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Recent Research on Hypertension and Related Complications
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Recent Research on Hypertension and Related Complications

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: closed (30 December 2025) | Viewed by 31587

Special Issue Editor

Prof. Dr. Marijn Speeckaert

E-Mail Website
Guest Editor
Department of Nephrology, Ghent University Hospital, 9000 Ghent, Belgium
Interests: biochemistry; biomarkers; hypertension; cardiovascular disease; kidney disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Hypertension remains the most common cardiovascular illness and a major public health concern worldwide. It is a significant risk factor for a variety of serious consequences, including myocardial infarction, cerebrovascular accidents and chronic kidney disease. Despite significant advances in medical study, the precise pathophysiological pathways driving hypertension and its complications are not fully understood. In order to gain a better understanding of the causes, treatment methods and preventive measures for hypertension, it is important to continue conducting research. This highlights the importance of having a dedicated platform where new scientific discoveries on this critical topic can be shared.

The main objective of this Special Issue is to gather the most recent research on hypertension and its associated issues, which are known for their complex nature. We invite papers that explore innovative diagnostic techniques, effective therapeutic strategies and preventive measures. Furthermore, we are quite supportive of studies that investigate the biochemical, environmental and genetic components of hypertension. We also promote research on novel strategies for management and intervention. This Special Issue will include review articles, original research papers and case reports to provide a comprehensive picture of recent advances in hypertension research. This Special Issue aims to expand our understanding of hypertension and contribute to the development of effective measures to reduce its impact on global health through collaboration among various scientific views.

Prof. Dr. Marijn Speeckaert
Guest Editor

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 250 words) can be sent to the Editorial Office for assessment.

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. International Journal of Molecular Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. There is an Article Processing Charge (APC) for publication in this open access journal. For details about the APC please see here. 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

  • arterial hypertension
  • cardiovascular disease
  • pathophysiology
  • molecular mechanisms
  • complications

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Published Papers (7 papers)

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Research

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14 pages, 847 KB  
Article
Evaluating an Early Risk Model for Uncomplicated Hypertension in Pregnancy Based on Nighttime Blood Pressure, Uric Acid, and Angiogenesis-Related Factors
by Isabel Fernandez-Castro, Nestor Vazquez-Agra, Ana Alban-Salgado, Mariña Sanchez-Andrade, Susana Lopez-Casal, Anton Cruces-Sande, Oscar Seoane-Casqueiro, Antonio Pose-Reino and Alvaro Hermida-Ameijeiras
Int. J. Mol. Sci. 2025, 26(13), 6115; https://doi.org/10.3390/ijms26136115 - 25 Jun 2025
Viewed by 903
Abstract
Uncomplicated hypertension (UH) during pregnancy represents a common condition, worsening maternal and fetal prognosis. However, no single biomarker has proven optimal for determining the risk of UH. We developed an early risk multivariate model for UH, integrating hemodynamics with biochemistry, focusing on the [...] Read more.
Uncomplicated hypertension (UH) during pregnancy represents a common condition, worsening maternal and fetal prognosis. However, no single biomarker has proven optimal for determining the risk of UH. We developed an early risk multivariate model for UH, integrating hemodynamics with biochemistry, focusing on the relationship between blood pressure (BP) indices, uric acid (UA), and angiogenesis-related factors (AF). We collected and analyzed data on 24 h ambulatory BP monitoring, demographic, epidemiological, clinical, and laboratory variables from 132 pregnancies. The main predictors were BP indices and serum UA and AF levels. Uncomplicated hypertension, defined as the presence of gestational hypertension or worsening of essential hypertension beyond the 20th week, was the main outcome. The combined second-degree polynomial transformation of UA and the AF (sFlt-1/PIGF) ratio, called the UA-AF Index, consistently showed a positive association with UH. The models incorporating nighttime BP indices combined with the UA-AF Index outperformed the others, with the best-performing model based on the nocturnal systolic BP (SBP). Specifically, in the best-fitting model (nighttime SBP + UA-AF Index as predictors), each 1 mmHg increase in nocturnal SBP was associated with a 10% higher risk of UH, while each one-unit increase in the UA-AF Index raised the likelihood of UH by more than twofold (accuracy: 0.830, AUC 0. 874, SE 0.032, p-value < 0.001, 95%CI 0.811–0.938). The combination of nighttime blood pressure indices, serum uric acid, and angiogenesis-related factors may provide added value in the assessment of uncomplicated hypertension during pregnancy. Full article
(This article belongs to the Special Issue Recent Research on Hypertension and Related Complications)
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Review

