irrespective of a person's place of residence.

Introduction: Dihydropyridine-calcium channel blockers (DHP-CCBs) are effective first-line blood pressure-lowering agents for primary hypertension. However, data comparing the variations in efficacy and safety between different types of DHP-CCBs are scarce.

Aims and objectives: This study aimed to summarize the latest evidence on the benefits and harms of seven DHP-CCBs (amlodipine, levamlodipine, felodipine, lacidipine, nitrendipine, nifedipine, and benidipine).

Methods: A meta-analysis of DHP-CCBs was carried out to explore differences in efficacy and safety. We searched PubMed, Embase, the Cochrane Library, CNKI, Wanfang Data, and VIP databases from inception to September, 2023, for randomized controlled trials (RCTs) comparing DHP-CCBs. The main outcomes were blood pressure lowering and adverse events (AEs) during treatment.

Results: We included 181 RCTs (21,383 patients) in this analysis. In terms of efficacy, levamlodipine ranked highest in reducing office blood pressure (surface under the cumulative ranking systolic blood pressure = 80.81%, diastolic blood pressure (DBP) = 82.42%) and 24-h ambulatory DBP (98.07%). Felodipine had the highest probability of reducing 24-h ambulatory blood pressure (80.65%). Regarding safety, levamlodipine had the least impact on heart rate (85.71%). In terms of AEs, benidipine had the highest rate for cardiovascular (86.58%) and digestive system (93.57%) AEs. Nifedipine and amlodipine had the highest rates of central (80.65%) and peripheral nervous system (83.28%) AEs, respectively. Levamlodipine exhibited significantly lower rates of total AEs (1.24%), central nervous system AEs (1.28%), and cardiovascular system AEs (3.62%) than the other interventions.

Conclusion: In the office setting, levamlodipine may be the best treatment for primary hypertension, and lacidipine shows good safety.

Background: Chronic Kidney Disease (CKD) is a known risk factor for End-Stage Renal Disease (ESRD) and Cardiovascular Diseases (CVD). Renal Doppler Ultrasound (RDU) can detect early renal involvement in CKD using the Renal Resistive Index (RRI).

Aims: This study aimed to investigate the effects of risk factors and clinical complications associated with CKD on RRI among patients with different stages of CKD.

Methods: In this analytical cross-sectional study, 186 patients referred to Poursina Hospital for RDU were categorized into six groups (normal and five stages of CKD). We analyzed the impact of demographic factors and clinical complications on RRI across all groups.

Results: Our findings indicated that CKD prevalence was particularly high among older patients and those with CVD, type 2 diabetes mellitus (DM), and hypertension (HTN). Elevated RRI in CKD patients was significantly associated with age, CKD stage, CVD, and HTN (p < 0.05). Furthermore, RRI was higher in CKD patients with elevated serum phosphorus (P) levels, higher low-density lipoproteins (LDL), and lower calcium (Ca) and hemoglobin (Hb) levels. Based on a multivariate regression model, CVD, lower Ca, high LDL, and proteinuria were identified as independent predictors of elevated RRI (p < 0.05).

Conclusion: This study concludes that elevated RRI is associated with the severity of CKD and its clinical complications, suggesting that RRI can serve as a reliable indicator for assessing CKD patients, managing treatment, and preventing early death complications.