High Blood Pressure & Cardiovascular Prevention最新文献

{"title":"Efficacy and Safety of ARB-Based Combination Therapies for Treatment of Hypertension: A Systematic Review and Meta-analyses.","authors":"Ranu Oza, Pravesh Aggarwal, Pankaj Bhardwaj, Rimple Jeet Kaur, Deepak Kumar, Akhil Dhanesh Goel, Dharamveer Yadav, Manoj Gupta, Nitin Joshi, Chandra Prabha, Jaykaran Charan","doi":"10.1007/s40292-025-00769-y","DOIUrl":"10.1007/s40292-025-00769-y","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension is leading non communicable disease associated with high morbidity and mortality. There is uncertainty about the superiority of angiotensin receptor blocker (ARB)-diuretic versus ARB-calcium channel blocker (CCB) combination for the treatment of hypertension.</p><p><strong>Aim: </strong>This meta-analysis compares the effectiveness of angiotensin receptor blocker (ARB)-diuretic versus ARB-calcium channel blocker (CCB) combination therapies in adults with hypertension.</p><p><strong>Methods: </strong>RCTs were identified through PubMed, Embase, Scopus, and Cochrane Central; data were analyzed using RevMan 5.4.1 with a random-effects model. Primary outcomes were mortality, systolic blood pressure (SBP), and diastolic blood pressure (DBP); secondary outcomes included serum electrolytes and renal function.</p><p><strong>Results: </strong>3549 studies were identified based on database searches. 19 studies were included for analyses. Meta-analysis revealed no significant difference between both the combination therapies for primary outcomes: all-cause mortality [RR: 1.19 (95% CI: 0.85 to 1.65; p = 0.31)], SBP [MD: 1.24 mmHg (95% CI: - 0.48 to 2.96; p = 0.16; I² = 59%)], and DBP [MD: 0.62 mmHg (95% CI: - 0.15 to 1.38; p = 0.11; I² = 0%)]. The diuretic group showed significant changes in serum sodium, chloride, creatinine, e-GFR, and increased uric acid. Risk of bias was mostly low, with moderate to high evidence certainty.</p><p><strong>Conclusion: </strong>Both ARB + CCB and ARB + diuretic combinations showed comparable effectiveness in lowering blood pressure and all-cause mortality in hypertensive adults. ARB + CCB seems to be having good safety profile, with better renal functions based on biomarkers.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"257-268"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipoprotein(a) in Essential Hypertension: Associations with Blood Pressure and Hypertension-Mediated Organ Damage.","authors":"Giulia Nardoianni, Giuliano Tocci, Barbara Pala, Marco Russo, Giovanni Marco Dutti, Federica Fogacci, Arrigo F G Cicero, Massimo Volpe, Emanuele Barbato","doi":"10.1007/s40292-026-00783-8","DOIUrl":"10.1007/s40292-026-00783-8","url":null,"abstract":"<p><strong>Introduction: </strong>Although recommended for cardiovascular (CV) risk stratification in adults, the role of lipoprotein(a) [Lp(a)] in hypertension is not fully established.</p><p><strong>Aim: </strong>To evaluate Lp(a) levels in adult outpatients with essential arterial hypertension.</p><p><strong>Methods: </strong>A retrospective, observational study was conducted in outpatients of both sexes, aged ≥ 18 years, with treated or untreated essential hypertension, who were consecutively evaluated at the Hypertension Unit, Excellence Hypertension Center, Sant'Andrea Hospital, Rome, Italy. Participants underwent office and out-of-office blood pressure (BP) measurements, as well as assessment of hypertension-mediated organ damage (HMOD). BP measurements were performed, and hypertension phenotypes were classified according to 2023 European hypertension guidelines. Lp(a) levels were measured, and the study population was stratified according to a Lp(a) cut-off value of ≥50 mg/dl. Due to the non-uniform distribution, absolute Lp(a) values were logarithmically transformed.</p><p><strong>Results: </strong>A total of 230 patients with available Lp(a) values were included (42.6% women, mean age 66.3 ± 11.5 years, BMI 27.1 ± 4.5 kg/m2, office BP 137.1 ± 18.1/83.7 ± 11.0 mmHg, 24-hour BP 129.8 ± 14.5/79.6 ± 9.8 mmHg, Lp(a) 51.4 ± 65.3 mg/dL), among whom 32.2% had Lp(a) ≥50 mg/dl. There were significantly higher proportions of men (74.3% vs. 49.4%; P < 0.001), dyslipidaemia (97.3% vs. 75.0%; P < 0.001) and comorbidities (55.4% vs. 30.8%; P < 0.001) in patients with high Lp(a) than in those with normal Lp(a), who also received more frequently lipid lowering therapies (P < 0.001) and aspirin (P = 0.003). However, lower office systolic BP values (133.5±18.8 vs. 138.8±17.6 mmHg: P = 0.036) were observed in patients with Lp(a) ≥50 mg/dL than in those with < 50 mg/dl. Also, no significant differences for Lp(a) levels were observed among various hypertension phenotypes, as defined by office (P = 0.156) or out-of-office BP values (P = 0.065). No significant correlations were found between Lp(a) and office or out-of-office BP levels, both in treated and untreated hypertensive outpatients.