International Journal of Hypertension

Association of Antihypertensive Drug-Related Gene Polymorphisms with Stroke in the Chinese Hypertensive Population
Liu H, Zhong H, Lin Y, Han L, Chen M, Tang T and Deng J
Antihypertensive therapy is crucial for preventing stroke in hypertensive patients. However, the efficacy of antihypertensive therapy varies across individuals, partially due to therapy-related genetic variations among individuals. We investigated the association of antihypertensive drug-related gene polymorphism with stroke in patients with hypertension.
The Link between Overweight/Obesity and Noncommunicable Diseases in Ethiopia: Evidences from Nationwide WHO STEPS Survey 2015
Ejigu BA and Tiruneh FN
Noncommunicable diseases (NCDs) are the leading cause of death worldwide. Each year, 15 million adults die from NCDs; more than 85% of these premature deaths occur in low- and middle-income nations. Evidence indicates that overweight and obesity are the main risk factors for NCDs. Although the literature indicates that the burden of NCDs is increasing in Ethiopia, no research has been conducted to demonstrate a link between overweight/obesity and NCDs. Therefore, the aim of this study is to examine the association between overweight/obesity and the common NCDs while adjusting for other important factors.
Lipid Horizons: Recent Advances and Future Prospects in LBDDS for Oral Administration of Antihypertensive Agents
Preeti , Sambhakar S, Malik R, Bhatia S, Harrasi AA, Saharan R, Aggarwal G, Kumar S, Sehrawat R and Rani C
The lipid-based drug delivery system (LBDDS) is a well-established technique that is anticipated to bring about comprehensive transformations in the pharmaceutical field, impacting the management and administration of drugs, as well as treatment and diagnosis. Various LBDDSs verified to be an efficacious mechanism for monitoring hypertension systems are SEDDS (self-nano emulsifying drug delivery), nanoemulsion, microemulsions, vesicular systems (transferosomes and liposomes), and solid lipid nanoparticles. LBDDSs overcome the shortcomings that are associated with antihypertensive agents because around fifty percent of the antihypertensive agents experience a few drawbacks including short half-life because of hepatic first-pass metabolism, poor aqueous solubility, low permeation rate, and undesirable side effects. This review emphasizes antihypertensive agents that were encapsulated into the lipid carrier to improve their poor oral bioavailability. Incorporating cutting-edge technologies such as nanotechnology and targeted drug delivery, LBDDS holds promise in addressing the multifactorial nature of hypertension. By fine-tuning drug release profiles and enhancing drug uptake at specific sites, LBDDS can potentially target renin-angiotensin-aldosterone system components, sympathetic nervous system pathways, and endothelial dysfunction, all of which play crucial roles in hypertension pathophysiology. The future of hypertension management using LBDDS is promising, with ongoing reviews focusing on precision medicine approaches, improved biocompatibility, and reduced toxicity. As we delve deeper into understanding the intricate mechanisms underlying hypertension, LBDDS offers a pathway to develop next-generation antihypertensive therapies that are safer, more effective, and tailored to individual patient needs.
Da-Chuan-Xiong Decoction Ameliorates Sodium Sensitivity and Plasma Norepinephrine via Attenuation of Brain Oxidative Stress in the DOCA-Salt Hypertensive Rats
Zhang Q, Li H, Zhao S, Li F and Tan Y
Da-Chuan-Xiong Decoction (DCXD) is an aqueous extract from a classic Chinese herbal formula composed of dried rhizomes of Ligusticum chuanxiong Hort and Bl. in the mass ratio of 4 : 1. It has been long used to treat chronic cardiovascular disease caused by blood stasis and wind pathogen in the clinic. This experimental study aimed to investigate the blood pressure (BP)-lowering effect of DCXD treatment on hypertension and underlying mechanisms.
