TRPV1 Ile585Val polymorphism modulates acute blood-pressure response to traffic-related air pollution exposure.

Prehypertension (PHT) is a critical precursor to hypertension, increasing the risks of stroke, heart attack, and heart failure, and contributing to vascular and renal complications. Our aim was to describe health literacy variability in individuals with PHT. We assessed 340 patients with PHT from a tertiary hospital in Nanning, China, using validated instruments to measure health literacy, psychological capital, and health-related behaviors. Latent profile analysis was used to identify 3 health literacy profiles: low, moderate, and high. Key determinants included socioeconomic status, lifestyle behaviors, and psychological capital. Individuals with low health literacy exhibited cognitive barriers and low motivation, highlighting the need for personalized educational and psychological interventions. Moderate-literacy individuals showed potential for improvement through enhanced communication and engagement strategies. Those with high literacy demonstrated strong self-management and community advocacy capabilities. These results suggest targets for development of stratified, tailored interventions to bridge health literacy gaps that could reduce progression from PHT to hypertension. Future researchers should explore these profiles in diverse populations and evaluate the long-term effects of targeted interventions.

Background:Addressing the rising burden of stroke in low-income countries will require pragmatic and scalable interventions targeting major risk factors. Under routine care settings, <10% of adults living with hypertension ever achieve blood pressure control, accentuating risks for adverse vascular events. The effectiveness of mobile health-centred, nurse-led interventions for the control of hypertension among recent stroke patients in a resource-limited African setting is unknown.Methods:The Phone-based Intervention under Nurse Guidance after Stroke (PINGS) trial compared the efficacy and safety of usual care versus a 12-month intervention comprising home blood pressure self-monitoring with nurse case management for elevated home BP recordings, use of phone alarms as medication reminders, and once-weekly education about cardiovascular risk reduction delivered via regular telephonic audio messages in selected Ghanaian dialects. This was a multicenter, randomized, open-label, blinded end-point evaluation, trial conducted at ten (10) hospitals between 23 October 2020 and 5 April 2024. We enrolled 500 patients ≥18 years with stroke within one month of onset and elevated blood pressure ≥140 and/or ≥90 mmHg. Primary outcome was systolic BP < 140 mmHg at month 12 by intention-to-treat principle. Secondary outcomes included major adverse cardiovascular events (MACE) and serious adverse events.Results:244 participants were assigned to the intervention group (PINGS) and 256 to usual care (UC) group, 43% were women, mean [SD] age 58 [11] years. Mean change in SBP at month 12 from baseline was −5.5 mm Hg (95%CI: −9.6 to −1.4 mmHg), p=0.008. Primary outcome was achieved in 163 (67%) patients with PINGS vs. 109 (43%) in UC arm, between-group difference of 24% (95% CI: 15–33%), p<0.001. No significant between group differences was noted in the secondary outcome of MACE or the presumed key mediator of medication adherence. Serious adverse events were 27/244 (11.1%) with PINGS vs 18/256 (7.0%) in UC, p=0.12.Conclusions:Leveraging mhealth with minimal sophistication and task shifting to nurses on top of usual care could safely improve blood pressure control among stroke survivors in low-resource settings, but further study is warranted to confirm these findings and understand outcome drivers.Trial registration:NCT04404166

