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Diagnostics
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New Progress in Diagnostics of Clinical Hypertension
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New Progress in Diagnostics of Clinical Hypertension

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 August 2023) | Viewed by 17348

Special Issue Editors

Dr. Nicole K. Bart

E-Mail Website
Guest Editor
Department of Cardiology, St Vincent's Hospital, Sydney, NSW 2010, Australia
Interests: Cardiology; heart failure; genetics; hypoxia; advanced cardiac imaging; magnetic resonance imaging
Dr. Audrey I. Adji

E-Mail Website
Guest Editor
Victor Chang Cardiac Research Institute, Sydney, NSW 2010, Australia
Interests: cardiology; cardiac ejection pattern; cardiac contractility; pulsatile function; human circulation; cardiovascular diseases
Dr. Sara Hungerford

E-Mail Website
Guest Editor
Department of Cardiology, Royal North Shore Hospital, Sydney, NSW 2010, Australia
Interests: cardiology; magnetic resonance imaging; advanced cardiac imaging

Special Issue Information

Dear Colleagues,

Hypertension is a leading global health disease burden, and its prevalence is anticipated to increase with an aging population. Hypertension is known to cause end organ damage and is an independent risk factor for a myriad of chronic cardiovascular, renal, and peripheral vascular diseases. Despite extensive research and intervention, there remains shifting goal posts for blood pressure management targets, especially in the setting of advanced age or complex comorbidities. Indeed, the diagnosis of hypertension reflects more than just the measurement of systolic or diastolic blood pressure. Clinical and diagnostic parameters to help to understand the entire vascular tree and global vascular load are of renewed importance. In this Special Edition, we invite papers on innovative methods to diagnose hypertension, blood pressure targets across age groups, as well as novel diagnostic strategies to assess global vascular load.

Dr. Nicole K. Bart
Dr. Audrey I. Adji
Dr. Sara Hungerford
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • hypertension
  • vascular load
  • blood pressure
  • diagnostic techniques
  • cardiology

Published Papers (7 papers)

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Research

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12 pages, 1113 KiB  
Article
Features of Allostatic Load in Patients with Essential Hypertension without Metabolic Syndrome Depending on the Nature of Nighttime Decreases in Blood Pressure
by Tatyana Zotova, Anastasia Lukanina, Mikhail Blagonravov, Veronika Tyurina, Vyacheslav Goryachev, Anna Bryk, Anastasia Sklifasovskaya and Anastasia Kurlaeva
Diagnostics 2023, 13(23), 3553; https://doi.org/10.3390/diagnostics13233553 - 28 Nov 2023
Cited by 1 | Viewed by 677
Abstract
Changes in the activity of the renin–angiotensin–aldosterone system are responsible for a stable shift in the regulation of the cardiovascular system in essential hypertension (EH). They can be characterized as hemodynamic allostasis. The purpose of our study was to determine the role of [...] Read more.
Changes in the activity of the renin–angiotensin–aldosterone system are responsible for a stable shift in the regulation of the cardiovascular system in essential hypertension (EH). They can be characterized as hemodynamic allostasis. The purpose of our study was to determine the role of hemodynamic parameters in allostatic load in patients with EH without metabolic syndrome. Twenty-four hours of ambulatory blood pressure monitoring was performed, followed by linear and non-linear rhythm analysis. Based on the daily index, patients with EH were divided into two groups: group 1—patients with no significant nighttime decrease in blood pressure (BP); group 2—patients who had a nocturnal decrease in BP. The control group included healthy persons aged 25 to 69 years. A linear analysis was used to determine the mean values of systolic and diastolic BP, heart rate (HR), time load of BP, circadian index, and structural point of BP. Non-linear analysis was applied to determine the mesor, amplitude, range of oscillations and % rhythm of BP and HR. The allostatic load index (ALI) was also calculated on the basis of the corresponding biomarkers. It was found that ALI was significantly higher in groups 1 and 2 in comparison with the control group. The hemodynamic mechanisms of this increase were different. Full article
(This article belongs to the Special Issue New Progress in Diagnostics of Clinical Hypertension)
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15 pages, 1906 KiB  
Article
Comparability of a Blood-Pressure-Monitoring Smartphone Application with Conventional Measurements—A Pilot Study
by Annina S. Vischer, Jana Rosania, Thenral Socrates, Christina Blaschke, Jens Eckstein, Yara-Maria Proust, Guillaume Bonnier, Martin Proença, Mathieu Lemay and Thilo Burkard
Diagnostics 2022, 12(3), 749; https://doi.org/10.3390/diagnostics12030749 - 19 Mar 2022
Cited by 4 | Viewed by 2108
Abstract
(1) Background: New cuffless technologies attempting blood-pressure measurements (BPM) offer possibilities to improve hypertension awareness and control. The aim of this study was to compare a smartphone application (app)-based algorithm with office BPM (OBPM). (2) Methods: We included consecutive patients with an indication [...] Read more.
(1) Background: New cuffless technologies attempting blood-pressure measurements (BPM) offer possibilities to improve hypertension awareness and control. The aim of this study was to compare a smartphone application (app)-based algorithm with office BPM (OBPM). (2) Methods: We included consecutive patients with an indication for ambulatory BPM. The smartphone app (RIVA digital) acquired the pulse wave in the fingers’ arterial bed using the phone’s camera and estimated BP based on photoplethysmographic (PPG) waveforms. Measurements were alternatingly taken with an oscillometric cuff-based device and smartphone BPM (AppBP) on two consecutive days. AppBP were calibrated to the first OBPM. Each AppBP was compared to its CuffBP (mean of the previous/following OBPM). (3) Results: 50 participants were included, resulting in 50 AppBP values on Day 1 and 33 on Day 2 after exclusion of 225 AppBP due to insufficient quality. The mean ± SD of the differences between AppBP and CuffBP was 0.7 ± 9.4/1.0 ± 4.5 mmHg (p-value 0.739/0.201) on Day 1 and 2.6 ± 8.2/1.3 ± 4.1 mmHg (p-value 0.106/0.091) on Day 2 for systolic/diastolic values, respectively. There were no significant differences between the deviations on Day 1 and Day 2 (p-value 0.297/0.533 for systolic/diastolic values). Overall, there were 10 (12%) systolic measurement pairs differing by >15 mmHg. (4) Conclusions: In this pilot evaluation, the RIVA Digital app shows promising results when compared to oscillometric cuff-based measurements, especially regarding diastolic values. Its differences between AppBP–CuffBP have a good stability one day after calibration. Before clinical use, signal acquisition needs improvement and the algorithm needs to undergo formal validation against a gold-standard BPM method. Full article
(This article belongs to the Special Issue New Progress in Diagnostics of Clinical Hypertension)
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Review