</p><p><strong>Conclusions: </strong>In our population, Lp(a) levels were not associated with either office or out-of-office BP values, irrespective of antihypertensive treatment status. The role of Lp(a) in hypertension warrants further investigation.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"337-349"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13222255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Altered p53 Gene Expression in Coronary Artery Disease Patients with Dyslipidemia: Implications for Atherogenesis.","authors":"Reshma Gopan M, Deepika Chandrasekaran, Dinesh Roy D, Natarajan Muninathan, S Mahila, Radhika Pr","doi":"10.1007/s40292-025-00776-z","DOIUrl":"10.1007/s40292-025-00776-z","url":null,"abstract":"<p><strong>Introduction: </strong>A concerning increase in coronary artery disease (CAD) among younger Indians calls attention to genetic biomarkers that indicate early vascular stress. The tumor suppressor gene p53, known primarily for its oncogenic role, also modulates vascular apoptosis and inflammation. However, its link with metabolic and nitrosative stress in CAD remains underexplored.</p><p><strong>Aim: </strong>To determine the potential of p53 as an integrated biomarker and to analyze the connection between p53 gene expression, lipid abnormalities, inflammatory (IL-6) and nitrosative (3-nitrotyrosine) markers in CAD.</p><p><strong>Methods: </strong>In this case-control study, 90 CAD patients and 90 age-matched healthy controls (18-50 years old) participated. Enzymatic techniques were used to evaluate lipid profile parameters, RT-PCR was used to detect p53 gene expression (2^^-ΔΔCt method), and ELISA was used to quantify the levels of interleukin-6 (IL-6) and 3-nitrotyrosine (3-NT). Data were analyzed with t-test, Mann-Whitney U, chi-square, and Pearson correlation (p < 0.05).</p><p><strong>Results: </strong>CAD subjects showed higher total cholesterol, triglycerides, LDL-C, IL-6,and 3-NT, and lower HDL-C compared with controls (all p < 0.01). p53 was up-regulated 1.6-fold in CAD and correlated positively with 3-NT (r = 0.709, p < 0.001) and IL-6 (r = 0.513, p < 0.01).</p><p><strong>Conclusion: </strong>This is the first Indian case-control study to integrate p53 gene expression with lipid, inflammatory, and nitrosative markers in relatively young CAD patients, offering a novel molecular perspective on early atherogenesis.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"277-285"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a Short-Term Nutritional Intervention on Vascular Changes in Individuals with Obesity and Low or Moderate Cardiovascular Health.","authors":"Michelle Rabello Cunha, Samanta Mattos, Mariana Ribeiro Costa Portugal, Elenilson Nobrega Gomes, Douglas Fernandes Souza, Wille Oigman, Márcia R S T Klein, Mario F Neves","doi":"10.1007/s40292-025-00765-2","DOIUrl":"10.1007/s40292-025-00765-2","url":null,"abstract":"<p><strong>Introduction: </strong>Most cardiovascular events can be prevented by controlling health conditions and behaviors that reflect cardiovascular health (CVH) classification as high, moderate, and low.</p><p><strong>Aim: </strong>To evaluate the effect of weight loss through an 8-week hypocaloric diet on vascular function and sympathetic tone in individuals with obesity and moderate or poor CVH.</p><p><strong>Methods: </strong>Individuals aged 40-70 years and body mass index  ≥ 30 kg/m² followed a low-calorie diet (800 kcal/day reduction) for 8 weeks. Central hemodynamics (Mobil-O-Graph®), heart rate variability (Polar® RS800), and microvascular reactivity (Laser Speckle Contrast Imaging) were assessed at baseline and post-intervention.</p><p><strong>Results: </strong>Seventy-one patients were divided into moderate CVH (n = 44) and low CVH (n = 27) groups. After the intervention, both groups presented similar weight loss (3.4 vs 3.1%). Only the low CVH group showed a significant reduction in central systolic blood pressure (cSBP, 113 ± 12 to 109 ± 9 mmHg; p = 0.049) and an increase in cutaneous vascular conductance in post-occlusive reactive hyperemia (CVC-PORH, 0.99 ± 0.28 to 1.08 ± 0.28 APU/mmHg; p = 0.039). Conversely, only the moderate CVH group exhibited an increase in RR interval (933 ± 130 to 994 ± 131 ms; p = 0.006) and a decrease in sympathetic nervous system index (iSNS). Significant inverse correlations were observed in the low CVH group between the variations in CVC-PORH with pulse wave velocity (r = - 0.40, p = 0.044) and with iSNS (r = - 0.52, p = 0.021).