Pressure Management Research Articles

Medical Management of Acute Stroke based on Japan Stroke Society Guidelines and the Japan Stroke Data Bank.

Stroke is a leading cause of death and disability in Japan, necessitating standardized treatment guidelines. The Japan Stroke Society (JSS) periodically revises its guidelines to incorporate new research. This review provides a short overview of acute stroke management based on JSS Guideline 2021 (revised 2023) and the Japan Stroke Data Bank (JSDB), and discusses future directions in stroke management. Acute stroke management emphasizes systemic support and complication management. Risk factor control during acute hospitalization is also crucial for preventing recurrent strokes in the chronic phase.In ischemic stroke, super-acute recanalization therapies, including intravenous thrombolysis and mechanical thrombectomy, are the most important and effective. Antiplatelet therapy, particularly aspirin and clopidogrel, is recommended for noncardiogenic stroke and high-risk transient ischemic attack. In cardioembolic stroke, early initiation of direct oral anticoagulants might be considered according to stroke severity.For brain hemorrhage, early blood pressure management is recommended. Specific reversal agents are advised for patients on anticoagulant therapy. Minimally invasive hematoma removal may improve outcomes for intracerebral hemorrhage.Subarachnoid hemorrhage treatments reported from Japan include intravenous drugs to prevent vasospasm.The JSDB revealed improvements in functional outcomes in patients with ischemic stroke over the past 20 years, although patients with hemorrhagic stroke showed no clear improvement. The evolving guidelines and research underscore the importance of stratified and timely intervention in stroke care.

Design and rationale of penn medicine healthy heart, a randomized trial of effectiveness of a centrally organized approach to blood pressure and cholesterol improvement among patients at elevated risk of atherosclerotic cardiovascular disease

Atherosclerotic Cardiovascular Disease (ASCVD) is the leading cause of morbidity and mortality in the United States. Suboptimal control of hypertension and hyperlipidemia are common factors contributing to ASCVD risk. The Penn Medicine Healthy Heart (PMHH) Study is a randomized clinical trial testing the effectiveness of a system designed to offload work from primary care clinicians and improve patient follow-through with risk reduction strategies by using a centralized team of nonclinical navigators and advanced practice providers, remote monitoring, and bi-directional text messaging, augmented by behavioral science engagement strategies. The intervention builds on prior nonrandomized evaluations of these design elements that demonstrated significant improvement in patients' systolic blood pressure and LDL Cholesterol (LDL-C). Penn Medicine Healthy Heart will significantly improve systolic blood pressure and LDL-C compared to usual care over the 6 months of this intervention. Randomized clinical trial of Penn Medicine Healthy Heart in patients aged 35-80 years at elevated risk of ASCVD whose systolic blood pressure and LDL-C are not well controlled. The intervention consists of 4 modules that address blood pressure management, lipid management, nutrition, and smoking cessation, offered in a phased approach to give the participant time to learn about each topic, adopt any recommendations, and build a relationship with the care team. University of Pennsylvania Health System at primary care practices located in inner-city urban and rural/semi-rural areas. Improvement in systolic blood pressure and LDL-C. Cost-effectiveness analyses are planned to evaluate the health care costs and health outcomes of the intervention approach. An implementation evaluation is planned to understand factors influencing success of the intervention. 2,420 active patients of Penn Medicine primary care practices who have clinical ASCVD, or who are at elevated risk for ASCVD, and who are (a) not on statins or have LDL-C >100 despite being on statins and (b) had systolic blood pressure >140 at 2 recent ambulatory visits. March 2024-March 2025. The intervention will last 6 months with a 12-month follow-up to determine whether its effects persist. Enrolling (1,240 enrolled as of August 15, 2024) CLINICAL TRIAL REGISTRATION: NCT06062394.