miR-145 Alleviates Smooth Muscle Cell Phenotype Transition via ADAM17-Mediated ACE2 Shedding
Wen J, Tang B, Guo L, Chen W and Tang X
It has been shown that miR-145 is involved in the differentiation of vascular smooth muscle cells (VSMCs) and may regulate vascular remodeling. However, the molecular mechanisms behind these pathological processes in hypertension are not fully elucidated. The present study was to examine whether miR-145 modulates phenotypic transformation of VSMCs under normal state and synthetic state and to explore the possible role of ADAM17-mediated ACE2 shedding and ACE2-Ang-(1-7)-Mas receptor axis. Wistar rats were fed with high-sucrose/high-fat diet for 30 weeks to establish a metabolic hypertension animal model. VSMCs were cultured and treated with Ang II with or without miR-145 mimics or miR-145 inhibitor. Results showed the expression of contractile markers -SMA and SM22, miR-145, ACE2, and Mas receptor reduced in the thoracic aorta of metabolic hypertensive rats (MHRs), while that of synthetic marker OPN increased as compared to the control group. In in vitro study, miR-145 inhibitor inhibited the expression of -SMA, SM22, ACE2, Mas receptor, and the Ang-(1-7) excretion and induced the expression of synthetic markers OPN, EREG, and MMP2. However, miR-145 mimic produced opposite effects on the VSMCs. In addition, in the synthetic VSMC induced by Ang II, miR-145 inhibitor partially reversed the induced expression of OPN, EREG, and MMP2 by Ang II, while further decreasing the expression of -SMA and SM22 and ACE2-Ang-(1-7)-Mas receptor. Cotreatment with ADAM17 siRNA partially reversed the inducible effect of miR-145 inhibitor on the EREG and MMP2, induced Ang-(1-7) excretion, and upregulated ACE2 and Mas receptor expression. In conclusion, miR-145 alleviates phenotype transition from contractile to synthetic type via ADAM17-mediated ACE2 shedding in VSMCs and retains the activation of ACE2-Ang-(1-7)-Mas axis, which may benefit the vascular structural remodeling in the metabolic hypertension.
Identifying Who Benefits the Most from a Community Health Worker-Led Multicomponent Intervention for Hypertension
Pan M, Beratarrechea A, Poggio R, He H, Chen CS, Chen J, Irazola V, Rubinstein A, He J and Mills KT
Uncontrolled hypertension is a major public health challenge in low- and middle-income countries. The Hypertension Control Program in Argentina (HCPIA) showed that a community health worker-led multicomponent intervention was effective for blood pressure (BP) reduction in resource-limited settings, but whether the intervention was equally effective across participant subgroups is unknown.
Blood Pressure Control and Associated Factors among Hypertension Comorbid Type 2 Diabetic Patients in Southeast Ethiopia
Desta F, Mengesha S, Belayneh F, Woldeyohannes D, Tekalegn Y, Zenbaba D, Sahiledengle B and Hailu D
Hypertension is the main contributor to the morbidity and mortality of patients with cardiovascular disease. Even though hypertension is very common in comorbid type 2 diabetic patients, it is frequently overlooked. This study aimed to assess blood pressure control and its associated factors among hypertension comorbid type 2 diabetic patients in Bale Zone public hospitals in Southeast Ethiopia.
Evaluation of Mean Platelet Volume in Children with Hypertension
Yildiz I and Kizilca O
Childhood hypertension, a disease with increasing prevalence, can lead to severe health problems. With the increased pressure on the vascular endothelium in hypertension, lesions in the endothelium result in endothelial activation and a process of inflammation, which causes platelet activation and in the bone marrow the release of platelet precursor cells into the peripheral blood stream. During inflammation, changes in the number and size of platelets are observed. With the release of platelet precursors into the peripheral blood stream due to platelet activation, an increase in mean platelet volume (MPV) is also seen.
Effect of Yogurt Intake Frequency on Blood Pressure: A Cross-Sectional Study
Li X, Zhao Z, Na L, Cui W, Che X, Chang J and Xue X
Yogurt consumption is a significant factor in reducing the risk of hypertension and preventing cardiovascular diseases. Although increasing evidence has emerged regarding the potential benefits of probiotics in hypertension, there is a lack of large, cross-sectional studies assessing the association between yogurt intake and blood pressure parameters. We aimed to evaluate the association between yogurt intake frequency and blood pressure. A cross-sectional study was designed using data from the National Health and Nutrition Examination Survey from 2003 to 2004 and 2005 to 2006. We included 3, 068 adults with blood pressure data and yogurt intake data. Multivariate regression analyses revealed significant inverse associations between yogurt and systolic blood pressure ( < 0.05), diastolic blood pressure ( < 0.05), and mean arterial pressure ( < 0.05) in nonhypertensive participants ( = 1 822) but not in hypertensive participants ( = 1 246). Furthermore, a high frequency of yogurt intake prevented hypertension; however, no additional antihypertensive effects were observed in patients already diagnosed with hypertension.