</p><p><strong>Conclusion: </strong>Even modest weight loss led to early improvements in vascular function and blood pressure in individuals with low CVH, while autonomic benefits were more evident in those with moderate CVH.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"195-206"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145603580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Hypertensive Crisis in Primary Care Health Facilities in Peru, 2019-2024.","authors":"Carlos Diaz-Arocutipa","doi":"10.1007/s40292-025-00763-4","DOIUrl":"10.1007/s40292-025-00763-4","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertensive crises are often managed in primary care, yet guideline-discordant use of short-acting oral antihypertensives remains common in low- and middle-income countries.</p><p><strong>Aim: </strong>We aimed to describe prescribing patterns of captopril, nifedipine, furosemide, and metamizole in Peru.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using nationwide data from the Peruvian Seguro Integral de Salud (2019-2024). Adults with hypertension and at least one hypertensive crisis episode (systolic blood pressure [BP] ≥ 180 mmHg and/or diastolic BP ≥ 110 mmHg) in primary care were included. Joinpoint regression assessed temporal trends, and multivariable logistic regression identified prescribing determinants.</p><p><strong>Results: </strong>We analyzed 163,166 episodes from 101,894 patients (mean age 67.3 ± 13.7 years, 60.9% women). Captopril use declined from 40.3 to 34.5% (average monthly percent change [AMPC] - 0.22%; p < 0.001), with steepest decreases in level I-1 healthcare facilities and patients ≥ 80 years. Nifedipine showed no significant overall change (AMPC + 0.07%; p = 0.406) but rose mid-period before declining. Combined captopril or nifedipine use decreased modestly (AMPC - 0.21%; p < 0.001). Furosemide or metamizole were prescribed in 4.7% of episodes, with stable trends but increases in level I-1 healthcare facilities. Higher systolic BP increased the probability of prescribing all medications; diastolic BP showed a non-linear association peaking at 100-110 mmHg. Younger ages were associated with greater medication use.</p><p><strong>Conclusions: </strong>Short-acting antihypertensives and other agents remain common in Peruvian primary care hypertensive crises. Targeted strategies are needed to align practice with evidence-based recommendations.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"183-193"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive Versus Standard Blood Pressure Control in Type 2 Diabetes: Cardiovascular and Microvascular Outcomes.","authors":"Ali Akhtar, Muhammad Basil Raza, Harsh Chawla, Lubna Alabdallat, Nissy Valsan Mathew, Harikrishnan Srinivasan","doi":"10.1007/s40292-025-00766-1","DOIUrl":"10.1007/s40292-025-00766-1","url":null,"abstract":"<p><strong>Introduction: </strong>Optimal blood pressure (BP) targets in type 2 diabetes mellitus (T2DM) remain uncertain, particularly following recent large-scale trials. The balance between cardiovascular protection and potential harms from intensive BP lowering continues to be debated.</p><p><strong>Aim: </strong>This study aimed to update the evidence comparing intensive versus standard BP control in T2DM by incorporating data from the recent BPROAD trial and reassessing cardiovascular and microvascular outcomes across major randomized trials.</p><p><strong>Methods: </strong>This meta-analysis included eight randomized controlled trials (ABCD, Mehler 2003, ABCD-2V, SANDS, INVEST, ACCORD-BP, J-DOIT3, and BPROAD), comprising a total of 25,686 participants. Intensive arms consistently achieved ~120/70 mmHg regardless of specific trial targets. Follow-up ranged 1.9-8.5 years. The primary end-point was a composite of fatal/non-fatal cardiovascular events; secondary endpoints were diabetic retinopathy, neuropathy and urine albumin excretion (UAE). Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with a random-effects model; heterogeneity was expressed as I².</p><p><strong>Results: </strong>Compared to standard BP control, intensive BP lowering reduced composite cardiovascular events (OR 0.88, 95% CI 0.79-0.97; I² = 17%). Retinopathy likewise fell (OR 0.84, 95% CI 0.71-0.98; I² = 0%). UAE risk declined (OR 0.82, 95% CI 0.71-0.94; I² = 62%). The analysis showed an OR of 1.48 (95% CI 1.05-2.10; P = 0.03; I² = 0%) for neuropathy, but the small sample size and wide confidence interval limit confidence in this result.