Risk Of Hypertension Research Articles

Hypertension (HTN) is a major global health burden influenced by multiple factors. Dietary flavonoids have shown health benefits, yet limited epidemiological studies focus on individual flavonoid intake and HTN risk. The baseline characteristics and disease data of the population in this study are derived from National Health and Nutrition Examination Survey, and the flavonoid intake data come from food and nutrient database for dietary studies. After feature selection, we employed multivariable logistic regression to calculate odds ratio and quantify the protective effect of flavonoids. We then conducted sensitivity analyses using a generalized additive model to assess the nonlinear relationship between flavonoid intake and HTN, and finally performed Shapley additive explanations analysis with 3 machine learning models to explore the ranking of variable importance. This study found that higher intakes of individual flavonoids, particularly quercetin, epicatechin, and naringenin, and of flavonoid subclasses, such as flavanones and flavonols, were associated with a lower risk of HTN. Among these, quercetin and naringenin emerged as the most important individual flavonoids in the machine learning models. Furthermore, the associations between flavanones and naringenin with HTN were linear and negative, whereas quercetin, epicatechin, and flavones exhibited nonlinear relationships with HTN. This study suggests that consuming foods rich in individual flavonoids, such as quercetin, epicatechin, and naringenin, may aid in the control and prevention of HTN, thereby reducing the overall cardiovascular disease burden in the population.

Synergistic effects of outdoor nighttime light, air pollution, and PM2.5 components on multimorbidity risk of hypertension, dyslipidemia, and liver diseases: a prospective cohort study.

The hepatic steatosis index (HSI), a noninvasive tool for assessing hepatic steatosis, has been linked to hypertension. This study aimed to investigate their nonlinear relationship and modifying factors. Using 2017-2020 NHANES data, we analyzed 7723 adults aged ≥ 20 years. Pearson chi-square test and Student t test were used to compare baseline characteristics across HSI quartiles (Table 1). Multivariable logistic regression assessed HSI-hypertension associations, while threshold regression identified inflection points. Subgroup analyses evaluated effect modifications. Baseline Characteristics: Higher HSI quartile (Q4) had a significantly different age distribution (P < .001), with the highest quartile (Q4) being younger on average (48.34 ± 16.28 years) than Q2 and Q3, female predominance (66.25%), and lower socioeconomic status (income-to-poverty ratio 2.38 ± 1.47, P < .001). Metabolic comorbidities showed dose-response trends, with diabetes prevalence rising from 5.33% (Q1) to 23.08% (Q4) (P < .001). Primary analysis: Each HSI unit was associated with a 4% higher risk of hypertension (odds ratio [OR] = 1.04, 95% confidence interval [CI]: 1.03-1.05). Q4 had a 2.65-fold higher risk than Q1 (95% CI: 2.23-3.15). Nonlinearity: A significant inflection point emerged at HSI = 50.33, with steeper risk slope below threshold (OR = 1.06, P < .001) versus null association above (OR = 0.99, P = .181). Subgroup Heterogeneity: Stronger associations occurred in males (β = 1.06 vs females 1.02), older adults (≥60 years), and coronary heart disease patients (threshold lowered to 38.67) (P interaction < 0.05). HSI exhibits a threshold-based nonlinear association with hypertension, demonstrating stronger associations in males, older adults, and cardiovascular disease subgroups, supporting its utility as a marker in metabolic hypertension risk stratification.

Hypertension is a leading cause of death globally and a critical risk factor for serious diseases. However, continuous monitoring and accurate acquisition of blood pressure (BP) values using photoplethysmography (PPG) techniques face significant challenges in daily life. High-fidelity PPG waveform acquisition is particularly susceptible to ambient light interference. Herein, anin situ fabricated ambient-light-immune WS2/Si hexagonal micro-holes (WS2/SiHM) heterojunction photodetector is developed by pulsed laser deposition (PLD) method. This device leverages the unique metallic phase characteristics ofPLD-1T-WS2. The heterojunction exhibits exceptional performance, including a broad near-infrared (NIR) spectral response (700-1550nm) and remarkable visible-light rejection, achieving a spectral rejection ratio >103. These properties, coupled with the custom-designed circuit, enable robust acquisition of PPG waveforms even under challenging ambient light conditions. Comparative evaluations against commercial broadband silicon photodiodes demonstrate superior performance in ambient light suppression and heart rate estimation accuracy. Furthermore, when integrated with a convolutional neural network, the system achieves hypertension classification accuracy exceeding 90%, highlighting its promising application in hypertension risk assessment. This work presents a new paradigm for ambient-light-immune NIR photodetector technology in wearable health monitoring, offering a viable solution to the longstanding challenges in continuous, non-invasive cardiovascular assessment.