Боротьба з корупцією в українському публічному секторі: оцінка ефективності антикорупційних стратегій та шляхи подальшого вдосконалення

The article is devoted to the analysis of the effectiveness of anti-corruption strategies in the Ukrainian public sector and the determination of ways of their further improvement. The main problems that hinder the successful fight against corruption in the state structures of Ukraine are investigated, and the existing strategies and their results are analysed. Based on the collected information, specific recommendations are offered to improve the effectiveness of anti-corruption measures in the public sector. One of the main factors complicating the fight against corruption in Ukraine is the insufficient effectiveness of the legal system, the weakness of law enforcement agencies, and the lack of a clear political will to carry out reforms. Insufficient coordination between various authorities and insufficient control over their activities is often observed, which makes it difficult to detect and punish corruption offences. In the context of anti-corruption strategies in Ukraine, several legislative acts were adopted and specialized agencies, such as the National Anti-Corruption Bureau and the Specialized Anti-Corruption Prosecutor’s Office, were established. However, some of these measures have not produced the expected results due to insufficient financial support, political pressure or ineffective management. To further improve anti-corruption strategies, it is important to pay attention to several aspects. First, it is necessary to ensure greater transparency and openness in the activities of state bodies, in particular, by implementing a system of electronic document circulation and public reporting. Secondly, it is important to strengthen the mechanisms of control over the activities of public officials and ensure their independence frompolitical influence. Thirdly, it is necessary to reformthe judicial systemto ensure objective examination of corruption cases and imposition of appropriate punishments.

Techno-economic design and placement tool for energy recovering pressure regulating turbines in water distribution systems

Water distribution systems present poor energy efficiency due to the significant amount of energy that dissipates in the form of excess water pressure. Besides energy losses, excess pressure increases water losses due to leakages and may result in pipeline damage. The employment of micro-turbines that concurrently harness excess energy and achieve pressure management is proposed by many researchers as potential replacements to the currently used pressure reduction valves. This work relies on previous work that determines the optimal design and operating point of such turbines integrated in the power distribution system, in order to develop an algorithm that considers the economic viability of such projects. The suggested algorithm has been applied to a simulated large-scale WDS in Kentucky that contains several locations where pressure regulation is currently performed or planned due to immense local pressure. Involving the economic viability of pressure regulating turbines within the design optimization process improves pay-back period and levelized cost of energy by more than 10 % and 20 %, respectively, compared to when their design is optimized solely for pressure regulation and maximum energy yield. The application of this approach to a typical WDS allowed more than 161 MWh/year of clean energy to be produced.

Prevalence of Pre-Hypertension and Hypertension in Rural Adults: The Role of Lifestyle and Yoga Participation

Hypertension (HTN) and pre-hypertension are significant global health challenges, particularly in rural populations where access to healthcare and lifestyle education is limited. This cross-sectional study, conducted at a tertiary care hospital in Erode, Tamil Nadu, beginning in October 2022, aimed to quantify the prevalence of hypertension and pre-hypertension among 412 rural adults and explore the role of lifestyle factors, particularly yoga participation, in blood pressure management. A total of 412 participants were surveyed for demographic details, lifestyle habits, and health metrics such as blood pressure, BMI, and heart rate. Hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg and diastolic blood pressure (DBP) ≥90 mmHg, while pre-hypertension was defined as SBP 120-139 mmHg or DBP 80-89 mmHg. The study found a 32% prevalence of hypertension and a 28% prevalence of pre-hypertension. Regular yoga participants had significantly lower systolic (mean 120 mmHg) and diastolic (mean 75 mmHg) BP compared to nonpractitioners (mean SBP 135 mmHg, DBP 85 mmHg). These findings highlight the critical role of yoga and lifestyle changes in managing blood pressure in rural populations, supporting the need for public health policies that promote yoga as a preventive intervention.

Anesthetic Management of Acute Ischemic Stroke Undergoing Mechanical Thrombectomy: An Overview.

Ischemic stroke, caused by the interruption of the blood supply to the brain, requires prompt medical intervention to prevent irreversible damage. Anesthetic management is pivotal during surgical treatments like mechanical thrombectomy, where precise strategies ensure patient safety and procedural success. This narrative review highlights key aspects of anesthetic management in ischemic stroke, focusing on preoperative evaluation, anesthetic choices, and intraoperative care. A rapid yet thorough preoperative assessment is crucial, prioritizing essential diagnostic tests and cardiovascular evaluations to determine patient frailty and potential complications. The decision between general anesthesia (GA) and conscious sedation (CS) remains debated, with GA offering better procedural conditions and CS enabling continuous neurological assessment. The selection of anesthetic agents-such as propofol, sevoflurane, midazolam, fentanyl, remifentanil, and dexmedetomidine-depends on local protocols and expertise balancing neuroprotection, hemodynamic stability, and rapid postoperative recovery. Effective blood pressure management, tailored airway strategies, and vigilant postoperative monitoring are essential to optimize outcomes. This review underscores the importance of coordinated care, incorporating multimodal monitoring and maintaining neuroprotection throughout the perioperative period.