</p><p><strong>Conclusion: </strong>Lowering BP to approximately 120/70 mmHg, representing a more stringent target than standard control (~135/80 mmHg) is associated with modest reductions in cardiovascular events and improvements in microvascular outcomes including retinopathy and albuminuria in type 2 diabetes. While these benefits are modest and neuropathy data remain limited, the findings support consideration of lower BP targets in this population, applied thoughtfully and tailored to individual risk and tolerability.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"153-158"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145563693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning Insights into Age-Related Sex Differences in Blood Pressure: Influence of Diabetes and Body Mass Index.","authors":"Alessandro Gentilin, Laurent Mourot","doi":"10.1007/s40292-025-00768-z","DOIUrl":"10.1007/s40292-025-00768-z","url":null,"abstract":"<p><strong>Introduction: </strong>The age-related dynamics of blood pressure (BP) arise from complex, often concurrent interactions among multiple factors (e.g., sex, type-2 diabetes mellitus [T2DM], body mass index [BMI]), making it challenging to isolate individual variable effects. Disentangling factor's contribution to BP trajectories across the lifespan remains a challenge.</p><p><strong>Aim: </strong>Machine learning (ML) algorithms were applied to data from 219 individuals from a publicly available dataset to model age-related trends in systolic and diastolic BP, using age, sex, BMI, heart rate, and T2DM as predictors.</p><p><strong>Methods: </strong>Five regression models (linear regression, random forests, support vector machines, gaussian process regression [GPR], and neural networks) were tested. The best-fitting models capturing complex predictor-target relationships were used to simulate systolic and diastolic BP trajectories under customized scenarios, independently varying sex, BMI, and T2DM to assess isolated effects.</p><p><strong>Results: </strong>The squared exponential GPR yielded the best predictions for systolic BP, while the Matern 5/2 kernel performed best for diastolic BP. Systolic BP increased with age, with steeper trends at higher BMI. Women had lower systolic BP in early and mid-adulthood, but values surpassed men's in older age, especially with T2DM. Diastolic BP rose until midlife, then declined in both sexes. Women showed a similar crossover pattern, attenuated by T2DM, particularly at higher BMI.</p><p><strong>Conclusion: </strong>ML simulations from a static dataset assessed individual factors' contributions to BP trajectories, producing results consistent with empirical evidence (e.g., greater T2DM impact on BP dynamics and faster age-related BP rise in women than men) and highlighting the potential for counterfactual analyses.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"227-237"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Use of the Triglycerides/Glucose (TyG) Index in the Early Assessment of Metabolic Alterations and Cardiovascular Remodeling in Essential Hypertensive Patients.","authors":"Luigi Petramala, Gioacchino Galardo, Luca Marino, Francesco Circosta, Giulia Nardoianni, Francesco Baratta, Luca Caprioni Grasso, Federica Moscucci, Giuliano Tocci, Giovambattista Desideri, Claudio Letizia","doi":"10.1007/s40292-025-00772-3","DOIUrl":"10.1007/s40292-025-00772-3","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity represents a significant public health problem, particularly due to its strong association with additional cardiovascular risk factors, such as hypertension, insulin resistance (IR), type 2 diabetes mellitus, metabolic syndrome (MS) and cardiovascular disease. IR is the underlying factor of the relationship between obesity and metabolic dysregulation. The identification of IR is crucial for early diagnosis, clinical management and specific treatment.</p><p><strong>Aim: </strong>This study aims to evaluate the diagnostic efficacy of the Triglycerides/Glucose (TyG) Index in identifying IR and target-organ damage in a cohort of patients with essential hypertension.</p><p><strong>Methods: </strong>we have evaluated 235 consecutive patients with essential hypertension (50.1% men and 49.9% women; mean age 51.9 ± 17.3 years), stratified for body mass index (BMI). Biochemical analysis and instrumental evaluation were assessed to identify target-organ damage.</p><p><strong>Results: </strong>Increased BMI was associated with higher values of blood pressure, glycaemia and triglycerides. In patients with higher BMI, we observed more prevalent target-organ damage, particularly cardiac remodeling (78.3%) and higher 24-h urinary albumin excretion (83.7±48 mg/L). The TyG index proved to be a stronger biomarker for identifying the development of MS (AUC 0.78) and cardiac remodeling (AUC 0.66).