Worldwide less than half of adults with hypertension are diagnosed and treated (only 42%), in addition one in five adults with hypertension (21%) has the condition under control. In the American continent, cardiovascular diseases (CVD) are the leading cause of death and high blood pressure (hypertension) is responsible for 50% of CVD deaths. Only a few countries show a population hypertension control rate of more than 50%. In this experimental study, we trained 15 regression-type machine learning algorithms, including traditional and ensemble methods to assess their effectiveness in estimating arterial pressure using noninvasive photoplethysmographic (PPG) signals extracted from 110 study subjects, to identify the risk of hypertension and its correlation with arteriosclerosis. We analyzed the performance of each algorithm using the metrics MSE, MAE, RMSE, and r2. A 10-fold cross-validation showed that the best algorithms for hypertension risk identification were LR, KNN, SVR, RF, LR Baggin, KNNBagging, SVRBagging, and DTBagging. On the other hand, the best algorithms for arterioclesrosis risk identification were LR, KNN, SVR, RF, LR Bagging, and DTBagging. These results suggest that this research is promising and offers valuable information on the acquisition and processing of PPG signals. However, as this is an experimental study, the effectiveness of our model needs to be validated with a larger database. On the other hand, this model represents a support tool for healthcare specialists in the early detection of cardiovascular health, allowing people to self-manage their health and seek medical attention at an early stage.

Background Glycated hemoglobin (HbA1c) reliably reflects long-term glucose control and has been linked to hypertension development. This study investigates the relationship between baseline HbA1c levels, HbA1c trajectories, and hypertension risk. Methods This retrospective cohort study included 10,138 adults from health screenings at Henan Provincial People’s Hospital (January 2018–January 2025). Mean age was 54.03 ± 12.97 years, with 31.44% women and mean follow-up of 43.92 months. We analyzed hypertension incidence across HbA1c groups using Kaplan–Meier curves and identified HbA1c trajectory patterns using latent class trajectory modeling (LCTM). Cox proportional hazards models evaluated associations between baseline HbA1c tertiles, HbA1c trajectories, and hypertension risk. Restricted cubic splines explored dose–response relationships. Results During follow-up, 3,452 participants (34.05%) developed hypertension. After adjustment, participants in the highest baseline HbA1c tertile had significantly increased hypertension risk versus the lowest tertile (HR = 1.49, 95%CI: 1.31–1.70). LCTM identified three distinct trajectories: low-stable (5.57 ± 0.36%), medium-stable (6.45 ± 0.59%), and high-stable (8.42 ± 1.39%). Compared to low-stable trajectory, medium-stable and high-stable groups showed significantly increased risks (HR = 1.38, 95%CI: 1.24–1.53; HR = 2.71, 95%CI: 2.21–3.32, respectively). Restricted cubic spline analysis revealed a J-shaped relationship with an inflection point at HbA1c = 5.70% ( P for nonlinearity &amp;lt; 0.001). Conclusion Elevated baseline HbA1c levels, particularly above 5.70%, and medium-to-high stable HbA1c trajectories significantly increase hypertension risk among adults undergoing health screening. HbA1c could serve as a valuable biomarker for hypertension risk assessment.

