Current Hypertension Reports最新文献

{"title":"Therapeutics Beyond Delivery: Repurposed Drugs and Biologic Pathways.","authors":"Michael Wilkinson, Jenny Myers","doi":"10.1007/s11906-026-01392-5","DOIUrl":"10.1007/s11906-026-01392-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Pre-eclampsia remains a leading cause of maternal and perinatal morbidity and mortality worldwide, yet no disease-modifying therapy currently exists. This review examines the challenges inherent in developing therapeutics for pre-eclampsia, and evaluates the evidence for repurposing existing drugs and developing novel biologic strategies to treat preterm pre-eclampsia.</p><p><strong>Recent findings: </strong>Metformin has demonstrated a trend towards prolongation of pregnancy in a randomized controlled trial, with larger trials ongoing. Proton pump inhibitors and sulfasalazine show compelling preclinical efficacy, though neither has yet translated to clinical benefit, possibly reflecting inadequate drug exposure in vivo. Novel biologic approaches, including sFlt-1-targeting siRNA, complement inhibition with eculizumab, and placenta-tropic lipid nanoparticle delivery systems, represent promising emerging strategies. Advancing molecular classification of pre-eclampsia is essential to identifying targetable pathways and selecting patients most likely to benefit from specific interventions. Improved pharmacokinetic evaluation in pregnancy, earlier identification of at-risk women using circulating biomarkers, and regulatory frameworks supportive of obstetric research will be critical to translating promising candidates into effective therapies.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":"28 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Blood Pressure Measurement.","authors":"Ayan Ali, Liann Abu Salman, Jordana B Cohen","doi":"10.1007/s11906-026-01391-6","DOIUrl":"10.1007/s11906-026-01391-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>We aimed to examine how inaccuracies and inequities in blood pressure (BP) measurement across office, ambulatory, home, and emerging cuffless modalities contribute to disparities in hypertension diagnosis and control, and to identify strategies to improve measurement equity.</p><p><strong>Recent findings: </strong>Disparities arise from nonstandardized office technique, inappropriate cuff sizing, limited access to validated home and ambulatory devices, reimbursement and implementation barriers, and underrecognition of masked and nocturnal hypertension in populations at higher risk. Cuffless technologies may expand access and reduce cuff-related barriers, but current devices have important limitations in validation, calibration, real-world accuracy, and performance across diverse populations. Improving equity requires standardized measurement, access to appropriately sized validated devices and out-of-office monitoring, inclusive device validation, and reimbursement and implementation strategies that reach underrepresented and under-resourced communities. Future research should test whether these approaches reduce diagnostic misclassification and improve BP control and cardiovascular outcomes across populations.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":"28 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Sleep Duration and Quality: Implications for Hypertension Risk.","authors":"Thainá Matos do Amaral, Josephine Dudzik, Marie-Pierre St-Onge","doi":"10.1007/s11906-026-01385-4","DOIUrl":"10.1007/s11906-026-01385-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review synthesizes evidence on the association between sleep and hypertension from the past five years, with an emphasis on sex differences in blood pressure regulation.</p><p><strong>Recent findings: </strong>Sleep is a modifiable risk factor for hypertension. In addition to overall sleep quality and duration, sleep disorders such as insomnia and obstructive sleep apnea are associated with elevated blood pressure. Emerging evidence suggests that these relations may differ by sex, reflecting variations in sleep characteristics, disorder presentation, and susceptibility to blood pressure dysregulation. Together, these findings support the concept of sleep as a multidimensional determinant of cardiovascular risk with different outcome presentation by sex. Sleep represents a clinically relevant and modifiable target for hypertension prevention and management and should be incorporated into cardiovascular risk assessment and clinical care. Sex-specific hormonal influences and autonomic dysfunction may contribute to the differences in associations between sleep disturbances and hypertension risk between males and females. Recognizing these mechanisms may inform more targeted strategies to reduce hypertension risk.