Letter to the editor: The role of postoperative blood pressure management in early postoperative hemorrhage in awake craniotomy glioma patients

Letter to the editor: The role of postoperative blood pressure management in early postoperative hemorrhage in awake craniotomy glioma patients

Innovation, simplification, and adherence to real life, 2024 ESC guidelines of elevated blood pressure and hypertension claimed for

Some relevant key messages from the first presentation of the 2024 ESC Guidelines for the management of elevated blood pressure (BP) and hypertension.Image 1.

The Benefits of Lifestyle Changes in the Management of Hypertension: A Review of the Literature

Introduction: Hypertension has been identified as an important health problem worldwide. It is a major factor in cardiovascular diseases with a resultant high mortality rate. Understanding the role of lifestyle modification in the management of hypertension is important in improving the health of the population, especially in middle-aged adults. Aim: The aim of this research is to identify and evaluate the positive effects of lifestyle changes, specifically dietary modifications and physical activities in the management of hypertension. Methods: This study employed a systematically structured literature review, with emphasis on important studies that focused on lifestyle changes and their effect on hypertension. The review focused on peer-reviewed articles that addressed dietary interventions and physical activity levels among middle-aged adults with hypertension. Results: The research revealed that changes in the lifestyle if properly implemented would have a positive impact on the management of high blood pressure. A more personalized dietary regimen and regular exercise are the strategies that were singled out as efficient for reducing blood pressure Conclusion: The findings of this study underscore the importance of lifestyle modifications in the management of hypertension. When applied correctly, these changes can significantly contribute to better health outcomes and reduced risks associated with high blood pressure.

Impact of expected blood pressure reduction on patient preferences for pharmaceutical and renal denervation treatment.

Effective patient-centered care requires an adequate understanding of patient preferences for different therapeutic options. We modelled patient preference for blood pressure (BP) management by pharmaceutical or interventional treatments such as renal denervation in patients with different profiles of uncontrolled hypertension. Modeling was based on the findings from a previously conducted quantitative discrete choice experiment (DCE). The likelihood of selecting either an interventional treatment option or additional antihypertensive medication option was calculated for three patient profiles that represent the range of patients with hypertension commonly encountered in clinical practice: treatment-naive, patients with uncontrolled BP while on one to three antihypertensive medications, and patients with drug-resistant hypertension. Variables in the preference model were treatment attributes from the DCE study: expected reduction in office SBP with each treatment, duration of treatment effect, risk of reversible drug side effects from drugs, and risk of temporary pain and/or bruising or vascular injury from interventions. Values of the variables were derived from published clinical studies or expert opinion. The model predicted that the likelihood of choosing renal denervation over initiating pharmacotherapy was 17.2% for previously untreated patients, 23.7% for patients with moderate hypertension currently on pharmacotherapy, and 41.8% for patients with drug-resistant hypertension. The dominant variable driving preference in these models was the expected BP reduction. Patient preferences for intervention are greater when drug nonadherence or increased SBP reduction at 3 vs. 1 year are included in the model. Baseline BP, drug side effects, or risks of the procedure had little influence on decisions. Modeling using patient preference weights predicts that a substantial minority of patients favor an interventional treatment such as renal denervation over initiation or escalation of medications. Awareness of a patient's interest in device-based versus pharmaceutical strategies should inform the shared decision-making process for hypertension treatment.

Unattended versus conventional blood pressure measurements in hospitalized hypertensive patients.

This study aims to compare the differences between unattended and conventional blood pressure measurements in hospitalized hypertensive patients. In fall of 2019, hypertensive patients at Ruijin Hospital underwent two rounds of unattended and conventional (nurse-monitored) blood pressure measurement. Both rounds used the same electronic blood pressure monitor with measurements taken three times, 30 s apart. Comparison was made using intra-class correlation coefficients, Bland-Altman plots, paired t-tests, etc. Among the 92 subjects in the study, the median age was 50 years old, with women accounting for 33.7%. Among the subjects, the median duration of hypertension was 8.0 years. The prevalence of diabetes, coronary heart disease, and stroke were 26.1%, 5.4%, and 6.5%, respectively. Whether unattended or conventional measurements were taken first, the average blood pressure measured first was slightly higher than the one measured later, but the difference was within 1-2 mmHg. Except that the average DBP during the round of conventional blood pressure measurements was significantly reduced by 1.6 mmHg compared to the conventional DBP, there were no other significant differences. Subgroup analysis by age, gender, BMI, and diabetes showed no significant difference in blood pressure measurement results between unattended and conventional methods. No significant difference was observed between unattended and conventional methods of blood pressure measurement in hospitalized hypertensive patients. Unattended blood pressure measurement can be adopted as the current standard for blood pressure management in hospitalized patients.