With changes in lifestyle, the incidence of hypertension in rural areas is on the rise. However, previous studies have not investigated the association between TyG index trajectories and the risk of hypertension in rural populations, particularly in multi-center natural population cohorts. Our study aimed to examine the association between TyG index trajectories and hypertension risk in rural populations. The study included 9343 rural residents from the Xinjiang Multi-Ethnic Cohort. The TyG index was calculated as Ln [fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2], and a group-based trajectory model was adopted to identify the TyG index trajectories. Cox regression model was applied to assess the associations between the TyG index trajectories and incident hypertension. At a median follow-up period of 35 months, 1687 participants experienced hypertension. Three distinct TyG index trajectories were identified: low stable (n = 4239, 45.37%), moderate stable (n = 4561, 48.82%), and high stable (n = 543, 5.81%). Compared with the low stable group, the hazard ratio (95% CI) of hypertension was 1.41 (95% CI, 1.26-1.58) and 1.82 (95% CI, 1.50-2.21) for the moderate stable and high stable group, respectively. In subgroup analyses, the associations between a high TyG longitudinal trajectory and hypertension seemed to be stronger among participants with a high healthy lifestyle score (HLS) compared to those with a low HLS. In rural residents, elevated trajectories of the TyG index were associated with an increased risk of hypertension. This finding underscores the importance of paying attention to TyG levels, even among people with a healthy lifestyle.

Trihalomethanes (THMs), the leading species of disinfection byproducts in chlorinated tap water, have demonstrated cardiovascular toxicity. However, the association between THM exposure and blood pressure (BP) among pregnant women remains unclear. This study included 1456 women from a Chinese prospective birth cohort. We determined blood THM concentrations [chloroform (TCM), bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform (TBM)] across pregnancy trimesters (n = 3642) and repeatedly measured BP throughout pregnancy (n = 5816) and during postpartum (n = 1062). Blood concentrations of TCM and chlorinated THMs (Cl-THMs; the sum of TCM, BDCM, and DBCM) in the second, but not first, trimester were positively associated with gestational diastolic BP and mean arterial pressure (MAP). Additionally, women with higher second-trimester blood concentrations of brominated THMs (the sum of BDCM, DBCM, and TBM) and total THMs (TTHM; the sum of 4 THM) had an increased risk of experiencing a sharply rising MAP throughout pregnancy. Second-trimester blood concentrations of TCM, Cl-THMs, and TTHMs were positively associated with the risk of hypertension during pregnancy, particularly among women carrying male fetuses. However, blood concentrations of THMs were unrelated to postpartum BP. In summary, THM exposure in the second trimester may be associated with elevated BP and a greater risk of hypertension during pregnancy.

Endometriosis is increasingly recognized as a systemic inflammatory disease rather than a localized gynecological disorder. This review integrates recent molecular and clinical evidence demonstrating how chronic inflammation, oxidative stress, and extracellular vesicle (EV) signaling interact to shape both local and systemic pathophysiology. Elevated cytokines such as IL-1β, IL-6, TNF-α, IL-8, MCP-1, and VEGF sustain angiogenesis, immune activation, and lesion persistence, while diminished IL-10 impairs immunoregulation. Concurrently, oxidative stress arising from peritoneal iron overload and mitochondrial dysfunction amplifies inflammatory signaling through NF-κB and TGF-β/SMAD pathways, promoting fibrosis, apoptosis resistance, and nociceptor sensitization. Recent discoveries highlight EVs as mediators of systemic communication, transferring microRNAs and proteins that modulate immune, endothelial, and neural targets, thereby linking pelvic inflammation to cardiovascular, metabolic, and autoimmune comorbidities. Evidence from multiple studies indicates that endometriosis confers elevated risks of hypertension, dyslipidemia, autoimmune disorders, and mood disturbances—hallmarks of systemic immune and vascular dysregulation. Furthermore, chronic oxidative and inflammatory exposure fosters genomic instability, explaining the observed association with ovarian clear-cell and endometrioid carcinomas. Recognizing endometriosis as a multisystemic disorder supports the development of integrative diagnostic and therapeutic strategies, including cytokine and exosomal biomarker panels and targeted anti-inflammatory, antioxidant, and anti-angiogenic treatments. Contributions from Mexico, Colombia, and Ecuador emphasize the need for regionally inclusive research and precision-medicine approaches. Endometriosis thus emerges as a model of systemic inflammation, exemplifying how immune, oxidative, and endocrine networks converge to produce both reproductive and extra-pelvic disease manifestations.