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":"28 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13584816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circadian Systems and Neural Control of Blood Pressure.","authors":"Hiruni M Aponso, Jennifer S Pollock, Bryan K Becker, David M Pollock","doi":"10.1007/s11906-026-01390-7","DOIUrl":"10.1007/s11906-026-01390-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>Blood pressure (BP) follows a robust circadian rhythm and disruption of this rhythm is associated with hypertension and increased cardiovascular disease risk. This review discusses the current understanding of how circadian mechanisms regulate the neural control of BP, with a focus on autonomic brain circuits, local molecular clocks, and emerging neuroimmune mechanisms contributing to the regulation of BP.</p><p><strong>Recent findings: </strong>Numerous studies show that autonomic control areas of the brainstem are important for circadian BP regulation. Regions such as the rostral ventrolateral medulla (RVLM), the nucleus tractus solitarius (NTS), and paraventricular nucleus of the hypothalamus (PVN) all contain intrinsic molecular clocks that play a role in sympathetic activity and baroreflex function. Emerging evidence also indicates that disruption of clock function in microglia within the RVLM acts as a potential mechanism that contributes to neuroinflammation, sympathetic overactivity, and non-dipping hypertension. The growing interest in chronotherapy, renal denervation, and ambulatory BP monitoring emphasizes the clinical importance of circadian BP regulation. Circadian regulation of BP is comprised of coordinated interactions between the SCN, autonomic neural circuits, and local molecular clocks. Disruptions in any of these mechanisms lead to abnormalities in BP rhythms increasing the risk of hypertension. Despite recent advances, many questions remain regarding the relative contributions of central and peripheral clocks, the causal role of circadian disruption in hypertension, and the mechanisms underlying sex differences. Addressing these gaps may identify new approaches for preventing and treating hypertension by targeting circadian regulation of cardiovascular function.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":"28 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthostatic Hypertension: Clinical Spectrum and Gaps in Knowledge.","authors":"David Moloney, Jens Jordan, Italo Biaggioni","doi":"10.1007/s11906-026-01386-3","DOIUrl":"10.1007/s11906-026-01386-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>Orthostatic hypertension (oHT) is increasingly recognized as a clinically relevant but poorly understood disorder of autonomic blood pressure control. This review aims to summarize the current understanding of the clinical spectrum and pathophysiology of oHT, evaluate its prognostic significance, and identify key gaps in knowledge to guide future mechanistic and clinical studies.</p><p><strong>Recent findings: </strong>Recent evidence has shifted the perception of oHT from a physiological variant to a condition associated with adverse outcomes. In younger adults, oHT has been linked to incident hypertension, while in older populations it is associated with cardiovascular, cerebrovascular, renal, and cognitive complications. Excessive sympathetically mediated vasoconstriction appears to be the predominant mechanism, although arterial stiffness, impaired baroreflex buffering, and abnormal vascular responsiveness may also contribute depending on the population. Consensus definitions have recently standardized diagnostic criteria, but uncertainties remain regarding optimal thresholds, measurement reproducibility, and the mechanisms underlying its heterogeneous presentation. Despite growing recognition, important questions remain regarding whether oHT represents an independent cardiovascular risk factor or primarily a marker of vascular aging and hypertension. Evidence supporting oHT-specific therapeutic strategies is currently lacking. Further research is needed to clarify its pathophysiology, refine diagnostic approaches, and determine its clinical and prognostic significance.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":"28 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum Hypertension: An Important Window of Opportunity to Optimize Maternal Health.","authors":"Allison Payne, Alisse Hauspurg","doi":"10.1007/s11906-026-01389-0","DOIUrl":"10.1007/s11906-026-01389-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Hypertensive disorders of pregnancy, including gestational hypertension and preeclampsia are a leading cause of maternal morbidity and mortality and confer substantial short- and long-term cardiovascular risk. This review summarizes current evidence regarding the classification, pathophysiology, acute and longitudinal management, and cardiovascular implications of postpartum hypertension, while highlighting emerging strategies to improve outcomes.