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40 pages, 13200 KB  
Review
Flavonoids: Potential New Drug Candidates for Attenuating Vascular Remodeling in Pulmonary Hypertension
by Xiaoyi Zhang, Mingshu Chen, Ranran Wang, Ruiqi Liu, Difei Gong, Meng Zhang, Yangyang He, Guanhua Du, Lianhua Fang and Tianyi Yuan
Int. J. Mol. Sci. 2026, 27(1), 210; https://doi.org/10.3390/ijms27010210 - 24 Dec 2025
Viewed by 275
Abstract
Pulmonary hypertension (PH) is a progressive and life-threatening disorder characterized by elevated pulmonary arterial pressure, leading to right ventricular remodeling and significant mortality. Pulmonary arterial remodeling, a critical pathological feature of PH, refers to structural alterations in the pulmonary vasculature driven by various [...] Read more.
Pulmonary hypertension (PH) is a progressive and life-threatening disorder characterized by elevated pulmonary arterial pressure, leading to right ventricular remodeling and significant mortality. Pulmonary arterial remodeling, a critical pathological feature of PH, refers to structural alterations in the pulmonary vasculature driven by various pathogenic factors. Targeting this remodeling process has emerged as a promising strategy for treating and potentially curing the disease. In recent years, growing interest has been directed toward exploring natural products as anti-PH agents. Among them, flavonoids have demonstrated potent efficacy in the cardiopulmonary system. As a prominent class of natural small-molecule compounds, flavonoids exhibit broad biological activities, such as antioxidant, anti-inflammatory, and anti-proliferative properties. They have shown the ability to inhibit remodeling and restore vascular function across various vessel types, including pulmonary arteries. This review summarizes the effects of flavonoids on PH, with emphasis on their inhibition of pulmonary arterial remodeling. We also discuss the therapeutic potential of flavonoids in PH and discuss their underlying mechanisms of action. These insights may guide the development of next-generation PH therapeutics, either through the utilization of flavonoid-based structures or the preparation of compound formulations containing flavonoids. Full article
(This article belongs to the Special Issue Recent Research on Hypertension and Related Complications)
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11 pages, 720 KB  
Review
Current Knowledge About Aprocitentan in Hypertension
by Emilie Mathilde Bank-Mikkelsen, Daniela Grimm and Markus Wehland
Int. J. Mol. Sci. 2025, 26(23), 11431; https://doi.org/10.3390/ijms262311431 - 26 Nov 2025
Viewed by 838
Abstract
Hypertension (HT) is the leading contributor to the global burden of disease and overall mortality and is expected to increase due to such factors as increased life expectancy and rising obesity rates. Although HT significantly contributes to cardiovascular disease, it is also considered [...] Read more.
Hypertension (HT) is the leading contributor to the global burden of disease and overall mortality and is expected to increase due to such factors as increased life expectancy and rising obesity rates. Although HT significantly contributes to cardiovascular disease, it is also considered one of the most modifiable risk factors. Aprocitentan (ACT) is a newly developed orally administered dual endothelin receptor antagonist. This review aims to give an overview of the current knowledge regarding ACT in HT, focusing on its pharmacological mechanisms and therapeutic potential. We conducted a search in the PubMed and Clinicaltrials.gov databases using the search terms “hypertension”, “aprocitentan”, high blood pressure” and “cardiovascular disease”, as well as all their permutations. Both human and animal studies have demonstrated significant blood pressure reductions within 14 days of administration, with 25 mg identified as the most effective dose and no severe adverse effects. Moreover, ACT was compatible with other antihypertensive agents, demonstrating synergistic or additive effects in some cases. Since HT is frequently associated with comorbidities and ACT targets a different pathway than the existing antihypertensive drugs, ACT may play a pivotal role in the management of resistant hypertension. Full article
