Jan 2nd, 2024

In the field of hypertension research, several recent studies have made significant contributions to our understanding of diagnostic techniques, pharmacotherapy, and non-pharmacological interventions.

The first study, a retrospective population-based cohort study, investigated blood pressure measurements for diagnosing hypertension in primary care (1). It involved 500 patients aged 40-70 years with new-onset hypertension and examined various blood pressure measurement methods such as OBPM, HBPM, OBP30, and 24H-ABPM. The study found that OBPM was the most used method, but diagnoses were often incomplete or misinterpreted. There was a small improvement in diagnostic accuracy between 2012 and 2016, underscoring the need for enhanced hypertension diagnosis in primary care.

In pharmacotherapy, the Quartet USA Trial, a double-blind randomized controlled trial, assessed the efficacy of low-dose quadruple therapy (LDQT) for hypertension (2). The trial included 62 patients with hypertension and found high satisfaction with LDQT, with 96% of participants finding the benefits outweighing the disadvantages. This trial's clinical significance lies in establishing LDQT as an acceptable treatment for hypertension, potentially reducing pill burden and improving adherence.

Regarding special populations, a study involving cancer survivors focused on intensive blood pressure control (3). This study, which analyzed SPRINT data, involved 9,336 cancer survivors and compared intensive blood pressure control to standard control. The results indicated a similar reduction in cardiovascular events in both cancer survivors and non-cancer patients, suggesting the effectiveness of intensive BP control in this demographic.

Another significant study examined the impact of renin-angiotensin system inhibitors (RASi) on bone fracture risk in a nationwide nested case-control study (4). Targeting elderly patients with hypertension at risk of fractures, the study matched 1,049 patients (case-control) and found that RASi use was associated with a lower incidence of fractures. This points to the potential of RASi as a preventive strategy for osteoporotic fractures.

Gender differences in hypertension were explored through a cross-sectional study assessing the role of occupational physical activity (5). This study involved 26,534 adults from the Korea National Health and Nutrition Examination Survey and found that higher levels of total physical activity and leisure time physical activity were associated with a lower prevalence of hypertension, with the association being stronger for women. Conversely, higher occupational physical activity was linked to increased hypertension in women.

The role of plasma calprotectin as a biomarker for hypertension risk was explored in a prospective cohort study involving 3,524 participants from the PREVEND study (6). The study identified an association between plasma calprotectin levels and new-onset hypertension, influenced by baseline systolic blood pressure. This suggests that plasma calprotectin could be a significant biomarker for hypertension risk, with sex-specific implications.

Lastly, the effectiveness of non-pharmacological interventions was examined through a randomized controlled assessor-blinded trial studying the effect of a home-based isometric handgrip training programme on systolic blood pressure in adults (7). Involving 48 adults with a mean age of 64 years, the study found that this intervention was not superior to usual care in lowering systolic blood pressure, as indicated by an adjusted mean difference of 8.12 mmHg.

In conclusion, these studies collectively enhance our understanding of hypertension management, spanning diagnostic accuracy, treatment efficacy, and implications in special populations and gender differences. They underscore the ongoing evolution of hypertension research and its critical role in guiding clinical practice.

1. Voorbrood VMI, de Schepper EIT, Bohnen AM, Ruiterkamp MFE, Rijnbeek PR, Bindels PJE. Blood pressure measurements for diagnosing hypertension in primary care: room for improvement. BMC Prim Care. 2024;25(1):6.

2. Sanuade OA, Jacobson TA, Quintana A, Flowers FM, Abbasi H, Vu MH, et al. Process Evaluation of a Double-Blind Randomized Controlled Trial to Assess the Efficacy and Safety of a Quadruple Ultra-Low-Dose Treatment for Hypertension Within a Federally Qualified Health Center Network (QUARTET USA). J Am Heart Assoc. 2024;13(1):e032236.

3. Li W, Wang Z, Jiang C, Hua C, Tang Y, Zhang H, et al. Effect of Intensive Blood Pressure Control on Cardiovascular Outcomes in Cancer Survivors. Hypertension. 2024.

4. Kim KM, Hwang EJ, Lee S, Yoon JH. The impact of Renin-Angiotensin System Inhibitors on bone fracture risk: a nationwide nested case-control study. BMC Musculoskelet Disord. 2024;25(1):3.

5. Cho MJ, Jung YJ, Min HJ, Kim HJ, Kunutsor SK, Jae SY. Sex disparities in physical activity domains and hypertension prevalence. Clin Hypertens. 2024;30(1):1.

6. Bourgonje AR, Bourgonje MF, la Bastide-van Gemert S, Nilsen T, Hidden C, Gansevoort RT, et al. Plasma Calprotectin Levels Associate With New-Onset Hypertension in the General Population: A Prospective Cohort Study. J Am Heart Assoc. 2024;13(1):e031458.

7. Danielsen MB, Andersen S, Ryg J, Bruun NH, Madeleine P, Jorgensen MG. Effect of a home-based isometric handgrip training programme on systolic blood pressure in adults: A randomised assessor-blinded trial. J Sports Sci. 2024:1-9.