High Blood Pressure

Dietary and Physical Activity Approaches to the Management of High Blood Pressure.

Whelton PK, Vinceti M, Filippini T · Current atherosclerosis reports · 2025

We appraise recent clinical trials, cohort studies, and meta-analyses on dietary and physical activity interventions for prevention and management of high blood pressure. We identified several notable new findings. Using a new statistical model for estimation of treatment dose-response patterns, potassium supplementation demonstrated a U-curve relationship, in contrast to the linear association for other exposures studied. Recent salt substitute reports document substantial BP lowering and prevention of cardiovascular and all-cause mortality. A large and statistically powerful alcohol dose-response meta-analysis of prospective cohort studies suggests there is no beneficial or safe level for alcohol consumption. Finally, large meta-analyses suggest isometric resistance exercise has substantial capacity to lower BP. A major area of uncertainty remains how best to implement the desired dietary and physical activity interventions. In addition to confirming and expanding core knowledge for

Impact of flavan-3-ols on blood pressure and endothelial function in diverse populations: a systematic review and meta-analysis of randomized controlled trials.

Lagou V, Greyling A, Ferruzzi MG, Skene SS, Dubost J, Demirkan A · European journal of preventive cardiology · 2025 · n=5205

Flavan-3-ols, found in cocoa, tea, and certain fruits, show promise in improving blood pressure (BP) and vascular function, but are currently not used for cardiovascular prevention. This meta-analysis evaluated the effects of flavan-3-ol-rich interventions on BP and endothelial function. PubMed was searched for randomized controlled trials (RCTs) published 1946-03/2024 on BP and flow-mediated dilation after flavan-3-ol-rich food, beverage, or supplement intake. Random-effects meta-analysis of 109 publications including 145 RCTs and 5205 participants was performed (PROSPERO: CRD42023454691). Flavan-3-ol interventions included epicatechin, epigallocatechin-gallate, cocoa products, tea, grape extract, and apples delivering 586 mg (95% CI 510, 662) total flavan-3-ols. Interventions decreased office (-2.8 [95% CI -3.9, -1.7]/-2.0 [-2.6, -1.3] mmHg) and 24 h-ambulatory BP (-3.7 [-5.8, -1.6]/-2.6 [-4.5, -0.8] mmHg) after chronic repetitive consumption. Effects were larger with

Differential effects of exercise training protocols on blood pressures and lipid profiles in older adults patients with hypertension: A systematic review and meta-analysis.

Hejazi K, Iraj ZA, Saeidi A, Hackney AC, Laziri F, Suzuki K · Archives of gerontology and geriatrics · 2025

Decreased physical activity and high blood pressure are both risk factors for cardiovascular diseases. Controlling blood pressure within the normal range can prevent or delay these complications. This systematic review and meta-analysis analyzed the effects of different types of exercise training on the blood pressure and lipid profiles of older adults patients with hypertension. Five electronic databases (Web of Science, Cochrane, PubMed, Google Scholar, and Scopus) were searched from their inception until March 03, 2024. English publications and randomized controlled trials involving different types of exercise training treatments for hypertensive populations were included. Data were analyzed using a random-effects model to estimate weighted mean differences (WMD) and 95 % confidence intervals. The systematic search identified 1998 articles, of which 92 studies met the inclusion criteria and were deemed eligible for inclusion. The results of the meta-analysis indicated that reduced s

Lifestyle Interventions Addressing Blood Pressure in Children: A Systematic Review.

Tiplady CH, Mynard JP, Vandeleur M, Ainkaran G, Li SX, Climie R · JAMA pediatrics · 2026

The prevalence of high blood pressure in children is increasing, with health consequences reaching into adulthood. Individual-level interventions may help address the burden of high blood pressure at a population level, but there is less evidence from pediatric settings. To assess the effectiveness of school- or community-based lifestyle interventions to reduce high blood pressure in children (aged 3-18 years) and identify components that support effectiveness. Ovid MEDLINE, Embase, and PubMed were searched for studies from June 2013 to March 2024. Randomized clinical trials and quasi-experimental studies were assessed using the following strict inclusion criteria: longer than 6-month intervention duration, participants aged 3 to 18 years, major aim to modify cardiometabolic risk, and measurement of blood pressure before and after the intervention. Interventions aimed at specific patient groups were excluded. Quality assessment was performed using the Joanna Briggs Institute critical

A systematic review of commencing full-dose antihypertensives in newly diagnosed hypertension.