Background: Commercial drivers are usually in transit and exposed to street foods. Their dietary choice and lifestyle could be influenced by nutrition knowledge, and predispose them to hypertension. Objective: To determine the level of nutrition knowledge, elevated blood pressure (EBP), and associated factors. Design A cross-sectional study was conducted using an interviewer-administered questionnaire. Data were analysed through SPSS 29.0 at 5% level of significance (p < 0.05). Setting: Three hundred commercial drivers were randomly selected from four motor parks in Ondo West local government area, Nigeria. Results: Participants were all males with a mean age and daily income of 42.0 ± 10.42 years and ₦3 932 ± 2 897.61, respectively. The majority (69.0%) had secondary education, 44.7% travelled interstate, 13.7% smoked cigarettes and 39.7% drank alcohol, while 51.6% frequently ate outside the home, and 48.7% had adequate nutrition knowledge. Overweight, obesity and abdominal adiposity and EBP accounted for 45.0%, 6.7%, 84.3% and 29.3%, respectively. Nutrition knowledge was associated with level of education (aOR: 1.59, 95% CI: 1.03–2.47; p = 0.038), cigarette smoking (aOR: 3.23, 95% CI: 1.49–7.02; p = 0.003) and frequency of eating outside the home (aOR: 1.39, 95% CI: 1.15–1.68; p = <0.001) while EBP was associated with waist–hip ratio (aOR: 6.17, 95% CI: 1.01–37.64; p = 0.049), route of transportation (aOR: 1.94, 95% CI: 1.04–3.64; p = 0.038) and brisk walking (aOR: 1.96, 95% CI: 1.09–3.51; p = 0.023). Conclusion: The findings indicate that inadequate nutrition knowledge predisposes to an unhealthy lifestyle, while abdominal adiposity and inactivity contribute to elevated BP. Incorporating nutrition and physical exercise into health education will help to alleviate cardiometabolic risk among commercial drivers in Nigeria.

GHC-net: A gramian angular field based hybrid CNN for cuffless blood pressure classification using PPG signals.

Asymptomatic hypertension is common among emergency department (ED) patients. However, follow-up occurs infrequently. Because recognition of elevated readings is a prerequisite for referrals, we investigated the factors associated with the documentation of elevated BP measurements in provider notes. Electronic medical record (EMR) data from the University of Iowa Healthcare system were used to identify patients who had an outpatient ED, primary care, or urgent care visit with high BP (140/90mmHg or greater) from 01 January 2017 through 31 December 2021 and no prior hypertension diagnosis. We measured whether clinical notes from each visit mentioned hypertension or high BP and modeled the probability of that event across visits in ED, urgent care, and primary care settings. Covariates included the busyness of the care setting at the time of the visit, patient demographics, visit vitals and diagnoses. We identified 13,777 distinct patients with 18,036 ED visits, 3564 urgent care visits, and 27,895 primary care visits. Patient BP was discussed in the notes for 27% of ED visits compared to 51% of visits for both primary and urgent care. High BP was more likely to be mentioned in ED visit notes when the visit included diagnoses indicating chest pain and during times when the ED was substantially less busy than normal. High BP was also more likely to be mentioned in notes of the ED for patients with any prior diagnosis code of nonhypertension-related elevated BP. High BP levels are frequently not discussed in clinical and discharge notes.

ABSTRACT Muscle Quality Index (MQI), a novel health metric, is determined by the ratio of handgrip strength to skeletal muscle mass. Despite its potential significance, the association between MQI and circadian syndrome (CircS) has not been explored. This study aims to elucidate the potential association between MQI and CircS. In this study, a cross-sectional analysis was conducted on data from NHANES 2011–2014. And the association between MQI and CircS was explored through a range of statistical methods, including ROC curve analysis, multivariate logistic regression, RCS regression, and subgroup analysis. In this study, a cohort of 2250 American adults was enrolled, among whom 229 individuals (10.2%) were diagnosed with CircS. Both RCS and logistic regression analyses indicated a significant negative linear association between MQI and the prevalence of CircS (OR = 0.35, 95% CI = 0.26, 0.46), as well as its five components, including elevated FPG, elevated BP, elevated WC, reduced HDL, and depression. Subgroup analyses demonstrate that this independent association remained consistent across various demographics and lifestyle factors, including age, physical activity, gender, BMI, and alcohol abuse and smoking status. ROC analysis reveals that, compared to handgrip strength (HGS) and skeletal muscle mass, MQI (AUC = 0.713, 95% CI = 0.678, 0.747) serves as a more reliable factor for identifying CircS. The findings indicate a significant inverse association between MQI and CircS. Promoting physical exercise, especially resistance training, may mitigate the risk of CircS.