An Assessment of the Prevalence and Risk Factors of Hypertensive Crisis in Patients Who Visited the Emergency Outpatient Department (EOPD) at Adama Hospital Medical College, Adama, Oromia, Ethiopia: A 6-Month Prospective Study
Abebe AT, Kebede YT and Mohammed BD
Over 1 billion people worldwide suffer from the common chronic medical condition of hypertension. A hypertensive crisis occurs when blood pressure exceeds 180/110 mmHg. Depending on whether the target organ is harmed, the situation may be presented as a hypertensive emergency or urgency.
Traditional Cardiovascular Risk Factors Associated with Diagonal Earlobe Crease (Frank Sign) in Mexican Adults: Aging, Obesity, Arterial Hypertension, and Being Male Are the Most Important
Molina-Gallardo R, Aurelien-Cabezas NS, Tiburcio-Jimenez D, Plata-Florenzano JE, Guzman-Esquivel J, Rodriguez-Sanchez IP, Martinez-Fierro ML, Molina-Osorio R, De-la-Madrid-Cernas AA, Barriguete-Melendez JA and Delgado-Enciso I
Cardiovascular risk factors such as obesity, type 2 diabetes, hypertension, smoking, and dyslipidemia enfold heart disease morbimortality. Diagonal earlobe crease has been proposed as a prognostic marker of extension and severity of illness in patients with acute coronary syndrome. But its usefulness remains unclear in patients with or without coronary disease.
Effects of Renal Denervation on Ouabain-Induced Hypertension in Rats
Tang M, Hu J, Li W, Zhang N, Ning S, Yan Y and Cui Z
Ouabain, a Na, K-ATPase inhibitor, is elevated in hypertensive patients. Evidence suggests ouabain contributes to hypertension mainly through activation of the sympathetic nervous system (SNS). Renal nerves play a vital role in the regulation of SNS activity, so we hypothesize that renal denervation may attenuate the development of ouabain-induced hypertension.
Platelet Indices and Hypertension: Results from Shahedieh Cohort Study, Yazd, Iran
Shakeri Shamsi F and Taheri Soodejani M
Hypertension is one of the most important diseases worldwide. In this study, we aim to demonstrate the relationship between platelet indices and hypertension.
Preliminary Consequences of Blood Pressure Management and Blood Homocysteine Levels with Perindopril in Newly Diagnosed Hypertensive Patients in the Vietnamese Population
Kim Tran S, Truong AB, Nguyen PH, Ngo TH, Vu TL, Dang Tran KD, Vo PM, Nguyen BT, Le Trong Huynh T, Nguyen KT and Tran HD
Perindopril is an ACE inhibitor that aids in both blood pressure regulation and homocysteine reduction.
Pharmacogenomics of Hypertension in Africa: Paving the Way for a Pharmacogenetic-Based Approach for the Treatment of Hypertension in Africans
Katsukunya JN, Soko ND, Naidoo J, Rayner B, Blom D, Sinxadi P, Chimusa ER, Dandara M, Dzobo K, Jones E and Dandara C
In Africa, the burden of hypertension has been rising at an alarming rate for the last two decades and is a major cause for cardiovascular disease (CVD) mortality and morbidity. Hypertension is characterised by elevated blood pressure (BP) ≥ 140/90 mmHg. Current hypertension guidelines recommend the use of antihypertensives belonging to the following classes: calcium channel blockers (CCB), angiotensin converting inhibitors (ACEI), angiotensin receptor blockers (ARB), diuretics, -blockers, and mineralocorticoid receptor antagonists (MRAs), to manage hypertension. Still, a considerable number of hypertensives in Africa have their BP uncontrolled due to poor drug response and remain at the risk of CVD events. Genetic factors are a major contributing factor, accounting for 20% to 80% of individual variability in therapy and poor response. Poor response to antihypertensive drug therapy is characterised by elevated BPs and occurrence of adverse drug reactions (ADRs). As a result, there have been numerous studies which have examined the role of genetic variation and its influence on antihypertensive drug response. These studies are predominantly carried out in non-African populations, including Europeans and Asians, with few or no Africans participating. It is important to note that the greatest genetic diversity is observed in African populations as well as the highest prevalence of hypertension. As a result, this warrants a need to focus on how genetic variation affects response to therapeutic interventions used to manage hypertension in African populations. In this paper, we discuss the implications of genetic diversity in genes, and chromosome 12q loci on hypertension susceptibility and response to antihypertensive therapy. We show that African populations are poorly explored genetically, and for the few characterised genes, they exhibit qualitative and quantitative differences in the profile of pharmacogene variants when compared to other ethnic groups. We conclude by proposing prioritization of pharmacogenetics research in Africa and possible adoption of pharmacogenetic-guided therapies for hypertension in African patients. Finally, we outline the implications, challenges, and opportunities these studies present for populations of non-European descent.
