International Journal of Hypertension最新文献

{"title":"Differential Effects of Antihypertensive Drug Classes on Home and Office Blood Pressure Variability.","authors":"Dong-Hyuk Cho, Mi-Na Kim, Jung-Joon Cha, Se Won Oh, Jae Hyoung Park, Kyung-Hee Cho, Seung Yong Shin, Eung Ju Kim, Hyung Joon Joo","doi":"10.1155/ijhy/2633062","DOIUrl":"10.1155/ijhy/2633062","url":null,"abstract":"<p><strong>Objective: </strong>Blood pressure (BP) variability provides prognostic information beyond mean BP. However, the class-specific associations of antihypertensive medications with BP variability remain uncertain, and few studies have directly contrasted home and office BP variability within the same patients while accounting for the white-coat effect.</p><p><strong>Methods: </strong>In a multicenter prospective registry, patients with hypertension and adequate measurements (≥ 10 home and ≥ 5 office readings) were analyzed. The primary outcomes were systolic and diastolic average real variability (ARV) of home and office BP. Associations of renin-angiotensin system inhibitors, beta-blockers, dihydropyridine calcium channel blockers (DHP-CCBs), and diuretics with BP variability were estimated using inverse probability of treatment weighting (IPTW) and doubly robust models. The white-coat effect was further adjusted using both a continuous office-home mean difference and a guideline-based white-coat definition. A true-monotherapy subcohort sensitivity analysis and class-by-class interaction tests were additionally performed.</p><p><strong>Results: </strong>Among 495 participants, home ARV differed minimally by antihypertensive class; a small beta-blocker-associated increase in home systolic BP (SBP)-ARV was attenuated with additional adjustment. In contrast, office BP ARV was higher with DHP-CCBs and diuretics, although the beta-blocker association was weakened after further adjustment. Following white-coat effect adjustment, home BP ARV remained neutral across drug classes, whereas DHP-CCB remained associated with higher office SBP-ARV and diuretics with higher office diastolic BP ARV. DHP-CCBs were also associated with a lower probability of office BP control. Home BP control rates did not differ significantly by antihypertensive class.</p><p><strong>Conclusions: </strong>In this cross-sectional observational cohort, antihypertensive medication classes showed context-dependent associations with BP variability, which were minimal for home BP but more pronounced for office BP, partially independent of the white-coat effect. Given potential residual confounding by indication, these hypothesis-generating findings warrant prospective confirmation.</p>","PeriodicalId":14132,"journal":{"name":"International Journal of Hypertension","volume":"2026 ","pages":"2633062"},"PeriodicalIF":3.1,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13430049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148669479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Associated Factors of Self-Medication Among Adults With Hypertension in Central Uganda: A Cross-Sectional Study.","authors":"Charity Kakuru, Julius Kyomya, Abraham Muhwezi, Tom Murungi, Henry Ochola, Eleanor Turyakira, Richard Migisha, Peter Chris Kawungezi","doi":"10.1155/ijhy/9749228","DOIUrl":"10.1155/ijhy/9749228","url":null,"abstract":"<p><strong>Background: </strong>Self-medication is a widespread practice among individuals with chronic conditions such as hypertension. It can lead to poor blood pressure control and an increased risk of complications. However, little is known about its prevalence and associated factors among patients with hypertension in Uganda. This study aimed to determine the prevalence and associated factors of self-medication among adults with hypertension at Masaka Regional Referral Hospital (MRRH), Central Uganda.</p><p><strong>Methods: </strong>A cross-sectional study was conducted during August and September 2024 among patients with known hypertension aged ≥ 18 years attending the MRRH Hypertension Clinic. Systematic sampling was used to recruit participants. Data were collected using a structured questionnaire, capturing sociodemographic and clinical characteristics. We defined self-medication as the use of antihypertensive medicines by individuals to treat hypertension without a formal prescription or guidance from a healthcare professional within the last 90 days before the survey. Modified Poisson regression was used to identify factors associated with self-medication.