What is New in the ESC Hypertension Guideline?

Blood pressure guidelines serve as a beacon of best practice for the diagnosis and management of hypertension. The many cultural and societal differences in hypertension risk factors and management patterns across geographic regions support the need for geographically distinct international guidelines. In 2018, the European Society of Cardiology (ESC) and European Society of Hypertension (ESH) released a joint guideline for the management of hypertension.1 This guideline represented a unified front across European hypertension-oriented societies. Similar to preceding hypertension guidelines, the 2018 guideline highlighted the myriad risks associated with inadequate blood pressure management and the importance of improving blood pressure control. The 2018 ESC/ESH guideline also offered a litany of nuanced recommendations on blood pressure measurement and management, including tiered blood pressure diagnosis and management thresholds across various ages and risk factors. For example, the guidelines recommended initiating antihypertensive therapy at a systolic blood pressure threshold of ≥140 mm Hg or a diastolic blood pressure of ≥90 mm Hg in individuals aged 18-79 years, and at a systolic blood pressure threshold of ≥160 mm Hg in individuals aged ≥80 years; treatment initiation could be considered at a blood pressure of ≥130/85 among individuals with established cardiovascular disease. Among individuals being treated for hypertension, the guideline recommended aiming for an initial blood pressure goal of <140/90 mm Hg in all individuals, and if tolerated, further aiming for a systolic blood pressure of 120-129 mm Hg in most individuals aged <65 years and considering a diastolic blood pressure of <80 mm Hg in all individuals. In contrast, contemporary to these guidelines, the 2017 American College of Cardiology/American Heart Association guidelines more broadly recommended stringent blood pressure diagnostic thresholds (≥140/90 mm Hg in lower risk individuals; ≥130/80 mm Hg in higher risk individuals including those with ≥10% 10-year risk of atherosclerotic cardiovascular disease) and management goals (<130/80 mm Hg in all individuals with hypertension). Thus, the 2018 ESC/ESH guideline focused much more on individualized goals. [See the full article for more].

Investigating water quality dynamics in distribution networks with dynamically adaptive connectivity

ABSTRACT Water distribution networks with dynamically adaptive connectivity offer greater operational flexibility. While this strategy has demonstrated improvements in pressure management and network resiliency, further research is needed to better understand its impact on water quality dynamics. This paper investigates the short-term variability of disinfectant residuals in a real-world distribution network operated with dynamic connectivity. We simulate water quality dynamics under two control configurations with pressure control and automatic flushing valve operations. Our simulation results inform the development of flow variability metrics to reveal the relationship between changing hydraulic conditions and increased water quality dynamics. These metrics can (i) improve observability by supporting the placement of additional water quality monitoring locations and (ii) enhance controllability by enabling the formulation of optimization problems that incorporate hydraulic surrogates for modelling water quality. Furthermore, we validate the identified regions of increased water quality dynamics using continuous disinfectant data from a large-scale experimental programme. Our findings emphasize the need for further analytical and experimental research to manage water quality in distribution networks with dynamically adaptive connectivity and hydraulic control.

Blood pressure management strategies and podocyte health.

Hypertension (HTN) is one of the key global cardiovascular risk factors, which is tightly linked to kidney health and disease development. Podocytes, glomerular epithelial cells that play a pivotal role in maintenance of the renal filtration barrier, are significantly affected by increased glomerular capillary pressure in HTN. Damage or loss of these cells causes proteinuria, which marks the initiation of the HTN-driven renal damage. It goes without saying that effective BP management should not only mitigate cardiovascular risks but also preserve renal function by protecting podocyte integrity. This review offers a comprehensive examination of current blood pressure (BP) management strategies and their implications for podocyte structure and function and emphasizes strategies for the reduction of proteinuria in HTN. We explore primary and secondary antihypertensive agents, including ACE inhibitors, ARBs, calcium channel blockers, diuretics, as well as newer therapies (SGLT2 blocking and endothelin receptor antagonism), emphasizing their mechanistic roles in safeguarding podocytes and curtailing proteinuria.