Visceral obesity contributes to hypertension through pathways of insulin resistance and inflammation. The joint association of C-reactive protein-triglyceride-glucose index (CTI), which integrates these pathways, and anthropometric indices with incident hypertension remains unclear, especially across different baseline blood pressure. The data for this study were obtained from the China Health and Retirement Longitudinal Study (CHARLS) across the 2011 to 2020 survey waves. Participants were stratified based on the median values of anthropometric indices and CTI. The associations with incident hypertension risk were evaluated using Kaplan-Meier curves, multivariable Cox regression, and restricted cubic spline (RCS) methods. Predictive performance was assessed by receiver operating characteristic (ROC) curve analysis, net reclassification improvement (NRI), and integrated discrimination improvement (IDI). Mediation and interaction analyses were conducted to explore potential mediating effects and the robustness of the findings. Among 4,735 eligible participants, the median age was 56years, and 46.04% were male. During the 9-year follow-up period, 1,852 participants (39.37%) developed hypertension. Cox regression analysis revealed that Compared with subjects with lower levels of both anthropometric indices and CTI, those with higher levels of both exhibited the highest risk of hypertension. Individuals with both BRI and CTI above the median consistently exhibited the highest risk of hypertension across all subgroups: HR = 1.51, 95% CI: 1.33-1.71 in the total population; HR = 1.58, 95% CI: 1.29-1.93 in the normal BP group; and HR = 1.45, 95% CI: 1.23-1.71 in the elevated BP group. After incorporating anthropometric indices and CTI into the basic model, the predictive performance for hypertension was significantly improved. The integrated model of BRI and CTI demonstrated the best overall predictive performance (AUC = 0.747). Mediation analysis revealed that CTI significantly mediated the association between anthropometric indices and hypertension. These anthropometric indices and CTI effectively predicted hypertension risk across populations with different baseline blood pressures, both independently and in combination. Among all evaluations, the combination of BRI and CTI emerged as the optimal approach, most robustly associated with incident hypertension and providing the greatest improvement in risk discrimination and reclassification.

Ambulatory blood pressure monitoring (ABPM), alongside peripheral blood pressure (BP) measurements, provides valuable insights into central hemodynamics, including pulse wave velocity (PWV), augmentation index (AI75%), and central pressure-factors closely linked to arterial stiffness. The progression of arterial stiffness is associated with matrix metalloproteinase-9 (MMP-9), an extracellular matrix enzyme. This study aims to assess the correlation between variables obtained through ABPM and MMP-9 levels across different BP categories. A total of 101 individuals were enrolled, divided into three groups: 21 normotensive (NT), 36 prehypertensive (PH), and 44 controlled hypertensive (CHT) participants. Peripheral and central BP parameters were evaluated using the Mobil-O-Graph® 24-hour PWA monitor, and plasma MMP-9 levels were measured in all participants. Participants' ages ranged from 30 to 71 years. MMP-9 concentrations were significantly higher in the PH group (4.74 ± 0.5 ng/mL) compared to the CHT group (4.41 ± 0.5 ng/mL; p = 0.002). MMP-9 levels showed a correlation with cardiac output and heart rate during all three ABPM evaluation periods (24h, wakefulness, and sleep). PWV values were higher in the CHT group than in the PH group (8.1 ± 1.2 vs. 6.9 ± 1; p = 0.0003), whereas AI75% did not differ significantly between the groups (22.6 ± 8.9 vs. 19.8 ± 7.4; p = NS). Prehypertensive individuals exhibit higher MMP-9 levels compared to controlled hypertensive patients, suggesting that antihypertensive therapy may contribute to reduced plasma MMP-9 levels.