</p><p><strong>Results: </strong>We enrolled 192 participants, with a mean age of 58 (±14) years; 143 (75%) were female. The prevalence of self-medication with antihypertensive drugs was 47% (95% confidence interval [CI] = 40%-54%). Factors associated with self-medication were low monthly income (< 2,00,000 UGX; aPR = 2.00; 95% CI: 1.04-3.86), 20 medication gap (adjusted Prevalence Ratio [aPR] = 1.46; 95% CI: 1.01-2.11), and familial influence (aPR = 1.41; 95% CI: 1.04-1.92).</p><p><strong>Conclusion: </strong>The prevalence of self-medication among hypertensive patients at MRRH was high. Self-medication was associated with low monthly income, medication gap, and familial pressure. The findings suggest that interventions addressing financial barriers, medication availability, and family influence warrant further evaluation as potential strategies to reduce self-medication.</p>","PeriodicalId":14132,"journal":{"name":"International Journal of Hypertension","volume":"2026 ","pages":"9749228"},"PeriodicalIF":3.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13420280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions, Practices and mHealth Readiness for Blood Pressure Self-Monitoring Among Ghanaian Hypertensive Patients.","authors":"Evelyn K Ansah, Valencia Koomson, Jacques Kpodonu, Saviour Edem Vidzro, John Tetteh, Swithin M Swaray, Alice Tang, John Kpodonu, Mark Tettey, Frank Edwin","doi":"10.1155/ijhy/5512077","DOIUrl":"10.1155/ijhy/5512077","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hypertension is a critical global health issue, with self-monitoring of blood pressure emerging as an essential tool for its management. In Ghana, clinic visits are mostly scheduled at 2-3 monthly intervals, making it difficult to assess patient blood pressure control in between visits. The use of mobile health applications for the self-monitoring of blood pressure among hypertensive patients is not well-documented. Empowering patients through self-monitoring of blood pressure along with feedback from an interactive mobile health application could potentially improve blood pressure control. To ensure that such applications are effective, patient knowledge, perceptions and practices with regard to hypertension must be taken into consideration in the development of the interactive mobile health application. This study investigated patient knowledge of hypertension and the prevalence and practice of self-monitoring, as well as perceptions of hypertension and self-monitoring of blood pressure among Ghanaian patients diagnosed with hypertension at two teaching hospitals.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional pilot study using a mixed-methods approach was conducted among patients aged 30 years and above who have been newly diagnosed without comorbidities with hypertension (blood pressure levels exceeding 140/90 mmHg). The pilot study explored perceptions and practices of the patients with regard to self-monitoring for blood pressure control prior to the introduction of a mobile health technology intervention. Newly diagnosed patients without comorbidities were specifically recruited so that the focus of the study would be solely on hypertension management, ensuring that participants' perceptions, knowledge and self-monitoring practices were not influenced or confounded by the concurrent management of other medical conditions. Recruiting patients at the point of diagnosis also ensured that baseline assessments were conducted prior to any formal patient education or structured self-monitoring coaching by healthcare providers, thereby providing an uncontaminated preintervention baseline for the planned mobile health intervention. Pregnant women and individuals with pre-existing hypertension and coexisting medical conditions were excluded. Quantitative data were analysed using STATA Version 16, while qualitative data from in-depth interviews were transcribed and analysed using NVivo Version 12. Themes from the qualitative analysis were used to contextualize the quantitative results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study included 32 hypertensive patients, with more males [53.1% (17/32)] than females. Overall, 71.9% (23/32) of patients knew normal and abnormal blood pressure values, with only 59.4% (19/32) demonstrating good general knowledge of hypertension. Notably, only 37.5% (12/32) of patients indicated that they routinely measured their blood pressure at home. Of the 12 respondents who did so, only nine e","PeriodicalId":14132,"journal":{"name":"International Journal of Hypertension","volume":"2026 ","pages":"5512077"},"PeriodicalIF":3.