Introduction: Personal care products (PCPs) are complex chemical mixtures, which include endocrine disrupting chemicals linked to elevated risk of hormonally-responsive chronic diseases. Blood pressure is influenced by sex hormones; however, the relationship between PCPs and hypertension is unclear. Hypothesis: We investigated whether PCP usage patterns were associated with risk of hypertension in U.S. women. Methods: The Sister Study is a prospective cohort study of 50,884 women recruited in 2003-2009. The participants self-reported their usage frequency of 41 PCPs in the 12-month period before baseline and doctor’s diagnosis of incident hypertension. We analyzed individual PCPs and four product groups (i.e., beauty, everyday hair, hygiene, and skincare products). Among product groups, latent class analyses were used to identify PCP usage patterns (“infrequent”, “moderate”, or “frequent”). Multivariable Cox regression was used to estimate the associations between PCPs and hypertension risk, adjusted for potential confounders. The population attributable risk percentage contrasting “frequent” versus “infrequent” users was calculated using Levin's formula. Results: We found an increasing dose-response relationship between beauty products and incident hypertension (p-trend&lt;0.0001; Table 1), with frequent users having a significantly higher risk compared with infrequent users (Hazard Ratio (HR)=1.11 (95% confidence intervals (CI):1.05,1.16)). A similar dose-response relationship was found for hygiene products (p-trend&lt;0.0001), with elevated risks observed in moderate (HR=1.07 (95%CI:1.01,1.13) and frequent (HR=1.13 (95%CI:1.08,1.19) users. An estimated 6.1% and 5.8% reduction in hypertension incidence would be observed among U.S. women with decreased use of beauty and hygiene products, respectively. Our findings were largely consistent across different subgroups defined by age, menopausal status, race, and socioeconomic status. The use of several individual everyday hair and skincare products was associated with increased risk of hypertension; however, latent classes of either everyday hair or skincare product use were not. Conclusions: We found that use of certain PCPs contribute to future development of hypertension, a strong but modifiable risk factor for most cardiovascular diseases. Our findings support the need to identify the pathogenic constituents of PCPs that drive hypertension risk.

Background: Body mass index (BMI) masks physiologic lean mass versus pathologic fat mass effects on blood pressure (BP) in youth. Elevated BP in adolescents predicts premature cardiac damage. While dual-energy X-ray absorptiometry (DXA) is the gold standard for fat mass assessment, it is costly and inaccessible. BMI has 65% agreement with DXA-measured fat mass, while waist-to-height ratio (WHtR) demonstrates 89% agreement with DXA-measured total and trunk fat. New WHtR cutoffs predicting normal, high, and excess fat have been proposed in pediatrics (https://urfit-child.com/waist-height-calculator/). Whether these WHtR cutoffs predict elevated BP and hypertension risk in youth remains unclear. Methods: We included 1,886 multi-racial US participants (mean age 14.7±4.5 years) from NHANES 2021-2023 with complete data for three BP measurements, waist circumference, and height. WHtR categories: normal fat (0.40-&lt;0.50 males, 0.40-&lt;0.51 females), high fat (0.50-&lt;0.53 males, 0.51-&lt;0.54 females), excess fat (≥0.53 males, ≥0.54 females). Elevated BP (≥120/70 mmHg) and hypertension (≥140/90 mmHg) risk assessed using logistic regression, adjusted for age, sex, education, smoking, race, sedentary time, moderate physical activity, fasting total cholesterol, and high-sensitivity C-reactive protein. Results: Among 1,886 participants (47.9% non-Hispanic White, 17.0% other/multi-racial, 13.3% non-Hispanic Black, 12.0% Mexican American, 9.8% other Hispanic), mean WHtR was 0.51±0.1. Distribution: 607 (32.2%) excess fat, 184 (9.8%) high fat, 1,095 (58.1%) normal fat. Unadjusted analyses showed high fat and excess fat WHtR categories associated with higher SBP versus normal fat (high fat: 1.70 mmHg [95% CI 0.65-2.75], p=0.043; excess fat: 1.27 mmHg [0.22-2.32], p=0.02), attenuated after adjustment. Elevated BP prevalence was 27%; hypertension 1%. Relative to normal fat, high-fat WHtR predicted elevated BP risk (adjusted OR 1.66 [1.14-2.42], p=0.009); excess fat showed a stronger association (adjusted OR 1.98 [1.48-2.65], p&lt;0.001). Hypertension associations attenuated after adjustment due to low prevalence. Conclusions: New WHtR pediatric adiposity cutoffs effectively identified youth at increased risk of elevated BP who are likely to progress to hypertension. These findings support the utility of WHtR as a universal, cheap, and easily accessible preventive and clinical tool for cardiovascular risk stratification in youth.