Karavadra B, D Elia A, Shantsila A, Lip GYH, Shantsila E · Blood pressure · 2025

Hypertension is the UK's most common treatable cause of mortality and morbidity, including cardiovascular disease (CVD), renal disease and dementia. This systematic review has explored the efficacy and safety of commencing full-dose antihypertensive treatment in individuals with essential hypertension. Method16 randomised controlled trials (RCTs) were eligible for inclusion, with some RCTs assessing more than one treatment. The review assessed commonly used antihypertensive drugs (perindopril 8 mg, ramipril 10 mg, amlodipine 10 mg, losartan 100 mg, irbesartan 300 mg, candesartan 16 mg and candesartan 32 mg) compared to low starting doses or placebo RCTs. Eligible studies included 12 RCTs that compared full vs low doses and 19 RCTs that compared full starting doses vs placebo. The primary outcome was the difference in blood pressure reduction compared to controls (reported or calculated). ResultsUsing full doses compared to low doses led to better BP reduction (overall, 3.9/2.2 mmHg l

Epidemiology of Renal Cell Carcinoma: 2022 Update.

Bukavina L, Bensalah K, Bray F, Carlo M, Challacombe B, Karam JA · European urology · 2022

International variations in the rates of kidney cancer (KC) are considerable. An understanding of the risk factors for KC development is necessary to generate opportunities to reduce its incidence through prevention and surveillance. To retrieve and summarize global incidence and mortality rates of KC and risk factors associated with its development, and to describe known familial syndromes and genetic alterations that represent biologic risk factors. A systematic review was conducted via Medline (PubMed) and Scopus to include meta-analyses, reviews, and original studies regarding renal cell carcinoma, epidemiology, and risk factors. Our narrative review provides a detailed analysis of KC incidence and mortality, with significant variations across time, geography, and sex. In particular, while KC incidence has continued to increase, mortality models have leveled off. Among the many risk factors, hypertension, obesity, and smoking are the most well established. The emergence of new g

2026

Measurement and management of adult blood pressure in the peri-operative period: updated guidelines from the Association of Anaesthetists and the British and Irish Hypertension Society.

McCormack T, Wickham A, McDonagh STJ, Wiles MD, Faconti L, Brooks R · Anaesthesia · 2026

Maintaining stable blood pressure during surgery is a key responsibility of anaesthetists. Peri-operative omission and reintroduction of antihypertensive drugs, general anaesthesia, neuraxial and regional techniques can all cause significant fluctuations in blood pressure, particularly in patients with hypertension. Since the first edition of this guideline there has been more literature regarding peri-operative management, but some areas still lack standardisation. This was a planned update of the 2016 guidelines from the Association of Anaesthetists and British Hypertension Society: The measurement of adult blood pressure and management of hypertension before elective surgery. An expert working party was convened. We conducted a targeted literature review followed by a modified Delphi process to formulate recommendations. We make recommendations on the management of blood pressure in the peri-operative period (from time of decision to operate until 30 days after surgery) for

2025 High Blood Pressure Guideline-at-a-Glance.

Gulati M, Moore MM, Cibotti-Sun M · Journal of the American College of Cardiology · 2025

Effects of Cuisine-Based Chinese Heart-Healthy Diet in Lowering Blood Pressure Among Adults in China: Multicenter, Single-Blind, Randomized, Parallel Controlled Feeding Trial.