</p><p><strong>Conclusions: </strong>This study confirms that obesity is correlated with a impaired hemodynamic and metabolic profile. The TyG index could represent an efficient and easy-to-use indicator for identifying both individuals developing MS and early cardiac remodeling, especially in normal-weight subjects.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"239-248"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145911147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammaging and Cardiovascular Risk in Old Women.","authors":"Federica Moscucci, Francesco Baratta, Valentina Bucciarelli, Anna Vittoria Mattioli, Marcello Pinti, Giada Zanini, Susanna Sciomer, Sabina Gallina, Gianfranco Piccirillo, Giovambattista Desideri","doi":"10.1007/s40292-025-00758-1","DOIUrl":"10.1007/s40292-025-00758-1","url":null,"abstract":"<p><p>Inflammaging is a chronic, low-grade inflammation that accompanies aging and contributes to the development of age-related diseases. Recent research has increasingly focused on its impact in women, recognizing that aging and inflammatory processes differ between sexes. Estrogens, known for their anti-inflammatory effects, offer protection during reproductive years. However, their decline during menopause and the climacteric period is linked to increased inflammation and a higher risk of chronic diseases such as osteoporosis, cardiovascular disease, and arthritis. X-linked immune-related genes play a critical role in immune system regulation. Epigenetic changes associated with aging can affect the expression of inflammation-related genes, with hormonal and genetic differences contributing to sex-specific responses. Women generally exhibit stronger immune responses than men, which can enhance infection resistance but also increase susceptibility to autoimmune diseases and inflammaging. Lifestyle factors, including diet and physical activity, significantly influence inflammation. Due to metabolic differences, women may respond differently to these interventions. Postmenopausal women, for example, often exhibit higher levels of inflammatory markers like C-reactive protein (CRP) and interleukin-6 (IL-6), which are associated with elevated risks of cardiovascular and other age-related conditions. These findings suggest that strategies to reduce inflammation-such as anti-inflammatory diets or medications-should be tailored to the unique hormonal and physiological context of women. Understanding the distinct manifestations of inflammaging in women is essential for developing gender-specific approaches to promote healthier aging and reduce the burden of chronic disease in later life.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"171-181"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12989026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transdermal Clonidine for Hypertension: An Underutilized Ally in the Modern Era.","authors":"Stefano Masi, Nicola Riccardo Pugliese, Stefano Taddei, Claudio Ferri, Claudio Borghi","doi":"10.1007/s40292-025-00770-5","DOIUrl":"10.1007/s40292-025-00770-5","url":null,"abstract":"<p><p>Despite advancements in pharmacological strategies, blood pressure (BP) control remains unsatisfactory in a significant proportion of hypertensive patients. This may be related to the multifactorial pathogenesis of hypertension, which makes treatment challenging and often requires the use of multiple BP-lowering pills that can reduce adherence. Transdermal clonidine, a central α₂-adrenergic agonist, offers a unique antihypertensive approach that may deserve renewed consideration. Although largely abandoned in the oral form due to side effects and withdrawal concerns, the transdermal patch provides a steadier drug release and improved tolerability. This review summarizes evidence from randomized and observational studies evaluating the efficacy, safety, and adherence profile of transdermal clonidine in the treatment of hypertension. Overall, the patch demonstrated blood pressure-lowering efficacy comparable to standard first-line agents, such as β-blockers, calcium channel blockers, and diuretics. It was particularly effective in improving treatment adherence and reducing the risk of rebound hypertension during discontinuation. Adverse effects, mainly dry mouth, sedation, and mild skin reactions, were generally well tolerated. These findings suggest that transdermal clonidine may serve as a useful adjunct or alternative therapy in patients with resistant hypertension, poor adherence to oral therapy, or intolerance to other drug classes, and that its role deserves to be reconsidered within contemporary, patient-centered antihypertensive strategies.</p>","PeriodicalId":12890,"journal":{"name":"High Blood Pressure & Cardiovascular Prevention","volume":" ","pages":"159-170"},"PeriodicalIF":2.9,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}