Hypertension, a major cardiovascular risk, is affected by body composition and metabolism. We assessed the associations of body composition with hypertension and the mediating role of insulin resistance (IR). In Hefei Hongsifang Company, 743 employees aged 40-60 were recruited consecutively. Logistic regression was used to assess the association between body composition and hypertension risk. Mediation analysis was conducted to explore the mediating role of IR between body composition and hypertension risk. Individuals with higher body fat percentage (BF%) (OR = 2.44, 95% CI 1.64-3.65, P <0.001) and Visceral adiposity index (VAI) (OR = 2.22, 95% CI 1.39-3.55, P <0.001) had significantly higher odds of hypertension. Conversely, higher levels of skeletal muscle mass percentage (SMM%) (OR = 0.35, 95% CI 0.21-0.56, P < 0.001), total body water percentage (TBW%) (OR = 0.36, 95% CI 0.23-0.59, P < 0.001), and bone mineral content percentage (BMC%) (OR = 0.34, 95% CI 0.21-0.54, P < 0.001) were all linked to lower odds of hypertension. IR significantly mediated the associations between body composition and hypertension risk. The mediation proportions were as follows: 29.4% for BF%, 61.5% for VAI, 33.7% for SMM%, 34.9% for TBW%, and 31.4% for BMC%. Our study demonstrated that, in middle-aged individuals, lower BF% and VAI, as well as higher SMM%, TBW%, and BMC%, were independently associated with a reduced risk of hypertension. IR partially mediated the associations between body composition and hypertension.

Background: Hemorrhagic transformation (HT) is still a major negative outcome of mechanical thrombectomy (MT) in acute ischemic stroke (AIS), significantly affecting death rates and health complications. Despite advances in patient selection and procedural procedures, reliable prediction models for stratifying patients based on their risk of hypertension are still lacking. Artificial intelligence (AI) facilitates the utilization of complex, multidimensional data to aid in early forecasting and tailored stroke treatment. Objective: To develop and validate a machine learning model for predicting hemorrhagic transformation after MT using a nationally representative inpatient database, and to identify the most impactful clinical predictors. Methods: We used the National Inpatient Sample (2016-2020) to conduct a retrospective cohort study. Adult patients (≥18 years) hospitalized with AIS (ICD-10: I63.x) and undergoing MT were identified. HT was defined using verified ICD-10 codes (I61.x and I62.x). A machine learning pipeline using Extreme Gradient Boosting (XGBoost) was created. Demographics, hospital characteristics, stroke risk factors (atrial fibrillation, hypertension, diabetes), thrombolytic usage, and surrogate indicators for stroke severity were all taken into account. The data were divided into training (80%) and testing (20%) cohorts. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), calibration plots, and SHAP (Shapley Additive Explanation) values, which stress feature relevance. Results: Among 45,321 AIS patients with MT, 3,746 (8.3%) developed HT. The AI model has an AUC of 0.87 (95% CI: 0.86-0.89), demonstrating excellent discriminatory performance. The use of thrombolytics, coagulopathy, chronic renal disease, advanced age, atrial fibrillation, and therapy at large metropolitan teaching institutions were all significant predictors of hypertension. SHAP analysis gives comprehensive insight into variable interactions, which improves the model's clinical interpretability. Conclusion: This research presents the first nationally representative AI-driven model for predicting hemorrhagic change after MT. The approach, which combines real-world data with machine learning, provides a therapeutically effective tool for pre-procedural risk classification and individualized post-thrombectomy treatment. Future inclusion into stroke treatment pathways might reduce complications and improve patient outcomes.