Wang Y, Feng L, Zeng G, Zhu H, Sun J, Gao P · Circulation · 2022 · n=265

More than one-fifth of the world's population consumes Chinese cuisines regularly, but no evidence-based healthy diets fitting the Chinese food culture are available for implementation. A multicenter, patient- and outcome assessor-blind, randomized feeding trial was conducted among 265 participants with 130 to 159 mm Hg baseline systolic blood pressure (SBP) for 4 major Chinese cuisines (Shangdong, Huaiyang, Cantonese, Szechuan). After a 7-day run-in period on a control diet matching the usual local diets, participants were randomized to continue with the control diet or the cuisine-based Chinese heart-healthy diet for another 28 days. The primary outcome was SBP, and secondary outcomes included diastolic blood pressure and food preference score. Linear regression models were used to estimate the intervention effects and adjustments for the center. The incremental cost per 1 mm Hg reduction in SBP was also calculated. A total of 265 participants were randomized (135 on

Effectiveness of a multifactorial intervention, consisting of self-management of antihypertensive medication, self-measurement of blood pressure, hypocaloric and low sodium diet, and physical exercise, in patients with uncontrolled hypertension taking 2 or more antihypertensive drugs: The MEDICHY study.

Unda Villafuerte F, Llobera Cànaves J, Lorente Montalvo P, Moreno Sancho ML, Oliver Oliver B, Bassante Flores P · Medicine · 2020 · n=424

High blood pressure is the leading modifiable risk factor for cardiovascular disease, and is associated with high morbidity and mortality and with significant health care costs for individuals and society. However, fewer than half of the patients with hypertension receiving pharmacological treatment have adequate blood pressure control. The main reasons for this are therapeutic inertia, lack of adherence to treatment, and unhealthy lifestyle (i.e., excess dietary fat and salt, sedentary lifestyle, and overweight). Cardiovascular risk and mortality are greater in hypertensive patients who are receiving treatment but have suboptimal control of blood pressure. This is a multicentre, parallel, 2-arm, single-blind (outcome assessor), controled, cluster-randomized clinical trial. General practitioners and nurses will be randomly allocated to the intervention group (self-management of antihypertensive medication, self-measurement of blood pressure, hypocaloric and low sodium diet, and physic

The effectiveness of physical activity interventions on blood pressure in children and adolescents: A systematic review and network meta-analysis.

Hassan MA, Zhou W, Ye M, He H, Gao Z · Journal of sport and health science · 2024

High blood pressure (BP) is a major contributor to mortality and cardiovascular diseases. Despite the known benefits of exercise for reducing BP, it is crucial to identify the most effective physical activity (PA) intervention. This systematic review and network meta-analysis (NMA) aimed to evaluate the available evidence on the effectiveness of various PA interventions for reducing BP and to determine their hierarchy based on their impact on BP. A search of PubMed, SPORTDiscus, PsycINFO, Web of Science, CINAHL, Cochrane, and Eric databases was conducted up to December 2022 for this systematic review and NMA. Randomized controlled trials and quasi-experimental studies targeting healthy children and adolescents aged 6-12 years old were included in this study. Only studies that compared controlled and intervention groups using PA or exercise as the major influence were included. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three

The Role of Diet in the Prevention of Hypertension and Management of Blood Pressure: An Umbrella Review of Meta-Analyses of Interventional and Observational Studies.

Aljuraiban GS, Gibson R, Chan DS, Van Horn L, Chan Q · Advances in nutrition (Bethesda, Md.) · 2024

High blood pressure (BP) is a major pathological risk factor for the development of several cardiovascular diseases. Diet is a key modifier of BP, but the underlying relationships are not clearly demonstrated. This is an umbrella review of published meta-analyses to critically evaluate the wide range of dietary evidence from bioactive compounds to dietary patterns on BP and risk of hypertension. PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched from inception until October 31, 2021, for relevant meta-analyses of randomized controlled trials or meta-analyses of observational studies. A total of 175 publications reporting 341 meta-analyses of randomized controlled trials (145 publications) and 70 meta-analyses of observational studies (30 publications) were included in the review. The methodological quality of the included publications was assessed using Assessment of Multiple Systematic Reviews 2 and the evidence quality of each selected me

The causal effects of lifestyle, circulating, pigment, and metabolic factors on early age-related macular degeneration: a comprehensive Mendelian randomization study.