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comprehensive Review on the Efficacy of Antihypertensives in Patients With End-Stage Renal Disease.","authors":"Oluwakorede Akele, Nnedindu Asogwa, Gennifer Wahbah Makhoul, Khalil El-Gharib, Joanne Ling, Alaukika Agarwal, Vanessa Agberien, Ngowari Pokima, Thomas Gut, Suzanne El-Sayegh","doi":"10.1155/ijhy/9930482","DOIUrl":"10.1155/ijhy/9930482","url":null,"abstract":"<p><p>End-stage renal disease (ESRD) patients are particularly susceptible to hypertension, as blood pressure (BP) dysregulation leads to increased mortality and morbidity, especially considering the heightened risk of cardiovascular complications, including myocardial infarction, stroke, and congestive heart failure. Given the lack of specific guidelines on therapies aimed at achieving adequate BP control in ESRD patients, we conducted a thorough literature review to identify relevant studies and articles exploring the associations of various therapies in ESRD patients and to provide a qualitative analysis based on these results. These include ACE inhibitors, ARBs, calcium channel blockers (CCBs), beta-blockers, diuretics, alpha-2 agonists, and direct vasodilators. ARBs are not affected by dialysis, while ACE inhibitors are dialyzable. Studies suggest that the incidence of cardiovascular events is significantly lower in ESRD patients receiving treatment compared to those without treatment. CCBs are nondialyzable and, thus, serve as a second-line treatment for BP control in ESRD patients. Limited evidence suggests that diuretic-based combination therapy may improve BP control in selected hemodialysis patients, but its effect on cardiovascular mortality remains uncertain. Beta-blockers have demonstrated a favorable profile but differ in dialyzability and cardioselectivity, making it challenging to endorse an ideal choice of drug. Direct vasodilators have been shown to reduce left ventricular hypertrophy, but further studies are needed to determine optimal dosing strategies. Clonidine, an alpha-2 agonist, lacks safety and efficacy evaluations but has been shown to reduce BP in ESRD patients.</p>","PeriodicalId":14132,"journal":{"name":"International Journal of Hypertension","volume":"2026 ","pages":"9930482"},"PeriodicalIF":3.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13386479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trunk-to-Appendicular Fat Ratio and Blood Pressure: Survey-Weighted Regression, Spline Modeling, and Exploratory Lipid Attenuation Analysis.","authors":"Bao The Nguyen, Tien Anh Hoang","doi":"10.1155/ijhy/3281602","DOIUrl":"10.1155/ijhy/3281602","url":null,"abstract":"<p><p>Central adiposity is closely linked to blood pressure (BP), yet body mass index (BMI) and waist circumference (WC) may not fully capture fat distribution. We analyzed 4307 adults from NHANES 2011-2018 with whole-body dual-energy X-ray absorptiometry (DXA) to examine whether the trunk-to-appendicular fat ratio (TAR), a marker of trunk-predominant adiposity, was associated with BP. Survey-weighted multivariable linear regression and restricted cubic spline models were applied. TAR showed the strongest correlation with systolic BP (SBP) and diastolic BP (DBP) (<i>r</i> = 0.326 and 0.330, respectively; both <i>p</i> < 0.001). After adjustment for demographic and clinical covariates and either BMI or WC, TAR remained associated with higher SBP and DBP (<i>p</i> < 0.001). Additional adjustment for serum lipids modestly attenuated these associations, with triglycerides showing the largest attenuation. Higher TAR was consistently associated with higher predicted BP, supporting TAR as a useful adiposity index for hypertension research.