Object: Aldehyde dehydrogenase 2 (ALDH2) rs671 polymorphism is an established genetic risk of hypertension, diabetes, and coronary heart diseases in Asian population. However, clinically, the association between ALDH2 polymorphism and metabolic signatures, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) remains unknown. We aim to investigate the relationship between ALDH2 rs671 polymorphism and metabolic signatures, providing early warning of metabolic syndromes based on ALDH2 genotyping. Method: A total of 200 patients were included between 2017 and 2020. The patients were divided into three groups according to their ALDH2 rs671 genotyping, AA (n=46), GA (n=83), and GG (n=71). Categorical data are presented as frequency and percentage. Continuous variables are reported as median and interquartile range (IQR). A one-way analysis of variance (ANOVA) or chi-squared test was performed as appropriate for intergroup comparison. Result: There were little differences among three groups of patients with regard to sex and age. Our result revealed that ALDH2 AA genotype (mutant homozygotes) exhibited a higher risk of hypertension than other groups (P=0.034, using a chi-square test). Furthermore, patients with ALDH2 AA genotype tended to have a habit of smoking (P=0.047, using a chi-square test), while they were less likely to drink (P=0.008, using a chi-square test). Speaking of metabolic signatures, ALDH2 AA genotype displayed lower TG (P=0.023, using a one-way ANOVA) and higher HDL (P=0.041, using a one-way ANOVA), with no significant influence on TC and LDL. Conclusion: This study revealed that ALDH2 rs671 polymorphism has an influence on certain metabolic signatures, including hypertension, smoke, drink, CG and HDL, indicating ALDH2 genotyping could be applied as a potential biomarker in metabolic syndromes.

Introduction: Food insecurity is associated with an increased hypertension risk, and women are disproportionately affected by food insecurity compared to men. However, limited research has examined how the relationship between food insecurity and hypertension varies across women’s life stages, despite age-related differences in social and economic circumstances. Objective: To examine age-related differences in the association between food insecurity and hypertension among U.S. women. Methods: We analyzed cross-sectional data from women aged 18 years and older in the 2010-2023 National Health Interview Surveys. We used survey-weighted, multinomial logistic regression models to examine the relationship between food insecurity and self-reported hypertension among younger (aged 18-44 years) and older (45 years and older) women. Effect modification was examined by age. Results: Among 354,032 women (55% aged ≥45 years), 10.3% experienced food insecurity (5.9% reported low food security; 4.4% reported very low food security). Younger women were more likely to be food insecure and less likely to be married or employed than older women (p &lt;0.001). After adjusting for marital status, educational attainment, race/ethnicity, employment status, and income, food insecurity was associated with significantly higher odds of hypertension (OR: 1.31; 95% CI: 1.26-1.36). A significant interaction was also observed between age and food insecurity, with the odds of hypertension significantly higher among younger, food-insecure women in comparison to older, food-insecure women (interaction OR: 1.34, 95% CI: 1.25-1.45). Conclusion: There was a significant difference in hypertension risk among food-insecure women by age, with younger, food-insecure women experiencing a higher risk compared to their older counterparts. These findings underscore the American Heart Association’s Call to Action to improve women’s cardiovascular health, which includes advocacy for healthy food access and food security as a critical intervention across the life course.