Prevalence of Hypertension and Associated Factors among Residents Aged ≥18 Years in Ganzhou, China: A Cross-Sectional Study
Gu J, Wang Q, Qiu W, Lin F, Wu C, Hao M and Wu P
Reliable epidemiologic data on the present burden of hypertension are needed in developing region-specific strategies since previous studies have suggested that China is lagging in risk factor management.
Awareness of Hypertension, Hypercholesterolemia, and Diabetes Mellitus and Associated Characteristics in Russian Adults
Sahatqija F, Hunsberger M, Cook S, Kholmatova K, Shapkina M, Malyutina S and Kudryavtsev AV
Russia has higher cardiovascular disease (CVD) mortality compared to other European countries. The major CVD risk factors are age, male sex, and three conditions, namely hypertension, hypercholesterolemia, and diabetes mellitus (DM). This study aimed to assess awareness of these three conditions among Russian adults ( = 3803) and the associated socio-demographic, lifestyle, and health characteristics. We used cross-sectional data from a randomly drawn population-based sample of Russians aged 35-69 years, who participated in the Know Your Heart (KYH) study conducted in Arkhangelsk and Novosibirsk between 2015-2018. Participants' self-reported awareness of hypertension, hypercholesterolemia, and DM was assessed against the measures at the KYH health check (blood pressure, cholesterol, HbA1c and/or use of medication for each condition). Prevalence estimates for the awareness were age- and sex-standardized to the Standard European Population. Socio-demographic, lifestyle, and health-related correlates of the awareness were investigated using logistic regression modelling. Among participants with hypertension ( = 2206), hypercholesterolemia ( = 3171), and DM ( = 329) recorded at a health check, 79%, 45%, and 61% self-reported these conditions, respectively. Higher awareness of hypercholesterolemia and hypertension was associated with older age, female sex, nonsmoking status, obesity, and history of CVD diagnoses. Low household income and history of CVD diagnoses were associated with being aware of DM. The awareness rates of hypertension were relatively high, whereas awareness rates of hypercholesterolemia and DM were relatively low. CVD prevention and early intervention could be improved in Russia through increasing the awareness of the risk factors.
Covariates of Knowledge, Attitude, Practice, and Burdens among the Caregivers of Hypertensive Patients
Nath SD, Chowdhury AS, Pinky SD, Akter KM, Nourin NA, Chowdhury T, Fahid HA, Sharmin KMS, Rana MM, Alam N, Ahsan MM and Mannan A
Caregivers of hypertensive patients play a significant role in ensuring adequate patient care and lowering the risk of hypertension-relatedcomplications. Caregivers are ideal study subjects for identifying gaps in hypertension management. Our study aimed to assess the knowledge, attitude, and practice (KAP) of hypertensive patients' caregivers, to identify their extent of involvement in patients' care, and to assess their care-related attributes. A descriptive cross-sectional study was conducted from August 2020 to February 2021 in the eight largest tertiary care medical college hospitals and all eight divisions of Bangladesh, with 949 caregivers enrolled. Data were collected using a pretested interviewer-administered questionnaire through snowball sampling and analyzed using a one-way ANOVA, independent-sample -test, and chi-square test. Among the 949 interviewed caregivers, 541 (57.0%) were female, and 479 (50.5%) were aged 18 to 25 years. The percentage scores regarding overall knowledge, attitude, and practice of the caregivers were 54.83 ± 17.95, 47.95 ± 24.05, and 61.26 ± 17.50, respectively. Caregivers' education, history of hypertension, residence, age, relationship with the patient, occupation, and caregiving duration were significantly associated with the KAP scores. In addition, factors such as relationship with the patient, age, educational status, occupation, residence, and caregiving duration/day had significant correlations with all types of burden. Findings of this study suggest the necessity for awareness programs for the caregivers of hypertensive patients to diminish the gap in their KAP and improve their mental and physical health.