Closing the Trauma Performance Improvement Loop With In-situ Simulation

IntroductionContinuous performance improvement (PI) programs are essential for excellent trauma care. We incorporated PI identified from trauma cases into an in-situ simulation-based medical education curriculum. This is a proof-of-concept study exploring the efficacy of high-fidelity pediatric trauma simulations in improving self-reported provider comfort and knowledge for identified trauma PI issues. MethodsThis study was performed at an American College of Surgeons-verified Level I Pediatric Trauma Center. Several clinical issues were identified during the trauma PI process, including management of elevated intracranial pressure in traumatic brain injury and the use of massive transfusion protocol. These issues were incorporated into a simulation-based medical education curriculum and high-fidelity in-situ trauma mock codes were held. In-depth debriefing sessions were led by a senior faculty member after the simulations. The study participants completed pre- and postsimulation surveys. Univariate statistics are presented. ResultsTwenty three providers completed surveys for the pediatric trauma simulations. Self-reported provider confidence Likert scale improved from pre- to postsimulation (P = 0.02) and trauma experience and knowledge scores improved from 82% presimulation to 93% postsimulation (P = 0.02). ConclusionsHigh-fidelity pediatric trauma simulations enhance provider comfort, knowledge, and experience in trauma scenarios. By integrating high-fidelity trauma simulations to address clinical issues identified in the trauma PI process, provider education can be reinforced and practiced in a controlled environment to improve trauma care. Future studies evaluating the implementation of clinical pathways and patient outcomes are needed to demonstrate the effectiveness of simulations in PI pathways.

Robot-assisted laparoscopic hepatectomy for hepatocellular carcinoma with Fontan-associated liver disease: a world-first case report

BackgroundFontan-associated liver disease (FALD) encompasses hepatic complications following the Fontan procedure, ranging from fibrosis to hepatocellular carcinoma (HCC). Despite advancements in surgical techniques and perioperative care, robot-assisted laparoscopic hepatectomy (RALH) for HCC in patients with FALD has not been previously reported owing to concerns about the Fontan circulation.Case presentationWe present the first case of RALH for recurrent HCC in a 45-year-old man after the Fontan procedure. The preoperative evaluation confirmed good cardiac function. The procedure involved meticulous monitoring and management of central venous pressure and was successfully completed with minimal blood loss. Postoperative recovery was uneventful. With thorough preoperative cardiac assessment and close collaboration between cardiologists and anesthesiologists, RALH can be safely performed in selected patients with FALD.ConclusionsEven if a patient has a history of FALD, RALH can be safely performed in selected patients under appropriate conditions.

Twelve hot questions in the management of hypertension in patients aged 80+ years and their answers with the help of the 2023 European Society of Hypertension Guidelines.

Arterial hypertension is a major risk factor for cardiovascular morbidity and mortality, and highly prevalent in older age, underscoring the importance of its appropriate management. The population is ageing at an increasing rate, with those aged 80+ years being the fastest growing population characterized by high heterogeneity in terms of functionality and autonomy. The prevalence of hypertension rises with increasing age, due to a significant increase in SBP largely as a result of age-related stiffening of the aorta and other large arteries, affecting almost 80% of those aged 80+ years. Appropriate management of blood pressure in this population is a priority for clinicians. Frailty is a condition characterized by marked vulnerability to adverse health outcomes and is common among older adults including those with hypertension. Hypertension increases frailty level and at the same time, individuals with increasing frailty present with more drug-related adverse effects meaning they are less tolerant to blood pressure lowering by medication. Thus, frailty is a factor that should be integrated when treating hypertension in this population. The European Society of Hypertension 2023 Guidelines on the management of Hypertension are the first international guidelines to integrate the concept of adapting blood pressure management in older adults according to their frailty/functionality level, and to propose practical tools for the application of this concept in the daily practice of physicians and other healthcare professionals. The present article prepared by the European Society of Hypertension Working Group on Hypertension in Older Adults aims to further address some important aspects mentioned concisely in the 2023 European Society of Hypertension guidelines, in order to help physicians and other healthcare professionals including those practicing in primary care. To this end, this study discusses 12 'hot questions' which are answered with the help of the 2023 European Society of Hypertension Guidelines. We hope the present article and Working Group's actions will contribute to understanding and applying the ideal management of hypertension in this most vulnerable population.