</p>","PeriodicalId":14132,"journal":{"name":"International Journal of Hypertension","volume":"2026 ","pages":"3281602"},"PeriodicalIF":3.1,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large-Scale Protein Assay Identifies Novel Protein Biomarkers Associated With Arterial Stiffness and Vascular Calcification Measures.","authors":"Rain Katz, Ryan Cvejkus, Jiebiao Wang, Bharat Thyagarajan, Emma Barinas-Mitchell, John Jeffrey Carr, James G Terry, Sangeeta Nair, Winnie Wan-Yee Tang, Rachel G Miller, Iva Miljkovic, Joseph M Zmuda, Allison L Kuipers","doi":"10.1155/ijhy/9724102","DOIUrl":"10.1155/ijhy/9724102","url":null,"abstract":"<p><p>Large-scale protein assays have the potential to identify novel biomarkers and improve prediction of cardiovascular disease (CVD) risk. The burden of atherosclerotic CVD and related risk factors is disproportionately high in Afro-Caribbean populations in whom novel risk prediction strategies may be warranted. Thus, we analyzed the association of early atherosclerosis markers with peripheral blood proteomic biomarkers quantified using the Olink Target 96 Cardiovascular III panel in 342 community-dwelling men from the Tobago Health Study. Atherosclerosis markers included pulse wave velocity (PWV), abdominal aortic calcification (AAC), and coronary artery calcification (CAC). Blood pressure, height, and weight were measured by trained clinic staff. Hypertension, dyslipidemia, and diabetes status were classified via clinical measures and the prescription of relevant medication. Statistical methods included differential expression analysis fully adjusted for assay batch, age, BMI, smoking, diabetes, dyslipidemia, and blood pressures. Men ranged from 53 to 89 years of age (mean ± SD = 63.3 ± 8.1 years). Average BMI was 27.7 ± 4.3 kg/m², 79.2% had hypertension, average LDL cholesterol was 129.4 ± 37.7 mg/dL, 24.6% had diabetes, and 5.9% were current smokers. In fully adjusted models, 18 proteins were associated with PWV and 1 was associated with CAC. There were no significant associations with AAC. Thirteen of these significant associations (12 PWV and 1 CAC) were novel, having never been identified as associated with these atherosclerosis measures in any previous study. While these proteins are involved in physiological processes known to contribute to CVD, such as inflammation, the strongest effects were seen for previously unreported protein associations. Our work is the first large-scale protein assay performed in an Afro-Caribbean population and adds to existing evidence that indicates that protein biomarker signatures of CVD may differ by racial/ethnic group. Further research is needed to understand the role of protein biomarkers in the prediction and progression of CVD among this high-risk group.</p>","PeriodicalId":14132,"journal":{"name":"International Journal of Hypertension","volume":"2026 ","pages":"9724102"},"PeriodicalIF":3.1,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13366776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolomics and Precision Medicine in Resistant Hypertension: Pathophysiological Insights, Biomarker Discovery, and Translational Strategies.","authors":"Yu Ra Lee, Miri Park, Yoon Shin Cho, Ho-Young Park","doi":"10.1155/ijhy/9656975","DOIUrl":"10.1155/ijhy/9656975","url":null,"abstract":"<p><p>Resistant hypertension (RH), defined as uncontrolled blood pressure despite the use of at least three optimally dosed antihypertensive agents, including a diuretic, remains a major clinical challenge associated with elevated cardiovascular risk. Metabolomics offers a dynamic approach to characterize biochemical perturbations related to amino acid metabolism, lipid remodeling, mitochondrial dysfunction, oxidative stress, renal impairment, and gut microbiota-derived metabolites. However, current evidence remains limited by small sample sizes, cross-sectional designs, heterogeneous definitions of RH, inadequate exclusion of pseudoresistance, medication confounding, and limited external validation. This structured narrative review synthesizes RH-specific metabolomic evidence and distinguishes it from findings extrapolated from broader hypertension populations. We further discuss methodological challenges, replication gaps, pharmacometabolomic confounding, and validation standards required for clinical implementation. Integrating metabolomics with clinical phenotyping, genomics, proteomics, and microbiome profiling may eventually support RH phenotyping, treatment-response prediction, and biomarker-guided precision medicine, but large longitudinal cohorts with confirmed true RH are needed before clinical translation.