Introduction: Semaglutide 2.4 mg has been shown to reduce the risk and severity of cardiometabolic comorbidities (CMCs) and to improve cardiometabolic biomarkers in patients with overweight or obesity in clinical trials. However, real-world evidence in these areas is limited. Research Question: This study compared the incidence rates of CMCs and 12-month changes in biomarkers between adults with overweight/obesity with and without once-weekly subcutaneous semaglutide 2.4 mg use. Methods: A retrospective cohort study using a large U.S. claims database linked with clinical data evaluated patients with semaglutide 2.4 mg use for ≥12 months (June 2021–June 2023) and those without. For each CMC, including hypertension, T2D, dyslipidemia, HF, prediabetes, ASCVD, and CVD, patients were excluded from analysis of each individual CMC if they had claims indicating the corresponding CMC during the 12-month baseline. For each biomarker, patients were required to have the corresponding biomarker measurements at both baseline and 12-month follow-up. For each CMC and biomarker, propensity score weighting was used to balance patient characteristics between semaglutide 2.4 mg users and non-users. Time to CMCs were compared using weighted Cox proportional hazards models and biomarker changes were compared using weighted linear regression. Results: Sample sizes ranged from 14,067 to 25,490 in semaglutide 2.4 mg users and 4,271,926 to 8,578,948 in non-users across CMCs. After balancing, baseline characteristics were similar between users and non-users. Mean age ranged from 44.4 to 47.2 years among users and 44.4 to 47.4 years among non-users; 77%–83% of users and 75%–82% of non-users were women. Compared to non-users, semaglutide 2.4 mg users had significantly lower risk of incident hypertension (Hazard ratio [HR]: 0.62, 95% confidence intervals [CI]: 0.57; 0.68), T2D (HR: 0.45, 95% CI: 0.39; 0.51), HF (HR: 0.48, 95% CI: 0.38; 0.61), prediabetes (HR: 0.75, 95% CI: 0.70; 0.80), ASCVD (HR: 0.65, 95% CI: 0.58; 0.72), and CVD (HR: 0.69, 95% CI: 0.64; 0.75) (all p&lt;0.001). The risk of dyslipidemia was similar between users and non-users (HR: 1.05, 95% CI: 1.00; 1.11, p=0.05). Semaglutide 2.4 mg use was also associated with significant improvements in cardiometabolic biomarkers specified in Table 1 and slower decline in eGFR. Conclusion: In adults with overweight/obesity, semaglutide 2.4 mg was associated with lower risk of specified CMCs and greater improvements in cardiometabolic biomarkers.

Background: Essential hypertension is associated with an increased risk of pulmonary hypertension (PH). PH is diagnosed more frequently in females. Little is known about the effects of a plant-based diet (PBD) in improving lung abnormalities in PH. Methods: We compared 28- and 40-week-old female normotensive Wistar Kyoto and spontaneously hypertensive rats (SHR), maintained from the age of 4 weeks on a control refined diet or a PBD, comprising 28% fruits, vegetables, nuts and legumes. A subset of control SHRs were switched to the PBD at 28 weeks of age. Lungs were taken for protein and histological analysis. Results: Relative to WKYs, SHRs consuming the control diet exhibited decreased lung endothelial nitric oxide synthase (eNOS). PBD consumption by SHRs prevented and reversed this phenotype. Expression of E-cadherin was also reduced in SHRs. This reduction was attenuated by PBD consumption treatment. The phosphorylation of extracellular signal-regulated kinase (ERK)1/2 in the lung was increased in SHRs and attenuated by PBD. The expression of activated transforming growth factor (TGF)-β1 was also attenuated by a PBD. Conclusions: The PBD favorably mediated hypertension-induced pulmonary molecular abnormalities in lung endothelium, epithelial junction and pro-fibrotic signaling. Future studies should assess the effects of a PBD in improving PH and lung function.

Introduction/Background: Gestational diabetes mellitus (GDM) is the most common metabolic complication during pregnancy. It increases the risk for endothelial dysfunction, hypertension and cardiovascular diseases in the mother and the child in later life. Endothelin-1 (ET-1) is a potent vasoconstrictor that promotes endothelial dysfunction and contributes to cardiovascular diseases. Research Question/Hypothesis: We hypothesise that ET-1 is a key mediator of fetal endothelial dysfunction in GDM. Methods/Approach: We obtained maternal and fetal vessels from human placentas of patients with insulin-treated GDM (iGDM) (n=10), diet-treated GDM (dGDM) (n=8) and normoglycemic controls (n=30). Groups were defined by oral glucose tolerance test and clinical data of mothers and newborns. Vascular function of fetal arteries was analyzed in a Mulvany Myograph. Fetal placental arteries from patients of all groups were incubated with the selective endothelin receptor A antagonist BQ123 and the selective endothelin receptor B antagonist BQ788. The impact of ET-1 on vascular function was studied in a concentration-dependent manner. Gene expression was quantified by real-time PCR in fetal vessels of the cotyledon base and maternal spiral arteries. ET-1 peptide levels in the venous fetal placental serum were quantified with a human ET-1 ELISA. Results/Data: ET-1-mediated vasoconstriction was shown in fetal placental arteries from the chorionic base in all study groups. At higher concentrations, ET-1-mediated vasoconstriction was significantly lower in patients with iGDM compared to normoglycemic controls. No differences in mRNA expression of pre-pro ET-1 gene (EDN1), endothelin-converting enzyme 1 (ECE1), endothelin receptor A (EDNRA) and endothelin receptor B (EDNRB) were found between study groups. Notably, mRNA expression of EDNRB was higher compared to EDNRA expression in fetal placental vessels of all groups. Significantly increased levels of ET-1 were detected in venous fetal placental serum in dGDM patients compared to control. The ET-1-mediated vasoconstriction was blocked by BQ123 and BQ788 in GDM patients and controls. The relative contribution of EDNRB to ET-1-mediated vasoconstriction is significantly higher in GDM patients, compared to normoglycemic controls. Conclusions: In conclusion, we could demonstrate that GDM impairs ET-1-mediated vasoconstriction in fetal placental vessels. This may contribute to the endothelial dysfunction in patients with GDM.