Thunderclap headache as a first manifestation of acute disseminated encephalomyelitis: case report and literature review

BackgroundAcute Disseminated Encephalomyelitis (ADEM) is an acute demyelinating disorder of the central nervous system, characterize by multiple white matter hyperintensities on T2 MRI. Patients usually present with subacute progressive encephalopathy and polyfocal neurological deficits. Possible treatments are corticosteroids, immunoglobulins and plasma exchange. Full clinical recovery is seen in more than half of the cases.CaseWe describe a case of a 62-year-old patient presenting with thunderclap headache as the first symptom, two weeks after an upper respiratory tract infection. The clinical course was complicated by progressive coma and intracranial hypertension mandating external ventricular drainage and sedation. Initial treatment with methylprednisolone was unsuccessful but clinical resolution and radiological regression was achieved after plasma exchanges and cyclophosphamide.ConclusionTo our knowledge, this is the first reported case of ADEM presenting with thunderclap headache. Intracranial hypertension with the need for invasive neuromonitoring and pressure management is also a very rare complication of ADEM. In this report, we describe the findings of the literature review concerning ADEM, thunderclap headache and intracranial hypertension.

Pheochromocytoma and Thyroid Storm Presenting as ST-Elevation Myocardial Infarction in a Patient with Non-Obstructive Coronary Arteries.

Pheochromocytomas can present as a diagnostic challenge, given their diverse clinical manifestations. Though classically taught as presenting with headaches, palpitations and paroxysmal hypertension, only 1 in 4 present with such a triad. Catecholamines affect the myocardium in various ways, ranging from beta-adrenergic receptor-mediated myofibril dysfunction to direct myocardial injury by catecholamine oxidation products. We report the case of a 41-year-old female with no significant past medical history, who presented with acute coronary syndrome. She was found to have myocardial infarction with non-obstructive coronary arteries (MINOCA), and her clinical course was complicated by erratic blood pressure management. Laboratory findings and imaging findings confirmed the diagnosis of pheochromocytoma. Post-cardiac catheterisation, she developed a thyroid storm and fatal cardiac arrest. The combination of hyperthyroidism with pheochromocytoma is rare but often fatal; iodinated angiography contrast likely precipitated her thyroid storm. This case underscores the importance of considering pheochromocytoma early in patients with MINOCA, particularly in those with erratic blood pressure. Pheochromocytomas have been reported to be associated with MINOCA in rare cases and have significant mortality. Current guidelines do not include pheochromocytoma as a possible differential diagnosis; recognition and early diagnosis are crucial for improved outcomes. Pheochromocytoma and thyroid disease should be added as recommended differential diagnoses in patients with myocardial infarction with non-obstructive coronary artery disease (MINOCA) despite current guidelines not including them in the routine work-up.For patients with erratic blood pressure and MINOCA, the possibility of a pheochromocytoma should be considered early, as a prompt diagnosis can result in favourable outcomes.

Management and Therapeutic Intervention for Hypertension: A Comprehensive Review

Hypertension, a chronic condition characterized by elevated blood pressure, is a major global health concern, affecting over 1.28 billion people and contributing to significant cardiovascular diseases such as heart attacks, strokes, and kidney failure. This comprehensive review explores the multifaceted approaches to managing and treating hypertension, including lifestyle modifications, pharmacological therapies, and innovative interventions. It highlights key therapeutic strategies such as the DASH diet, regular exercise, and stress management, along with pharmacological treatments like diuretics, beta-blockers, and angiotensin-converting enzyme inhibitors. Additionally, emerging therapies such as renal denervation, baroreceptor activation therapy, and precision medicine offer new avenues for treating resistant hypertension. The role of telemedicine and digital health tools in enhancing blood pressure management is also discussed. Despite these advancements, challenges such as patient adherence, healthcare disparities, and aging populations persist. Future research should focus on precision medicine, improving adherence, and expanding access to cost-effective treatments in low-resource settings. Addressing these challenges through global collaboration can significantly reduce the global burden of hypertension and improve patient outcomes. Keywords: Hypertension, blood pressure management, pharmacological therapy, lifestyle interventions.