</p><p><strong>Recent findings: </strong>Recent studies support tighter postpartum blood pressure control, expanded use of remote blood pressure monitoring, and multidisciplinary care models to improve hypertension detection, reduce readmissions, and facilitate cardiovascular risk reduction. Contemporary cardiovascular guidelines increasingly recognize hypertensive disorders of pregnancy as sex-specific risk enhancers that warrant earlier preventive interventions. The postpartum period represents a critical window to long-term maternal health. Future research should define optimal postpartum blood pressure targets, explore underlying mechanisms contributing to persistent postpartum hypertension, refine risk prediction, and evaluate interventions that reduce long-term cardiovascular morbidity and mortality.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":"28 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148954796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indigenous Health Disparities in Hypertensive Disorders of Pregnancy Within the United States.","authors":"Thoai T Vu, Haley E Watts, Claudia Meyer, Irena Kuzma, Katelyn Baggett, Biak L Tial, Theresa Boyer, Phebe Ismail, Erin D Michos, Allison G Hays, Anum S Minhas","doi":"10.1007/s11906-026-01383-6","DOIUrl":"10.1007/s11906-026-01383-6","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review examines determinants across structural, institutional, interpersonal, and individual domains that contribute to hypertensive disorders of pregnancy (HDPs) in American Indian and Alaska Native (AI/AN) populations and their long-term cardiovascular consequences. It suggests paths forward for equitable research and clinical practice.</p><p><strong>Recent findings: </strong>AI/AN women have the highest HDP prevalence among all racial and ethnic groups at 9.1% and experience severe maternal morbidity at 1.6 times the rate of non-Hispanic white women. Pre-existing cardiometabolic disease, including obesity affecting 40% and metabolic syndrome affecting up to 55% of AI/AN adults, compounds pregnancy risk. Beyond individual factors, structural determinants, such as the legacy of colonization, racial misclassification, violations of tribal data sovereignty, and disrupted traditional birthing practices, have perpetuated systemic barriers and health inequities. Qualitative evidence documents pervasive discrimination, cultural dismissiveness, and provider bias during perinatal care. Despite the 2-fold increased long-term cardiovascular disease risk from HDPs, AI/AN women face persistent barriers to postpartum follow-up and cardiovascular screening. Effective evidence-based preventive strategies, including low-dose aspirin prophylaxis, blood pressure management, and telehealth-based postpartum monitoring, remain understudied in AI/AN populations. Addressing HDP disparities in AI/AN populations requires moving beyond individual risk factors to confront structural determinants. Meaningful progress requires community-based participatory research that centers tribal data sovereignty, incorporation of Indigenous scholars into research leadership, and policy-level changes. Ultimately, these efforts may expand culturally concordant perinatal care, reduce acute maternal morbidity, and reduce long-term HDP-related cardiovascular risk.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":"28 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cardio-Renal-Hepatic Axis in MASLD. Role of BDNF, NGF, and Metabolic Cross-Talk.","authors":"Lucy C Taylor, Michael I Adenawoola, Claire B Wingfield, Maren K Nadolski, David E Stec","doi":"10.1007/s11906-026-01388-1","DOIUrl":"10.1007/s11906-026-01388-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>To evaluate the crosstalk between the liver, heart, and kidneys in metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH), highlighting the distinct regulatory roles of non-traditional hepatokines, and to assess shared therapeutic targets and molecular mechanisms driving cardiorenal complications in MASLD patients.