American Scientific Societies (AHA/ACC and others) updated in 2025 the Guideline on High Blood Pressure following 2024 ESC and 2023 ESH updates from Europe. Guidelines mostly agree on who should receive pharmacotherapy and on a common target of systolic blood pressure (SBP <130 mmHg) and diastolic blood pressure (DBP) <80 mmHg for most, as well as on individualizing BP targets according to patient characteristics. However, they differ in nomenclature, pharmacotherapy for people at lower cardiovascular risk and aiming at SBP <120 mmHg. Overall, 2025 AHA/ACC supports pharmacotherapy earlier and achieving lower BP targets than other recent guidelines: it recommends (high CVD risk) or finds reasonable (not high CVD risk, if not corrected by lifestyle) initiating pharmacotherapy for hypertension, defined as SBP ≥130 mm Hg or DBP ≥80 mmHg. The recommended (high CVD risk) or reasonable (not high CVD risk) target is SBP at least <130 mmHg, with encouragement to achieve SBP <120 mmHg, and DBP <80 mmHg. However, 2024 ESC and 2023 ESH use alternative terms (high normal or elevated BP) for BP values (i.e., ≥130-139 or ≥80-89 mmHg) that require pharmacotherapy only in high-risk groups. Additionally, 2023 ESH recommends avoiding actively aiming for SBP <120 mmHg or DBP < 70 mmHg. 2024 KDIGO avoids the term hypertension and suggests a target SBP <120 mmHg for people with CKD. It would be desirable that guidelines converge on such key issues as nomenclature and therapeutic targets.

Cardiovascular disease (CVD) remains the leading cause of premature death in England, with ethnic minority populations disproportionately affected, largely due to differences in socioeconomic factors, exposure and/or susceptibility to CVD risk factors. Midlife risk assessment does not fully account for observed variation in CVD incidence and mortality. Early and precise quantification of risk factor burden across diverse populations is therefore essential to inform targeted prevention strategies. This study assessed the prevalence of CVD risk factors in apparently healthy individuals residing in London. This cross-sectional study included CVD-free individuals aged 30-90years residing in London and registered with general practices using the Egton Medical Information Systems (EMIS) electronic health record system. Unadjusted, crude estimates of traditional CVD risk factors were assessed across participants of different ethnicities who underwent a CVD risk assessment between 2009-2020. Among 607,327 registered individuals, 83,414 were included (52.0% women, median age 45 [IQR:36-48] years). Ethnic distribution was as follows: White (43.6%), Asian (30.1%), Black (9.7%), Chinese/Other (4.0%), Mixed (2.1%). Overall, 7.8% were current smokers, 31.5% had obesity (universally defined as body mass index (BMI) ≥ 30.0kg/m2), 48.5% had elevated blood pressure (BP ≥ 140/90mmHg), 44.9% had hypercholesterolemia (≥ 5.0mmol/l), 28.2% had elevated triglycerides (TG) ≥ 1.7mmol/l, and 25.9% had low high-density lipoprotein cholesterol (HDL-C < 1.0/1.3mmol/l for males/females, respectively). Smoking prevalence was highest among White individuals (9.7%). Obesity prevalence varied across groups, with higher proportions in Black participants (42.3%) and lower in Asian individuals (26.1%). Elevated BP was recorded more frequently in Mixed (54.9%) and Black (53.0%) participants and less frequently in those classified as Chinese/Other (42.7%). Total cholesterol ≥ 5.0mmol/L was more commonly documented in Mixed (56.8%) and White (49.8%) participants. Higher proportions of Asian individuals had elevated TG (30.9%) and low HDL-C (31.6%), while corresponding proportions were lower among Black participants (14.4% and 19.5%, respectively). This large-scale analysis of a diverse population suggests variation in CVD risk factor burden among relatively young individuals without CVD. While not implying causality, these findings reflect inequalities between ethnic groups and support an appraisal of early, tailored, and equitable public health policies to improve CVD risk management across diverse populations.