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19 pages, 2407 KiB  
Review
The Role of Heart Rate Variability (HRV) in Different Hypertensive Syndromes
by Louise Buonalumi Tacito Yugar, Juan Carlos Yugar-Toledo, Nelson Dinamarco, Luis Gustavo Sedenho-Prado, Beatriz Vaz Domingues Moreno, Tatiane de Azevedo Rubio, Andre Fattori, Bruno Rodrigues, Jose Fernando Vilela-Martin and Heitor Moreno
Diagnostics 2023, 13(4), 785; https://doi.org/10.3390/diagnostics13040785 - 19 Feb 2023
Cited by 13 | Viewed by 5700
Abstract
Cardiac innervation by the parasympathetic nervous system (PNS) and the sympathetic nervous system (SNS) modulates the heart rate (HR) (chronotropic activity) and the contraction of the cardiac muscle (inotropic activity). The peripheral vasculature is controlled only by the SNS, which is responsible for [...] Read more.
Cardiac innervation by the parasympathetic nervous system (PNS) and the sympathetic nervous system (SNS) modulates the heart rate (HR) (chronotropic activity) and the contraction of the cardiac muscle (inotropic activity). The peripheral vasculature is controlled only by the SNS, which is responsible for peripheral vascular resistance. This also mediates the baroreceptor reflex (BR), which in turn mediates blood pressure (BP). Hypertension (HTN) and the autonomic nervous system (ANS) are closely related, such that derangements can lead to vasomotor impairments and several comorbidities, including obesity, hypertension, resistant hypertension, and chronic kidney disease. Autonomic dysfunction is also associated with functional and structural changes in target organs (heart, brain, kidneys, and blood vessels), increasing cardiovascular risk. Heart rate variability (HRV) is a method of assessing cardiac autonomic modulation. This tool has been used for clinical evaluation and to address the effect of therapeutic interventions. The present review aims (a) to approach the heart rate (HR) as a CV risk factor in hypertensive patients; (b) to analyze the heart rate variability (HRV) as a “tool” to estimate the individual risk stratum for Pre-HTN (P-HTN), Controlled-HTN (C-HTN), Resistant and Refractory HTN (R-HTN and Rf-HTN, respectively), and hypertensive patients with chronic renal disease (HTN+CKD). Full article
(This article belongs to the Special Issue New Progress in Diagnostics of Clinical Hypertension)
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16 pages, 1549 KiB  
Review
Cardiac Magnetic Resonance in Hypertensive Heart Disease: Time for a New Chapter
by Marija Zdravkovic, Slobodan Klasnja, Maja Popovic, Predrag Djuran, Davor Mrda, Tatjana Ivankovic, Andrea Manojlovic, Goran Koracevic, Dragan Lovic and Viseslav Popadic
Diagnostics 2023, 13(1), 137; https://doi.org/10.3390/diagnostics13010137 - 31 Dec 2022
Cited by 3 | Viewed by 1835
Abstract
Hypertension is one of the most important cardiovascular risk factors, associated with significant morbidity and mortality. Chronic high blood pressure leads to various structural and functional changes in the myocardium. Different sophisticated imaging methods are developed to properly estimate the severity of the [...] Read more.
Hypertension is one of the most important cardiovascular risk factors, associated with significant morbidity and mortality. Chronic high blood pressure leads to various structural and functional changes in the myocardium. Different sophisticated imaging methods are developed to properly estimate the severity of the disease and to prevent possible complications. Cardiac magnetic resonance can provide a comprehensive assessment of patients with hypertensive heart disease, including accurate and reproducible measurement of left and right ventricle volumes and function, tissue characterization, and scar quantification. It is important in the proper evaluation of different left ventricle hypertrophy patterns to estimate the presence and severity of myocardial fibrosis, as well as to give more information about the benefits of different therapeutic modalities. Hypertensive heart disease often manifests as a subclinical condition, giving exceptional value to cardiac magnetic resonance as an imaging modality capable to detect subtle changes. In this article, we are giving a comprehensive review of all the possibilities of cardiac magnetic resonance in patients with hypertensive heart disease. Full article
(This article belongs to the Special Issue New Progress in Diagnostics of Clinical Hypertension)
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12 pages, 485 KiB  
Review
A New Perspective on the Renin-Angiotensin System
by Adrian Martyniak and Przemysław J. Tomasik
Diagnostics 2023, 13(1), 16; https://doi.org/10.3390/diagnostics13010016 - 21 Dec 2022
Cited by 15 | Viewed by 4355
Abstract
Cardiovascular disease (CVD) is the leading cause of death in the world. Hypertension is a serious medical problem not only in adults but also in children and adolescents. The renin-angiotensin-aldosterone system (RAAS) is one of the most important mechanisms regulating blood pressure and [...] Read more.
Cardiovascular disease (CVD) is the leading cause of death in the world. Hypertension is a serious medical problem not only in adults but also in children and adolescents. The renin-angiotensin-aldosterone system (RAAS) is one of the most important mechanisms regulating blood pressure and the balance of water and electrolytes. According to the latest reports, RAAS acts not only on endocrine but also on paracrine, autocrine, and intracrine. Moreover, RAAS has a component associated with hypotension and cardioprotective effects. These components are called alternative pathways of RAAS. The most important peptide of the alternative pathway is Ang 1–7, which is related to the Mas receptor. Mas receptors have widely known antihypertension properties, including vasodilatation, the release of nitric oxide, and increased production of anti-inflammatory cytokines. Another interesting peptide is angiotensin A, which combines the properties of the classical and alternative pathways. No less important components of RAAS are the proteolytic enzymes angiotensin convertase enzyme type 1 and 2. They are responsible for the functioning of the RAAS system and are a hypertension therapeutic target. Also involved are tissue-specific enzymes that form a local renin-angiotensin system. Currently, a combination of drugs is used in hypertension treatment. These drugs have many undesirable side effects that cannot always be avoided. For this reason, new treatments are being sought, and the greatest hope comes from the ACE2/ang 1–7/MasR axis. Full article
(This article belongs to the Special Issue New Progress in Diagnostics of Clinical Hypertension)
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Other