Introduction: Prior studies suggest that androgenetic alopecia (AGA) may increase cardiovascular and metabolic disease risk, but findings have been inconsistent due to methodological limitations, reliance on self-reported data, and small sample sizes. This study aimed to evaluate the association between AGA and cardiometabolic outcomes using large-scale clinical data. Methods: We conducted a retrospective cohort study using the TriNetX US Collaborative Network to evaluate cardiometabolic outcomes, including abdominal obesity, dyslipidemia, hypertension, and diabetes mellitus, in 30,282 propensity-matched male patients (aged 18–45 years) diagnosed with AGA compared to 30,282 controls from general screening encounters. Outcomes were analyzed up to five years post-diagnosis using risk ratios, risk differences, and Kaplan-Meier survival analysis. Results: Patients with AGA demonstrated significantly lower risks of abdominal obesity (RR 0.53; 95% CI 0.45–0.61), dyslipidemia (RR 0.63; 95% CI 0.60–0.67), hypertension (RR 0.59; 95% CI 0.54–0.65), and diabetes mellitus (RR 0.43; 95% CI 0.36–0.51) compared to controls. Kaplan-Meier analysis confirmed a reduced hazard for diabetes mellitus (HR 0.44; 95% CI 0.37–0.52). Conclusion: AGA diagnosis was not associated with increased cardiometabolic risk. The observed risk reduction may reflect healthcare-seeking behaviors rather than a biological relationship. Introduction

IntroductionThe burden of cardiovascular disease in Sub-Saharan Africa has increased in recent years, and high blood pressure is the leading cause. One established risk factor for hypertension and cardiovascular disease is dietary salt intake. The World Health Organisation has highlighted low-sodium salt substitutes (LSSS) as a potential method to lower sodium intake. LSSS enriched with potassium may additionally support improving sodium-potassium balance. Studies in India and China have investigated the impact of LSSS on reducing sodium intake and the risk of stroke and hypertension in adults. However, evidence in African populations, and in particular youth, is lacking. As such, this protocol describes a phase 1 double-blinded randomised controlled trial to assess the efficacy of a potassium-enriched LSSS compared to traditional salt to improve urinary sodium-to-potassium ratio and blood pressure in African adolescents and their families.MethodsWe will enrol 600 adolescents (13–19 years old) and their primary caregivers living in Soweto, South Africa. Adolescents and their households will be randomised to receive a LSSS or traditional table salt (NaCl) for a 16-week period. All other household salt products will be removed. Anthropometrics and questionnaire data will be collected at 0 and 16 weeks. Spot urine samples and blood pressure will be collected at 0, 4, 12 and 16 weeks. Safety screening for kidney function will be conducted on household members at baseline. The trial protocol received ethics approval from the University of Witwatersrand Medical Human Research Ethics Committee (M221056).DiscussionThe obtained results will, to the best of our knowledge, be the first in an African population to provide insights into the efficacy of a potassium-enriched LSSS in improving urinary sodium-to-potassium ratio and blood pressure.Trial registrationThis trial is registered with the Pan African Clinical Trials Registry (https://pactr.samrc.ac.za); identifier: PACTR202306727520808 (09 June 2023).Supplementary InformationThe online version contains supplementary material available at 10.1186/s13063-025-09184-z.