Dyslipidemia is a major metabolic disorder and a key risk factor for atherosclerotic cardiovascular disease (ASCVD), particularly in the geriatric population. Elderly patients frequently present with multiple comorbidities, such as hypertension and hyperuricemia, which complicate clinical management and substantially increase cardiovascular risk. Moreover, acute conditions, including trauma-related injuries, may further disrupt metabolic control, functional capacity, and adherence to long-term therapy. This case report describes a 70-year-old male patient (RE) who presented to a primary healthcare center with swelling and intermittent pain in the right lower extremity following a fall. The patient had a known history of dyslipidemia, hypertension, and hyperuricemia. Laboratory investigations revealed elevated total cholesterol (242 mg/dL), borderline fasting plasma glucose (102 mg/dL), and uric acid level of 6.6 mg/dL. Physical examination was unremarkable except for edema and localized tenderness in the affected limb, consistent with a soft tissue injury. A holistic management approach was implemented, integrating pharmacological and non-pharmacological interventions. Statin therapy was initiated to address dyslipidemia, antihypertensive treatment was optimized, and analgesic therapy combined with limb elevation was provided to manage acute pain and edema. Non-pharmacological strategies included comprehensive lifestyle modification, encompassing dietary counseling (low saturated fat, low salt, and low purine diet), gradual resumption of physical activity following injury recovery, and structured patient–family education to improve adherence and prevent recurrent falls. Follow-up evaluation demonstrated clinical improvement, including resolution of edema, improved functional mobility, and better metabolic control. The novelty of this case lies in demonstrating how acute trauma in geriatric patients can act as a critical entry point for integrated chronic disease management within primary care settings. This case emphasizes that holistic, biopsychosocial–spiritual management not only improves lipid and blood pressure control but also enhances functional outcomes and quality of life in elderly patients with complex comorbidities.

Multivitamin-multimineral (MVM) supplements have been associated with lower blood pressure (BP) in several small trials. We investigated the effects of a MVM on incident hypertension and BP in a secondary analysis of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS). COSMOS is a 2×2 factorial, double-blinded RCT testing effects of cocoa extract and MVM supplementation among women aged ≥65 years and men aged ≥60 years. Among 8905 COSMOS participants free from hypertension, effects of MVM supplementation on incident hypertension were investigated. Hypertension diagnosis was ascertained through self-reports. Additionally, in two substudies with BP measurements (N = 529 at clinic by research staff and 994 at home by technician), we evaluated the effects on 2-year BP changes. Incident hypertension was observed in N = 1034 (22.9%) in MVM arm and N = 1039 (23.6%) in placebo arm over a median of 3.4 years (IQR: 3.0, 3.9) of follow-up, with hazard ratio (HR) 0.98 [95% CI: 0.90, 1.06]. Effects differed according to baseline diet quality, with HRs of incident hypertension 0.81 [0.70, 0.95] and 1.14 [1.01, 1.28] among participants with lower and higher Alternate Mediterranean Diet score, respectively (P-interaction = .001). There was no effect of MVM on 2-year changes in systolic BP (4.4 mmHg in MVM; 4.5 mmHg in placebo), while pronounced effects were observed for baseline normal BP (P-interaction = .004). MVM supplementation versus placebo did not reduce hypertension incidence or lower BP overall. Exploratory analyses showed greater reduction in hypertension risk and BP changes among those with lower dietary quality and normal BP at baseline, respectively. NCT02422745.

Sex differences in blood pressure (BP) regulation may modify associations between BP variability (BPV) and hypertension-mediated organ damage (HMOD), but organ-specific effects remain unclear. We studied 398 hypertensive patients from a multicenter home BP monitoring registry. The office-home BP difference (ΔBP = office-home) was analyzed as a single continuous exposure variable, with positive values indicating the white-coat effect and negative values indicating the masked effect. Multivariable regression examined sex-specific associations of BPV patterns with HMOD, including electrocardiographic left ventricular hypertrophy (ECG-LVH) and microalbuminuria/proteinuria. Women demonstrated higher home systolic BPV than men despite similar mean BP levels (P < .01). Office BP was the primary determinant of white-coat phenotypes (office SBP: adjusted odds ratio [aOR] 1.29 [95% CI: 1.22-1.37]; office DBP: aOR 1.27 [1.19-1.37], both P < .01), while home BP predicted masked phenotype (home SBP: aOR 1.23 [1.12-1.39]; home DBP: aOR 1.34 [1.23-1.48], both P < .01). White-coat effects showed protective associations with total HMOD (systolic aOR 0.97 [0.94-1.00], P < .05), while office BPV demonstrated consistent positive associations (systolic aOR 1.10 [1.05-1.16]; diastolic aOR 1.12 [1.05-1.20], both P < .01). Critically, significantly sex interaction emerged for ECG-LVH, while microalbuminuria/proteinuria showed consistent associations across sexes. Sex fundamentally modifies BP patterns-HMOD relationships in an organ-specific manner. Cardiac target organ damage requires sex-attentive monitoring approaches, while renal damage shows universal associations with office BPV. These findings support precision medicine approaches to hypertension management incorporating sex-specific BP assessment strategies.