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3 pages, 190 KiB  
Reply
Reply to Hungerford, S.; Bart, N. Blood-Pressure-Monitoring Smartphone Applications: Ushering in a New Era of Wearable Cardiac Devices? Comment on “Vischer et al. Comparability of a Blood-Pressure-Monitoring Smartphone Application with Conventional Measurements—A Pilot Study. Diagnostics 2022, 12, 749”
by Annina S. Vischer, Jana Rosania, Thenral Socrates and Thilo Burkard
Diagnostics 2023, 13(2), 291; https://doi.org/10.3390/diagnostics13020291 - 12 Jan 2023
Viewed by 743
Abstract
We would like to thank Drs. Hungerford and Bart for their kind comment [...] Full article
(This article belongs to the Special Issue New Progress in Diagnostics of Clinical Hypertension)
3 pages, 186 KiB  
Comment
Blood-Pressure-Monitoring Smartphone Applications: Ushering in a New Era of Wearable Cardiac Devices? Comment on Vischer et al. Comparability of a Blood-Pressure-Monitoring Smartphone Application with Conventional Measurements—A Pilot Study. Diagnostics 2022, 12, 749
by Sara Hungerford and Nicole Bart
Diagnostics 2023, 13(2), 290; https://doi.org/10.3390/diagnostics13020290 - 12 Jan 2023
Cited by 1 | Viewed by 887
Abstract
Systemic arterial hypertension in adults is generally defined as a systolic blood pressure (SBP) of >140 mmHg and/or a diastolic blood pressure (DBP) of >90 mmHg [...] Full article
(This article belongs to the Special Issue New Progress in Diagnostics of Clinical Hypertension)
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