To investigate the association between longitudinal trajectories of metabolic risk clusters and the risk of progression to end-stage kidney disease (ESKD) and major adverse kidney events (MAKEs) in patients with chronic kidney disease (CKD). Prospective registry-based cohort study. Secondary and tertiary care settings in Taiwan, using data from a multidisciplinary pre-ESKD care programme. A total of 1494 adult patients with CKD stages 3b-5 enrolled in a structured pre-ESKD care programme. Time to initiation of dialysis (primary outcome) and time to MAKE, defined as a composite of dialysis initiation or all-cause mortality (secondary outcome). Group-based multitrajectory modelling was used to categorise longitudinal trajectories of metabolic risk clusters, including systolic blood pressure, fasting blood glucose and low-density lipoprotein (LDL) cholesterol. Four trajectory groups were identified: Group I had controlled blood pressure and glucose but elevated LDL (dialysis incidence: 19.5 per 1000 person-years); Group II had borderline-high blood pressure and elevated glucose (33.6 per 1000 person-years); Group III had controlled glucose and low LDL but borderline-high blood pressure (38.8 per 1000 person-years) and Group IV had controlled glucose but elevated blood pressure and LDL (46.7 per 1000 person-years). Compared with the other groups, Group I exhibited significantly longer dialysis-free and MAKE-free survival (log-rank test, p<0.001). With covariates adjusted for, Groups II (HR 1.02, 95% CI 0.52 to 2.00) and III (HR 1.46, 95% CI 0.85 to 2.52) showed non-significant elevations in dialysis risk, whereas Group IV (HR 1.96, 95% CI 1.01 to 3.78) exhibited a significantly higher risk compared with Group I. Similar patterns were observed for MAKE outcome, confirming the association between trajectory groups and adverse kidney events. Longitudinal trajectories of metabolic risk cluster are associated with differential risks of CKD progression to ESKD and death. Our findings provide valuable insights into the monitoring of metabolic risk profiles over time in patients with CKD.

Impact of the mindfulness-based blood pressure reduction (MB-BP) program on cardiovascular health: A randomized clinical trial

Synergistic gut microbiome-host lipid axis underlies the antihypertensive effect of Qianyang Yuyin formula.

Despite sustained public health efforts, hypertension remains highly prevalent in the United States, with persistent disparities across demographic and socioeconomic groups. We examined 25-year trends in hypertension prevalence, undiagnosed hypertension, and on-treatment uncontrolled hypertension in the United States using nationally representative National Health and Nutrition Examination Survey (NHANES) data from adults aged ≥18 years. Hypertension was defined as systolic BP ≥130 mmHg, diastolic BP ≥80 mmHg, or current antihypertensive use. Undiagnosed hypertension was defined as elevated BP without prior diagnosis or treatment, while on-treatment uncontrolled hypertension was defined as diagnosed hypertension with BP ≥130/80 mmHg despite treatment. Survey-weighted generalized linear models were used to estimate adjusted prevalence ratios (PRs), accounting for age, sex, race and ethnicity, family income-to-poverty threshold ratio, and study period, with interaction terms to assess differential temporal trends. Among 61,847 participants (51.7% women; 21.0% Black; 25.1% Hispanic; 23.2% aged >65 years), adjusted hypertension prevalence was 44.3% (95% CI: 43.6-44.9) and remained stable over time (p for trend = 0.50). Relative to >65 years adults, hypertension prevalence increased significantly over time among the younger groups. Compared to White adults, Black adults had higher hypertension prevalence (52.7% vs 44.7%; p < 0.001), and Hispanic adults experienced a greater increase in prevalence over time. Among individuals with hypertension, undiagnosed hypertension declined from 46.4% to 41.5%, and on-treatment uncontrolled hypertension declined from 74.7% to 63.9% (both p < 0.001). Despite improvements in diagnosis and treatment control, hypertension prevalence remains high, with persistent sociodemographic disparities highlighting the need for targeted and equity-focused interventions.