Isometric exercise has emerged as an effective strategy for blood pressure (BP) management, offering potential advantages over traditional exercise modalities; however, evidence regarding its 24-h effects in medicated hypertensive postmenopausal women remains limited. This study investigated the effects of a single session of multijoint isometric exercise on 24-h ambulatory hemodynamic variables in medicated hypertensive postmenopausal women. In this randomized crossover trial, 10 medicated hypertensive postmenopausal women (59 7 years) completed two experimental sessions: an isometric exercise session and a control session. The isometric exercise consisted of six multijoint exercises (upper and lower limbs), each performed for three sets of 1 min at 30% of 1-repetition maximum, with 2-min rest intervals. The control session involved sitting at rest for an equivalent duration. Following each session, 24-h ambulatory BP monitoring was conducted. Significant systolic BP reductions were observed following the isometric exercise session compared with the control session at 1 h ( P < 0.05), 6 h ( P < 0.05), and 24 h ( P < 0.05). Diastolic BP was also reduced at 1 h ( P < 0.05) and 12 h ( P < 0.05). Both awake and asleep periods showed significant BP reductions for systolic and diastolic BP (all, P < 0.05). A single session of multijoint isometric exercise effectively reduces ambulatory BP over a 24-h period in medicated hypertensive postmenopausal women, including both awake and asleep periods. These findings support the potential clinical utility of isometric exercise as an adjunctive strategy for BP management in this population.

Cross-sectional associations between actigraphy-measured sleep and 24-h ambulatory blood pressure phenotypes among self-reported short sleepers with elevated blood pressure.

Elevating blood pressure in neurogenic orthostatic hypotension: Investigating the efficacy and tolerability of rebreathing therapy.

The effects of cold application on blood pressure in patients with hypertension: A randomized placebo-controlled trial.

Caribbean and South American team-based strategy to control hypertension (CATCH): Rationale and study design of a cluster randomized trial.

Nocturnal hypertension, especially with well-controlled daytime blood pressure (BP), has emerged as a significant risk factor for cardiovascular disease. This study investigated its prevalence by morning home BP cut-off values and examined associated patient characteristics using data from the Japan Morning Surge-Home Blood Pressure (J-HOP) study. This post hoc analysis included 2675 participants from the J-HOP study who had complete data on nighttime home BP, measured using validated automatic oscillometric devices. Nocturnal hypertension was defined as a nighttime systolic BP greater than or equal to 120 mmHg and diastolic BP greater than or equal to 70 mmHg. Among the participants, 60.5% had nocturnal hypertension. The proportion of patients with nocturnal hypertension decreased as the cut-off value for morning home BP was lowered: 40.5, 32.1, 23.7, and 14.6% for less than 135/85 mmHg, less than 130/80 mmHg, less than 125/75 mmHg, and less than 120/70 mmHg, respectively. The prevalence of nocturnal hypertension was significantly higher in individuals with diabetes compared with those without, at morning home BP thresholds of less than 135/85 mmHg (48.1 vs. 39.3%; P = 0.03) and less than 130/80 mmHg (41.0 vs. 30.6%; P = 0.01). Individuals taking diuretics had a significantly lower prevalence of nocturnal hypertension compared with those not taking diuretics, at a morning home BP threshold of less than 135/85 mmHg (35.3 vs. 42.9%; P = 0.01). A considerable number of patients continued to show nocturnal hypertension even at lower morning home BP thresholds. Diabetes may contribute to nocturnal hypertension despite well-controlled morning BP, while diuretic use may help prevent it.

Cardiovascular responses to a 3-minute Harvard step test in Paediatric competitive athletes.

Hypertensive disorders during the postpartum period are a major contributor to maternal morbidity and mortality. The most recent statistics suggest that 16% of pregnancies are complicated by hypertension, and that number is increasing. The majority of complications occur in the postpartum period, and new publications have revolutionized the way we manage postpartum hypertension. Recent studies have shown that tight blood pressure (BP) control in the postpartum period may decrease adverse maternal outcomes. Several studies have demonstrated that nifedipine lowers BP more effectively than labetalol, resulting in fewer readmissions. The use of diuretics is a topic of controversy, with mixed evidence regarding their effectiveness. A remote patient monitoring system may improve postpartum BP follow-up in low-resource settings. Patients with hypertension during pregnancy have an increased lifetime risk of cardiovascular diseases, and establishing care for long-term follow-up is an essential part of postpartum care. Contrary to historical teaching, not all hypertensive disorders are cured by delivery. Hypertension requires close follow-up during the fourth trimester, and these patients may benefit from tighter BP control. Further research should be done to establish guideline-based treatment and monitoring throughout the lifetime.