</p><p><strong>Recent findings: </strong>Emerging evidence highlights that hepatic lipid accumulation drives cardiac damage, which manifests as adverse remodeling, diastolic dysfunction, and coronary microvascular dysfunction. These abnormalities are mediated primarily by systemic lipotoxicity, inflammation of epicardial adipose tissue, and a pro-thrombotic environment. Mechanistically, altered hepatokine signaling mediates systemic cross-talk. Specifically, the downregulation of cardioprotective and renoprotective brain-derived neurotrophic factor (BDNF) and the dual metabolic roles of nerve growth factor (NGF), fibroblast growth factor (FGF) 19, and FGF21 accelerate the progression of both heart failure and chronic kidney disease (CKD). Concurrently, metabolic therapies such as glucagon-like peptide-1 (GLP-1) receptor agonists, sodium-glucose cotransporter-2 (SGLT2) inhibitors, and peroxisome proliferator-activated receptor (PPAR) agonists demonstrate significant efficacy in ameliorating steatosis, inflammation, and overall metabolic outcomes. MASLD acts as a systemic driver of multi-organ dysfunction within the cardio-renal-hepatic axis. Profiling specific hepatokine signatures offers a promising frontier for identifying novel therapeutic targets and biomarkers of disease acceleration. Furthermore, while current metabolic therapies show remarkable potential, rigorous clinical testing remains critical to definitively determine whether their cardiovascular and renal benefits stem from direct tissue-specific protective mechanisms or secondary metabolic improvements.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":"28 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13541824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational Physical Activity and Hypertension: A Narrative Review.","authors":"Tyler D Quinn, Mikenna Love, Vikrant Jagadeesan, William R Boyer","doi":"10.1007/s11906-026-01384-5","DOIUrl":"10.1007/s11906-026-01384-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>To summarize the prospective and experimental evidence examining occupational physical activity (OPA) and hypertension-related outcomes, discuss potential physiological mechanisms, and identify methodological challenges contributing to heterogeneity across studies.</p><p><strong>Recent findings: </strong>Prospective evidence linking OPA with hypertension and resting blood pressure remains limited and inconsistent, with studies reporting predominantly null or modestly inverse associations. Some evidence suggests very high OPA may be unfavorable in specific subgroups, particularly when combined with low recovery or high cardiovascular strain. Experimental and ambulatory monitoring studies indicate that some forms of OPA may produce higher ambulatory cardiovascular load, and impaired autonomic recovery despite limited impacts on resting clinic blood pressure. In contrast, leisure-time physical activity consistently demonstrates antihypertensive benefits. OPA and leisure-time physical activity may not have equivalent cardiovascular impacts. Future research should prioritize improved exposure assessment, ambulatory cardiovascular monitoring, and mechanistic study designs.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":"28 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental Obesity and Offspring Risk for Cardiorenal Diseases.","authors":"Jussara M do Carmo, John E Hall, Zhen Wang, Alan J Mouton, Ana C M Omoto, Luciana Jorge, Alexandre A da Silva","doi":"10.1007/s11906-026-01379-2","DOIUrl":"https://doi.org/10.1007/s11906-026-01379-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Obesity rates have increased dramatically during the past four decades, and these increases have occurred in children and adolescents, as well as in adults at reproductive age. Currently, 40.3% of men and 39.7% of women 20-39 years of age in the United States are classified as obese, leading to a substantial rise in parental obesity. Obesity is a major risk factor for cardiovascular, metabolic and renal diseases, including hypertension, type 2 diabetes, and chronic kidney diseases. This review examines current evidence of how parental obesity programs offspring susceptibility to cardiorenal and metabolic dysfunction and discusses the potential underlying mechanisms that contribute to the long-term health consequences in the offspring.</p><p><strong>Recent findings: </strong>Increasing evidence indicates that parental obesity, particularly maternal obesity, predisposes offspring to cardiovascular, metabolic, and renal dysfunction that can emerge early in life and persist into adulthood, even when controlled for lifestyle factors. Although alterations in the intrauterine and early postnatal environments are believed to underlie developmental programming, the mechanisms by which parental obesity influences long-term offspring health remain poorly understood. Emerging evidence suggests that dysregulation of neurohumoral pathways, chronic inflammation, mitochondrial dysfunction, and intercellular signaling may be transmitted across generations and contribute to increased risk of cardiorenal and metabolic diseases. Elucidating these mechanisms is essential for identifying novel therapeutic targets and determining whether interventions implemented before conception, during pregnancy, or during early life can mitigate adverse health outcomes and improve long-term offspring health.</p>","PeriodicalId":10963,"journal":{"name":"Current Hypertension Reports","volume":"28 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}