Shen G, Chen Y, Chen J, Wang L, Cheng H, Hu B · Journal of translational medicine · 2024

Early detection of lifestyle factors, skin and hair color, circulating parameters, and metabolic comorbidities is crucial for personalized prevention and treatment of early age-related macular degeneration (AMD). This study aimed to assess the relationships between genetically predicted comprehensive risk factors and early AMD. Publicly available genome-wide association study (GWAS) data were utilized to identify genetic variants significantly associated with each trait. We applied a Bonferroni-corrected significance level of P < 0.0017. P values between 0.0017 and 0.05 were considered suggestive associations. Univariable Mendelian randomization (MR) analyses revealed that elevated serum HDL-C, lower serum TG, and decreased three circulating fatty acids levels were robust indicators of an increased risk of early AMD (all P < 0.0017), with odds ratios (ORs) and 95% confidence intervals (CIs) of 1.218 (1.140-1.303), 0.784 (0.734-0.837), 0.772 (0.698-0.8

Gut dysbiosis is linked to hypertension.

Yang T, Santisteban MM, Rodriguez V, Li E, Ahmari N, Carvajal JM · Hypertension (Dallas, Tex. : 1979) · 2015

Emerging evidence suggests that gut microbiota is critical in the maintenance of physiological homeostasis. This study was designed to test the hypothesis that dysbiosis in gut microbiota is associated with hypertension because genetic, environmental, and dietary factors profoundly influence both gut microbiota and blood pressure. Bacterial DNA from fecal samples of 2 rat models of hypertension and a small cohort of patients was used for bacterial genomic analysis. We observed a significant decrease in microbial richness, diversity, and evenness in the spontaneously hypertensive rat, in addition to an increased Firmicutes/Bacteroidetes ratio. These changes were accompanied by decreases in acetate- and butyrate-producing bacteria. In addition, the microbiota of a small cohort of human hypertensive patients was found to follow a similar dysbiotic pattern, as it was less rich and diverse than that of control subjects. Similar changes in gut microbiota were observed in the chronic angioten

High Blood Pressure (Hypertension)

CDC

The CDC provides essential information on high blood pressure, including causes, symptoms, risk factors, prevention, and management strategies for the general public.

Hypertension

WHO

The World Health Organization provides global fact sheets and information on hypertension, covering prevalence, risk factors, prevention, and control strategies worldwide.

A Text Message Intervention to Promote Health Behaviors in Cardiac Risk Conditions

n=69 · NCT04382521 · COMPLETED · COMPLETED

This is a randomized pilot trial to examine the feasibility, acceptability, and preliminary efficacy of an adaptive text message intervention (TMI) to promote well-being and health behavior adherence in 60 patients with two or more cardiac risk conditions (hypertension, type 2 diabetes, or hyperlipidemia).

NIMS- New Implantable Pump in Pulmonary Arterial Hypertension, a Safety Follow up

n=40 · NCT01977014 · COMPLETED · COMPLETED

This observational study aims to chart patients which get their prostacyclin treatment via the subcutaneous LenusPro pump. How the surgical procedure is performed and the clinical follow-up of these patients. And by this also charting complications that might occur in relation to treatment. Participating centres are located in Denmark, Norway and Sweden.

Observational Study to Evaluate the Effect of Parathyroidectomy on Renal Function, Endothelial Function and Blood Pressure

n=20 · NCT00452049 · UNKNOWN · UNKNOWN

Secondary hyperparathyroidism (HPT) is a known complication of chronic renal failure. Elevated concentrations of parathyroid hormone (PTH) play a role not only in the pathogenesis of renal bone disease, but also in the development of cardiovascular risk factors such as disturbed lipid metabolism, glucose intolerance, and hypertension. HPT is also known to play an important role in the development of structural abnormalities of both large arteries and the heart (left ventricular hypertrophy, interstitial fibrosis). In the last couple of years there has been increasing evidence from animal studies that the endothelium is a target organ of PTH. Hypothesis: PTH has clinically relevant effects on renal hemodynamics, renal function and endothelial function. Aims: 1. To evaluate the effect of parathyroidectomy (PTX) on renal hemodynamics in stable renal transplant recipients 2. To evaluate the effect of PTX on endothelial function in stable renal transplant recipients/chronic kidney disease (CKD) stage 5 patients 3. To evaluate the effect of PTX on blood pressure in stable renal transplant recipients/CKD stage 5 patients

Cochrane Library: Hypertension

Cochrane

The Cochrane Library provides systematic reviews and meta-analyses on various interventions for hypertension, offering high-quality evidence to inform clinical practice and policy.