We investigated whether three days of hypoxic exposure in a hypobaric chamber, and the associated nocturnal periodic breathing (nPB), reduce sympathetic nerve activity (MSNA) transduction to blood pressure (BP). While hypoxia did not affect MSNA transduction to BP, larger drops in BP occurred following cardiac cycles without sympathetic bursts, suggesting increased reliance on sympathetic vasoconstrictor support for beat-to-beat BP. Prevention of nPB by inspiratory carbon dioxide administration did not affect MSNA transduction to BP in hypoxia.

This study aimed to validate the accuracy of the YuWell YE990 automated oscillometric upper-arm blood pressure (BP) monitor in pregnant adults according to the Advancement of Medical Instrumentation/European Society of Hypertension/International Organization for Standardization Common Criteria Universal Standard (ISO 81060-2:2018 + Amd.1:2020). Participants with normotension, hypertension without proteinuria, or pre-eclampsia were enrolled in this study. BP measurements were performed using a calibrated mercury sphygmomanometer (reference) and a YE990 device (test) following a same-arm sequential protocol conducted by two trained observers. A total of 46 participants (138 paired readings) were included in the final analysis. For criterion 1 of the standard, the mean difference between the test and reference devices was -2.9 ± 6.9 mmHg for systolic BP (SBP) and 0.0 ± 6.5 mmHg for diastolic BP (DBP), both within the required limits. For criterion 2, the subject-level SDs were 5.6 mmHg for SBP and 5.7 mmHg for DBP, also satisfying the ISO thresholds of 6.30 and 6.95 mmHg, respectively. YuWell YE990 met all accuracy criteria specified by the ISO 81060-2:2018 + Amd.1:2020 standard and is recommended for clinical use in pregnant populations.

To evaluate the efficacy and safety of transmucosal administration of detomidine gel to induce emesis in cats. Cats presenting on an emergency basis due to dietary indiscretion were eligible for enrollment at 2 emergency and specialty hospitals from January to August 2024. After baseline vital signs including heart rate, respiratory rate, and blood pressure were obtained, cats were administered 4 mg/m2 detomidine gel (Dormosedan gel) transmucosally and monitored for emesis for 15 minutes. After 15 minutes, 100 μg/kg atipamezole was administered IM for reversal, recheck vital signs were obtained, and a sedation score was recorded. 60 cats were enrolled, and 57 cats were included in the final dataset. Emesis was induced in 28 (49.1%) of the cats presented, and emesis did not occur in 29 cats (50.9%). The median time to emesis induction was 11 minutes (range, 2 to 18 minutes). Heart rate and respiratory rate were significantly reduced (-42.6 beats/min and -11.91 breaths/min, respectively) compared to baseline. Thirty-seven cats (69.8%) had recorded sedation scores of 0 to 1/4. No cats experienced complications from transmucosal detomidine that required medical intervention. Transmucosal detomidine gel induced emesis in 49.1% of cats. Changes in heart rate, blood pressure, respiratory rate, and sedation were observed but did not result in significant complications. Detomidine gel may be considered to induce emesis in cats, as it is moderately successful, is easy to administer, and appears to have manageable side effects.

Introduction: Hypertensive emergencies represent lifethreatening conditions characterised by acute elevations in blood pressure with evidence of target organ damage. They remain a significant contributor to cardiovascular, neurological, and renal morbidity and mortality, often leading to hospitalisation. Early detection of end-organ involvement is therefore crucial to prevent irreversible damage and improve clinical outcomes. Aim: To study the association between patients presenting with hypertensive emergency in the Medical Intensive Care Unit (MICU) and target end-organ damage across different genders and age groups. Materials and Methods: The present cross-sectional study was conducted among adult patients aged 18-80 years presenting with blood pressure ≥180/120 mmHg at R. D. Gardi Medical College and Charitable Hospital, Ujjain, Madhya Pradesh, India, over a period of six months, from June 2024 to November 2024. Demographic data, medical history, and other clinical information, including Electrocardiography (ECG), Two Dimensional (2D) echocardiography, chest X-ray, funduscopic examination, ultrasonography of the abdomen, and neuroimaging studies, were collected. Data were analysed using SPSS software (Statistical Package for the Social Sciences (SPSS) Inc., Chicago, IL), version 29.0.10, with a p-value &lt;0.05 considered statistically significant. Results: Among the 96 patients, 58 (60%) were male and 38 (40%) were female. The mean {±Standard Deviation (SD)} age was 58.66±12.62 years (range: 18-80 years). A past history of hypertension was present in 58 (60.4%) patients, with a mean duration of 6.51±4.34 years (range: 1-20 years). The most common forms of acute target organ damage were Cerebrovascular Accident (CVA) with retinopathy in 24 patients (25%), followed by Myocardial Infarction (MI) with retinopathy in 15 (15.6%), retinopathy alone in 13 (13.5%), retinopathy with pulmonary oedema and acute heart failure in 11 (11.5%), and MI alone in 10 patients (10.4%). Conclusion: Hypertensive emergencies were more frequent among middle-aged and elderly males, most of whom had a prior history of hypertension. CVAs and retinopathy were the leading complications, followed by MI either alone or in combination with retinopathy. Strengthening early detection and ensuring strict blood pressure control are essential to reduce the burden of target organ damage in these patients.