</p>","PeriodicalId":14132,"journal":{"name":"International Journal of Hypertension","volume":"2026 ","pages":"9656975"},"PeriodicalIF":3.1,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13366778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-World Effectiveness and Safety of Ramipril/Indapamide Combination Therapy in Essential Hypertension: A Retrospective Study on UK Primary Care Records.","authors":"Mariusz Mogielnicki, Marian Płaszczyca, Andrew Leary, Mateusz Piechaczek, Quirino Schefer, Volodymyr Stus","doi":"10.1155/ijhy/1999424","DOIUrl":"10.1155/ijhy/1999424","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the patient characteristics, effectiveness, safety, adherence, and persistence of ramipril/indapamide (R/I) free combination therapy in patients with essential hypertension inadequately controlled with monotherapy.</p><p><strong>Methods: </strong>This retrospective observational cohort study used anonymized UK primary care electronic health records from IQVIA's Medical Research Database (IMRD), incorporating \"The Health Improvement Network\" (THIN), a Cegedim Database. Adults with essential hypertension who switched from ramipril or indapamide monotherapy to R/I between database inception and January 1, 2021, were enrolled. Outcomes included changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP), proportions achieving BP < 140/90 mmHg or SBP ≥ 20 mmHg/DBP ≥ 10 mmHg decrease, proportion of days covered (PDC), persistence, and adverse events (AEs) over 12 months.</p><p><strong>Results: </strong>A total of 1089 patients met inclusion criteria (mean age 63.5 years; 55.6% female). Mean baseline BP on monotherapy was 156.0/89.1 mmHg. Over 12 months, mean SBP decreased by 18.7 mmHg and DBP by 8.9 mmHg (both <i>p</i> < 0.001); 54.3% of patients achieved BP < 140/90 mmHg, and 61.6% met the predefined BP decrease threshold. A dose-response relationship was observed for BP outcomes. Mean PDC was 92.4% at 3 months and 86.2% at 12 months; persistence was 87.7% and 81.5%, respectively. The most frequent AE was cough (10.38%); gout occurred in 0.73%, exclusively in indapamide-naïve patients. The outcomes remained consistent across sensitivity and subgroup analyses.</p><p><strong>Conclusion: </strong>Switching from ramipril or indapamide monotherapy to their free combination was associated with clinically meaningful BP decreases, high adherence and persistence, and a favorable safety profile in routine practice. These findings are consistent with current therapeutic guidelines that endorse its use in essential hypertension management.</p>","PeriodicalId":14132,"journal":{"name":"International Journal of Hypertension","volume":"2026 ","pages":"1999424"},"PeriodicalIF":3.1,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148446190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Pressure and Hypertension Among Adults Aged 80 and Above: Findings From the Population-Based German Health Survey Gesundheit 65.","authors":"Dorothea Möẞnang, Julia Charlotte Büschges, Giselle Sarganas, Beate Gaertner, Judith Fuchs, Hannelore Neuhauser","doi":"10.1155/ijhy/2366213","DOIUrl":"10.1155/ijhy/2366213","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is highly prevalent in older adults; therefore, hypertension management remains essential. Nevertheless, population data is scarce. Until recently, population blood pressure (BP) monitoring in Germany only included the population up to age 79. This study investigates BP and hypertension management in octogenarians and nonagenarians in Germany from the study Gesundheit 65+.</p><p><strong>Methods: </strong>In 2022-2023, brachial BP measurements (Mobil-O-Graph, IEM GmbH, Aachen/Germany) and health questionnaires were conducted in 807 participants aged 80-99 years of the German population-based Gesundheit 65+ study. Hypertension was defined as BP ≥ 140/90 mmHg, or antihypertensive treatment in participants with self-reported hypertension. Hypertension control was defined as BP < 140/90 mmHg among participants with hypertension. Weighted prevalence of hypertension, awareness, treatment and control by sex were estimated with 95% confidence intervals (CIs). Partitioning Around Medoids cluster analysis was performed to identify distinct subtypes among participants with hypertension.