Epidemiology and Risk Factors for Orthostatic Hypotension and Its Severity in Residents Aged > 60 years: A Cross-Sectional Study
Yang M, Peng R, Wang Z, Li M, Song Y, Niu J and Ji Y
This cross-sectional study investigated the epidemiology and risk factors associated with orthostatic hypotension (OH) and its severity in older adults residing in the Jizhou community of Tianjin and the Jimei community of Xiamen. The study, conducted from March to September 2019, involved adults aged over 60. A comprehensive questionnaire survey was administered, resulting in the enrolment of 4383 older adults. The overall prevalence of OH was found to be 11.7% (516 out of 4383). Notably, a significant gender difference was observed, with a prevalence of 10% among males (194 out of 1926) and 13.1% among females (322 out of 2457) (=0.002). Among individuals with OH, 332 exhibited mild symptoms, 64 had moderate OH, 58 had severe OH cases, and 50 have very severe OH. Multivariable logistic regression analysis revealed that being female, widowed, engaging in general social activities, and a history of hypertension, migraines, heart disease, cerebrovascular disease, and mental health conditions (anxiety and depression) were independently associated with OH. Ordinal logistic regression analysis further confirmed that hypertension, migraine, and a history of general anesthesia surgery were independently associated with the severity of OH. This study highlights a relatively high prevalence of OH among older adults in the Jizhou community of Tianjin and the Jimei community of Xiamen, China. The identified risk factors, particularly social activities, and hypertension, significantly influence the severity of OH. Further examination is required to corroborate these findings and investigate potential interventions.
Comorbidity of Anxiety and Hypertension: Common Risk Factors and Potential Mechanisms
Qiu T, Jiang Z, Chen X, Dai Y and Zhao H
Anxiety is more common in patients with hypertension, and these two conditions frequently coexist. Recently, more emphasis has been placed on determining etiology in patients with comorbid hypertension and anxiety. This review focuses on the common risk factors and potential mechanisms of comorbid hypertension and anxiety. Firstly, we analyze the common risk factors of comorbid hypertension and anxiety including age, smoking, alcohol abuse, obesity, lead, and traffic noise. The specific mechanisms underlying hypertension and anxiety were subsequently discussed, including interleukin (IL)-6 (IL-6), IL-17, reactive oxygen species (ROS), and gut dysbiosis. Increased IL-6, IL-17, and ROS accelerate the development of hypertension and anxiety. Gut dysbiosis leads to hypertension and anxiety by reducing short-chain fatty acids, vitamin D, and 5-hydroxytryptamine (5-HT), and increasing trimethylamine N-oxide (TAMO) and MYC. These shared risk factors and potential mechanisms may provide an effective strategy for treating and preventing hypertension and comorbid anxiety.
Effect of Hydrogen Sulfide on Sympathoinhibition in Obese Pithed Rats and Participation of K Channel
Gomez CB, Sánchez-López A, Carvajal K and Centurión D
Elevated blood pressure is the leading metabolic risk factor in attributable deaths, and hydrogen sulfide (HS) regulates vascular tone and blood pressure. Thus, this study aims to evaluate the mechanism by which NaHS (HS donor) produces inhibition of the vasopressor sympathetic outflow in obese rats. For that purpose, animals were fed a high-fat diet (HFD) (60% calories from fat) for 12 weeks. They were anesthetized, pithed, and cannulated to evaluate the role of the potassium channel on NaHS-induced sympathoinhibition. Animals received selective electrical stimulation of the vasopressor sympathetic outflow, an intravenous (i.v.) administration of (1) tetraethylammonium (TEA, non-selective K channel blocker, 16.5 mg/kg), (2) 4-aminopyridine (4-AP, K channel blocker, 5 mg/kg), (3) barium chloride (BaCl, K channel blocker, 65 g/kg), (4) saline solution (vehicle of TEA, 4-AP, and BaCl, 1 mL/kg), (5) glibenclamide (K channel blocker, 10 mg/kg), and (6) glibenclamide vehicle (DMSO + glucose 10% + NaOH, 1 mL/kg), and then a 310 g/kg·min NaHS i.v. continuous infusion. We observed that (1) NaHS produced inhibition of the vasopressor sympathetic outflow and (2) the sympathoinhibitory effect by NaHS was reversed by the K channel blocker, BaCl, in obese rats. The above data suggest that the potassium channel could be involved in the sympathoinhibition induced by NaHS.