(This article belongs to the Special Issue Recent Research on Hypertension and Related Complications)
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29 pages, 2201 KB  
Review
Zilebesiran as an Innovative siRNA-Based Therapeutic Approach for Hypertension: Emerging Perspectives in Cardiovascular Medicine
by Petruta A. Morosan, Amelian M. Bobu, Alexandru Carauleanu, Radu Popa, Claudia F. Costea, Cristiana Filip, Catalin M. Buzduga, Emilia Patrascanu, Andrei I. Cucu, Razvan I. Tudosa, Roxana Covali and Anca Haisan
Int. J. Mol. Sci. 2025, 26(21), 10717; https://doi.org/10.3390/ijms262110717 - 4 Nov 2025
Viewed by 2799
Abstract
Zilebesiran represents an innovative antihypertensive therapy employing small interfering RNA (siRNA) to inhibit hepatic angiotensinogen, a key regulator of the renin–angiotensin–aldosterone system. By directly targeting the source of angiotensin II production, zilebesiran offers a novel mechanism distinct from conventional antihypertensive treatments. In the [...] Read more.
Zilebesiran represents an innovative antihypertensive therapy employing small interfering RNA (siRNA) to inhibit hepatic angiotensinogen, a key regulator of the renin–angiotensin–aldosterone system. By directly targeting the source of angiotensin II production, zilebesiran offers a novel mechanism distinct from conventional antihypertensive treatments. In the clinical studies KARDIA-1 and KARDIA-2, zilebesiran demonstrated clinically significant reductions in systolic blood pressure, with effects lasting up to 24 weeks after a single subcutaneous injection. In KARDIA-1, doses of 300 mg and 600 mg administered every 6 months resulted in reductions of over 15 mmHg in systolic blood pressure at 3 months compared with placebo. KARDIA-2 further showed an additional reduction of up to 12.1 mmHg at 3 months when zilebesiran was used as an adjunct to standard antihypertensive therapy. KARDIA-3 is currently evaluating the therapy in a larger global population to assess its impact on major cardiovascular outcomes. Zilebesiran has demonstrated a favorable safety profile with minimal adverse events, offering potential advantages for patients with resistant or uncontrolled hypertension and those at high cardiovascular risk, especially where adherence to daily oral medications is challenging. Beyond blood pressure reduction, zilebesiran may protect target organs, including the heart, kidneys, and retina. In conclusion, zilebesiran represents a promising siRNA-based therapy that may redefine the management of difficult-to-control hypertension, offering durable, targeted, and patient-friendly treatment with broad cardiovascular benefits. Future studies will clarify its long-term safety, efficacy across diverse populations, and integration into personalized hypertension management strategies. Full article
(This article belongs to the Special Issue Recent Research on Hypertension and Related Complications)
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38 pages, 1758 KB  
Review
Beyond Blood Pressure: Emerging Pathways and Precision Approaches in Hypertension-Induced Kidney Damage
by Charlotte Delrue and Marijn M. Speeckaert
Int. J. Mol. Sci. 2025, 26(15), 7606; https://doi.org/10.3390/ijms26157606 - 6 Aug 2025
Cited by 2 | Viewed by 3642
Abstract
Recent studies have demonstrated that the development and progression of hypertensive kidney injury comprise not only elevated systemic blood pressure but also a complex interplay of cellular, molecular, and genetic mechanisms. In this report, we outline the key emerging pathways—ranging from dysregulated renin–angiotensin [...] Read more.