Vascular stiffness predicts plasma markers of neurodegeneration among older African Americans.

The effectiveness of financial incentives on clinical outcomes of cardiovascular disease risk factors: A systematic review and meta-analysis.

Risk-associated and clinically informative biomarkers for cardiovascular risk stratification in metabolic dysfunction-Associated steatotic liver disease.

To examine the effect of excess body weight on the blood pressure (BP) of children aged 6-12 years. This was a prospective longitudinal study conducted with 187 children at the participants' home in southern Brazil. BP was measured using the auscultatory method. Generalized linear mixed models, including fixed and random effects and adjusted for important covariates, were used to estimate the relative risk (RR) of excess body weight on the incidence of high BP in children throughout the three follow-ups of the study (at ages 6, 9, and 12 years). The prevalence of high BP increased from 25.0 to 66.7% in children with excess body weight from 6 to 12 years of age. For every 1 kg/m 2 increase in the child's BMI, there was an 8% increase (RR = 1.08, 95% confidence interval: 1.00-1.16, P = 0.042) in the risk of the child having high BP from 6 to 12 years of age, even after adjusting for prepregnancy BMI. Excessive BMI in children increased the risk of high BP in Brazilian children from 6 to 12 years of age. Special attention must be paid to children under 12 years of age with excess body weight to mitigate the onset of cardiovascular diseases throughout life.

Introduction: Ischaemic Heart Disease (IHD) and other cardiovascular conditions remain the foremost contributors to global illness and death, with India bearing a considerable share of this burden. Although progress has been made in treatment through medical and surgical approaches, inadequate patient awareness, limited self-care practices, and poor adherence to lifestyle changes continue to affect outcomes and Quality of Life (QoL). Nurse-led interventions, focusing on patient education, counselling, and ongoing support, have emerged as a potential strategy to address these challenges. Aim: To assess the impact of a nurse-led transitional care model on health outcomes (selected bio-physiological parameters) and QoL among individuals with IHD. Materials and Methods: A two-phase design was adopted. Phase I employed a mixed-methods exploratory approach at Dhiraj Hospital, Vadodara, Gujarat, India and Railway Hospital, Lucknow, India. The study period for Phase I was 7 weeks, including (quantitative data collection for 4 weeks and qualitative data collection for consecutive 3 weeks). Based on these findings, a structured video-assisted nurse-led intervention was developed. In Phase II, an experimental study was carried out involving 90 post-operative IHD patients, who were randomly allocated to intervention and control groups. The intervention group received structured counselling, video-assisted education, and weekly telephone follow-ups for 12 weeks, while the control group continued with routine care. Outcomes were assessed using the McNew Heart Disease Health-Related Quality of Life Questionnaire and clinical parameters such as Blood Pressure (BP), Body Mass Index (BMI), and lipid profile, as shown by the results of the mean, standard deviation, and Unpaired t-test results. Results: In Phase I, a total of 46 patients were included, and the mean age of participants was 55.36±7.00 and 56.2±6.34 among the control and intervention groups. The majority of the population (n=17) highlighted major gaps in patients’ understanding of lifestyle adjustments, medication adherence, recognition of danger signs, and follow-up practices. In Phase II, after 12 weeks of intervention, patients in the experimental group showed significant improvements in clinical variables life including systolic BP (p-value=0.001), diastolic BP (p-value=0.016), and BMI (p-value=0.004). Lipid profile changes were not statistically significant, as evident from the mean, standard deviation, and the Unpaired t-test results. Quality of life showed marked improvement in physical, social, and global domains (p-value &lt;0.001), though the emotional domain did not show significant change. Overall, 64.4% of participants in the intervention group reported good QoL compared to only 13.3% in the control group. Conclusion: The nurse-led intervention effectively improved QoL and clinical outcomes in IHD patients, highlighting the value of structured education, video learning, and follow-up, with larger multicentric studies needed to validate these findings.