A recent survey in the Philippines, PRESYON-4, showed increasing prevalence of hypertension from 22% in the 1990s to 37% in 2021, of which only 52% were aware of their diagnosis. While rates of treatment and adherence were 68% and 86%, respectively, the rate of BP control was low at 37%. Furthermore, there remained a high degree of unawareness regarding hypertension, its role in CV morbidity and mortality, and how it can be optimally managed. In particular, there is a knowledge gap in the diagnostic approach and management of severe acute elevations in blood pressure. In response to this, the Philippine Society of Hypertension, Philippine Heart Association, and multiple experts from various sectors worked together to develop the 2024 Clinical Practice Guideline on the Diagnosis and Management of Severe Blood Pressure Elevation. The CPG provides eleven (11) recommendations and four (4) best practice statements addressing key clinical questions on the diagnosis and management of severe BP elevation. The guideline development process adhered to the GRADE approach through the Evidence to Decision (EtD2) framework, including the identification of critical questions and outcomes, retrieval of current evidence, appraisal and synthesis of the evidence, and formulation of draft recommendations. A multisectoral consensus panel (CP) was convened to discuss values, preferences, and socioeconomic impact and finalize the strength of the recommendations. The CPG is intended to be used by general practitioners, specialists, family physicians, allied health professionals, emergency medical personnel, and healthcare workers who may encounter adult patients with hypertension, whether in the inpatient or outpatient setting.

Objective: Prevalence of pre-high blood pressure and hypertension in early adolescent children between 12-14years old age. Study Design: Cross-section studyPlace and Duration of Study: This study was conducted at the schools of intermediate public in Al-Diwaniyah Governorate, Iraq from 1st January 2023 to 15th April 2023. Methods: This cross-section study was done in schools of intermediate public in Al-Diwaniyah Governorate, Iraq. The participants were carried out on 200 (100 males and 100 females) early adolescent children aged 12-14 years. Results: There were79% of normal blood pressure values, and 13% of them were in pre hypertension state with 4:5 male to female rate, 2% of them were in hypertension stage 1 with 3:1 male to female rate, 1% were stage 2 all females, 1.5% were isolated systolic hypertension with 1:2 male to female rate, 2% were isolated diastolic hypertension with 1:3 male to female rate, and the remainder were white coat hypertension. Conclusion: The increasing prevalence of hypertension in childhood were carrying problem of global health, demands early recognition with good treatment, a guide in a specific direction evolve progress with raise awareness of this subject shall be predicted, where early prevention could resolute before all measures.

Background/Objectives: Insulin resistance and ambulatory blood pressure monitoring (ABPM) abnormalities represent distinct but interrelated pathways contributing to cardiovascular risk. The triglyceride–glucose (TyG) index reflects metabolic burden, whereas arterial load—captured through arterial stiffness, blood pressure variability, and morning surge—reflects hemodynamic instability. Whether the coexistence of these domains identifies a particularly high-risk ambulatory phenotype remains unclear. To evaluate the independent and combined effects of metabolic burden (TyG) and arterial load on circadian blood pressure pattern and short-term systolic blood pressure variability. Methods: This retrospective cross-sectional study included 294 adults who underwent 24 h ABPM. Arterial load was defined using three ABPM-derived indices (high AASI, high SBP-ARV, high morning surge). High metabolic burden was defined as TyG in the upper quartile. The “double-high” phenotype was classified as high TyG plus high arterial load. Primary and secondary outcomes were non-dipping pattern and high SBP variability. Multivariable logistic regression and Firth penalized models were used to assess independent associations. Predictive performance was evaluated using ROC analysis. Results: The double-high phenotype (n = 15) demonstrated significantly higher nighttime SBP, reduced nocturnal dipping, and markedly elevated BP variability. It was the strongest independent predictor of non-dipping (adjusted OR = 42.0; Firth OR = 11.73; both p < 0.001) and high SBP variability (adjusted OR = 41.7; Firth OR = 26.29; both p < 0.001). Arterial load substantially improved model discrimination (AUC = 0.819 for non-dipping; 0.979 for SBP variability), whereas adding TyG to arterial load produced minimal incremental benefit. Conclusions: The coexistence of elevated TyG and increased arterial load defines a distinct hemodynamic endotype characterized by severe circadian blood pressure disruption and exaggerated short-term variability. While arterial load emerged as the principal determinant of adverse ambulatory blood pressure phenotypes, TyG alone demonstrated limited discriminative capacity. These findings suggest that TyG primarily acts as a metabolic modifier, amplifying adverse ambulatory blood pressure phenotypes predominantly in the presence of underlying arterial instability rather than serving as an independent discriminator. Integrating metabolic and hemodynamic domains may therefore improve risk stratification and help identify a small but clinically meaningful subgroup of patients with extreme ambulatory blood pressure dysregulation.