Recent studies have demonstrated that the development and progression of hypertensive kidney injury comprise not only elevated systemic blood pressure but also a complex interplay of cellular, molecular, and genetic mechanisms. In this report, we outline the key emerging pathways—ranging from dysregulated renin–angiotensin system signaling, oxidative stress, immune-mediated inflammation, and metabolic abnormalities to epigenetic alterations and genetic susceptibilities—that contribute to kidney damage in hypertensive conditions. In addition, we also discuss precision medicine approaches like biomarker-directed therapies, pharmacologically targeted therapies, and device-based innovations for modulating these pathways. This integrative review emphasizes the application of omics technologies and genetically guided interventions to better stratify patients and offer personalized care for hypertensive kidney disease. Full article
(This article belongs to the Special Issue Recent Research on Hypertension and Related Complications)
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18 pages, 1049 KB  
Review
Hypertension: A Continuing Public Healthcare Issue
by Samaneh Goorani, Somaye Zangene and John D. Imig
Int. J. Mol. Sci. 2025, 26(1), 123; https://doi.org/10.3390/ijms26010123 - 26 Dec 2024
Cited by 17 | Viewed by 18768
Abstract
Hypertension is a cardiovascular disease defined by an elevated systemic blood pressure. This devastating disease afflicts 30–40% of the adult population worldwide. The disease burden for hypertension is great, and it greatly increases the risk of cardiovascular morbidity and mortality. Unfortunately, there are [...] Read more.
Hypertension is a cardiovascular disease defined by an elevated systemic blood pressure. This devastating disease afflicts 30–40% of the adult population worldwide. The disease burden for hypertension is great, and it greatly increases the risk of cardiovascular morbidity and mortality. Unfortunately, there are a myriad of factors that result in an elevated blood pressure. These include genetic factors, a sedentary lifestyle, obesity, salt intake, aging, and stress. Although lifestyle modifications have had limited success, anti-hypertensive drugs have been moderately effective in lowering blood pressure. New approaches to control and treat hypertension include digital health tools and compounds that activate the angiotensin receptor type 2 (AT2), which can promote cardiovascular health. Nonetheless, research on hypertension and its management is vital for lessening the significant health and economic burden of this condition. Full article
(This article belongs to the Special Issue Recent Research on Hypertension and Related Complications)
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17 pages, 1311 KB  
Review
An Overview on Renal and Central Regulation of Blood Pressure by Neuropeptide FF and Its Receptors
by Hewang Lee, Jun B. Feranil and Pedro A. Jose
Int. J. Mol. Sci. 2024, 25(24), 13284; https://doi.org/10.3390/ijms252413284 - 11 Dec 2024
Viewed by 2816
Abstract
Neuropeptide FF (NPFF) is an endogenous octapeptide that was originally isolated from the bovine brain. It belongs to the RFamide family of peptides that has a wide range of physiological functions and pathophysiological effects. NPFF and its receptors, NPFFR1 and NPFFR2, abundantly expressed [...] Read more.
Neuropeptide FF (NPFF) is an endogenous octapeptide that was originally isolated from the bovine brain. It belongs to the RFamide family of peptides that has a wide range of physiological functions and pathophysiological effects. NPFF and its receptors, NPFFR1 and NPFFR2, abundantly expressed in rodent and human brains, participate in cardiovascular regulation. However, the expressions of NPFF and its receptors are not restricted within the central nervous system but are also found in peripheral organs, including the kidneys. Both NPFFR1 and NPFFR2 mainly couple to Gαi/o, which inhibits cyclic adenosine monophosphate (cAMP) production. NPFF also weakly binds to other RFamide receptors and the Mas receptor. Relevant published articles were searched in PubMed, Google Scholar, Web of Science, and Scopus. Herein, we review evidence for the role of NPFF in the regulation of blood pressure, in the central nervous system, particularly within the hypothalamic paraventricular nucleus and the brainstem, and the kidneys. NPFF is a potential target in the treatment of hypertension. Full article
(This article belongs to the Special Issue Recent Research on Hypertension and Related Complications)
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