</p><p><strong>Results: </strong>The prevalence of hypertension in women was 77.8% [95% CI: 71.4-83.2] and in men 72.3% [65.7-78.0]. Among those with hypertension, 85.2% were aware, 81.7% treated, and 57.3% controlled. Control was significantly lower in women compared to men, with half of women having controlled hypertension, compared to two-thirds of men. The cluster analysis revealed two subgroups among women with hypertension: a well-treated/controlled but multimorbid group and an untreated/uncontrolled but subjectively healthier group. Three clusters emerged among men with hypertension: treated/controlled, less treated/uncontrolled and a severely multimorbid cluster with high treatment and control rates.</p><p><strong>Conclusion: </strong>Among octogenarians and nonagenarians in Germany, hypertension prevalence is higher in women than in men, while hypertension control among women is lower. This underscores the need for more attention to BP in older women. Furthermore, our findings indicate that high BP, as a largely asymptomatic health risk, may be inadequately controlled among otherwise healthy older adults.</p>","PeriodicalId":14132,"journal":{"name":"International Journal of Hypertension","volume":"2026 ","pages":"2366213"},"PeriodicalIF":3.1,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Divergent Blood Pressure Thresholds in Hypertensive Disorders of Pregnancy: A Narrative Review of Global Guideline Discordance and Clinical Implications.","authors":"Prosper Akankwasa, Jackson Kakooza, Esther Namutosi, John Katongole, Hakizimana Theoneste, Ephraim Onaba, Fatima Abdirizak Muse, Carlos Antonio Batista Cedeño, Catherine R Lewis, Emmanuel Okurut","doi":"10.1155/ijhy/8873687","DOIUrl":"10.1155/ijhy/8873687","url":null,"abstract":"<p><p>Hypertensive disorders of pregnancy (HDP) remain a leading cause of preventable maternal and perinatal morbidity and mortality. Although blood pressure (BP) thresholds guide diagnosis, treatment, and delivery, international and national guidelines differ, resulting in inconsistent management. This narrative review synthesizes contemporary evidence to map divergences in BP thresholds across global guidelines and evaluate their implications for clinical decision-making and maternal and fetal outcomes, particularly in low- and middle-income countries (LMICs). Comprehensive searches of PubMed, Scopus, Web of Science, and Lens.org were performed. Twenty-five eligible sources, including 12 major international and national guidelines and 13 supporting peer-reviewed sources, were synthesized following SANRA principles. Additional contextual references were cited where necessary but were not counted as included sources in the threshold-synthesis dataset. Diagnostic thresholds, hypertension criteria, treatment initiation thresholds, target BP goals, and magnesium sulfate indications were reviewed. All 12 guidelines uniformly diagnosed hypertension at ≥ 140/90 mmHg. Near-consensus exists for defining severe hypertension at ≥ 160/110 mmHg, though several LMIC guidelines adopt lower thresholds (≥ 150/100-110 mmHg). The most clinically impactful divergence concerns antihypertensive treatment initiation, which varies from ≥ 140/90 mmHg to ≥ 160/110 mmHg, with intermediate thresholds (≥ 150/100 mmHg) used in several LMICs. Additional differences such as the inclusion of fetal growth restriction in some diagnostic frameworks further contribute to misclassification. These inconsistencies create a 20 mmHg \"treatment gap,\" leading to guideline-dependent over- or under-treatment and widening disparities in resource-limited settings. Marked threshold discord across the 12 major HDP guidelines results in systematic misclassification and divergent management pathways. Harmonization initiatives, transparent communication of evidence limitations, and context-specific implementation research, particularly in LMICs, are urgently needed to support equitable, evidence-based maternal care.</p>","PeriodicalId":14132,"journal":{"name":"International Journal of Hypertension","volume":"2026 ","pages":"8873687"},"PeriodicalIF":3.1,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}