To evaluate the gender-specific predictive performance of 12 anthropometric indices for metabolic syndrome (MetS) among Lahu ethnic adults with dyslipidemia. This cross-sectional study employed stratified cluster sampling in two Lahu communities in southwest China. MetS was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) criteria. Twelve indices were assessed: body mass index (BMI), waist circumference (WC), lipid accumulation product (LAP), visceral adiposity index (VAI), a body shape index (ABSI), body adiposity index (BAI), body roundness index (BRI), relative fat mass (RFM), uric acid-to-HDL-C ratio (UHR), triglyceride-glucose index (TyG), cardiometabolic index (CMI), and Chinese visceral adiposity index (CVAI). Receiver operating characteristic (ROC) curve analysis evaluated predictive performance, and binary logistic regression assessed associations with MetS and its components. This study of 1257 Lahu adults with dyslipidemia (48.5% male) revealed a 23.4% MetS prevalence, significantly higher in females (29.2% vs 17.2%, p<0.001). The TyG index emerged as the strongest MetS predictor in both sexes (AUC: males 0.828, females 0.784), followed by CMI, VAI, LAP and CVAI with moderate predictive ability (AUC range: 0.678-0.779). Other indices showed limited predictive value, while ABSI was not significant. For MetS components, BRI showed strong associations with elevated BP in both genders (males: 1.666[1.228-2.261]; females: 1.804[1.388-2.344]) and with elevated TG (1.644[1.248-2.166]) in males. Female‑specific associations included VAI with reduced HDL‑C, and BMI/CVAI with elevated FPG. Among dyslipidemic Lahu adults, all indices except ABSI demonstrated predictive efficacy for MetS, with the TyG index outperforming all others. These simple, low-cost indices could be applied for early MetS screening or risk stratification in this population, particularly in rural or resource-limited settings. Notably, gender-specific differences should be considered in clinical applications.

Hypertension (HT) is a 'by-product' to the forces of natural selection against environmental drift and salt availability, therefore contributed to differential HT susceptibility. This study provides further supporting evidence through: (i) associating three salt-sensitive related candidate gene variants, to the susceptibility of HT among the Malays from Peninsular Malaysia with a detail genotype-phenotype evaluation; (ii) comparing the blood pressure and the frequency spectrums of these variants across global populations; (iii) correlating them with the geographical coordinates and BP of the respective populations, and evaluating the presence of local adaptation in these candidate variants. We tested the genetic association of six SNPs underlying CYP11B2, AGT and ADRB2 in 918 normotensives and hypertensives Malays, men and women. CYP11B2 and ADRB2 were associated with elevated BP in males and females, respectively. Evaluation of these gene variations across 38 populations residing in different latitudinal clines revealed strong correlations between CYP11B2, AGT and latitudinal coordinates; whilst ADRB2 to a weaker extent. Tajima's D analyses suggested a non-neutral evolution on CYP11B2, which suggested a modest putative signals of local adaptation. In summary, we complement the notion that effective pharmacogenetic marker(s) to predict responsiveness of anti-HT medication requires comprehensive characterization of population genetics and HT phenotypes.