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Hypertension: Clinical Treatment and Management

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Dr. José L. Flores-Guerrero

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Interdisciplinary Center for Research and Science Education, Autonomous University of Puebla, Puebla, Mexico
Interests: lifestyle interventions; weight control; blood pressure telemonitoring; wearable technology; immune therapy; microbiota; hypertension

Special Issue Information

Dear Colleagues,

This Special Issue, “Hypertension: Clinical Treatment and Management”, delves into advancements and strategies for managing hypertension, a leading cause of cardiovascular morbidity and mortality globally. This issue highlights the importance of weight control as a cornerstone of hypertension prevention and treatment, emphasizing the role of diet, exercise, and behavioral interventions. It also explores the integration of emerging technologies, such as wearable devices and telemonitoring systems, to enhance the accuracy and frequency of blood pressure assessments, improve adherence to treatment, and enable the early detection of complications. Additionally, this issue examines the potential of immune therapy as a novel approach to treating resistant hypertension, focusing on the interplay between immune system modulation and blood pressure regulation. Through these various topics, this Special Issue aims to provide clinicians, researchers, and public health experts with cutting-edge insights into comprehensive hypertension management, ultimately reducing the global burden of this condition.

Dr. José L. Flores-Guerrero
Guest Editor

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10 pages, 469 KB

Open AccessArticle

Screening and Awareness for Blood Pressure in a Non-Medical Setting: The Vienna Hairdresser Initiative

by Simone Aufhauser, Michael Weber, Thomas W. Weiss and Maximilian Will

J. Clin. Med. 2025, 14(16), 5639; https://doi.org/10.3390/jcm14165639 - 9 Aug 2025

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Abstract

Background: Arterial hypertension (HTN) is the leading modifiable cardiovascular risk factor for overall mortality worldwide. In Austria, 1.6 million individuals above the age of 15, representing 20% of the total population and 70% of adults aged 65 and older, suffer from HTN. Despite numerous antihypertensive treatment options on the European market, only 38.8% of patients on optimal medical treatment (OMT) reach their treatment goal. Primary prevention remains a challenge, particularly for HTN and the consequential risk of cardiovascular diseases (CVDs). Thus, there is an urgent need for Disease Management Programs (DMPs). We sought to study a possible trial to diagnose hypertension in a non-medical setting at a very early stage of the disease and raise awareness for hypertension in affected people to avoid future complications of unrecognized and untreated HTN. For a non-medical setting, hairdressers fulfil many criteria for an optimal blood pressure (BP) measurement. Methods: This is a pilot study. A total of 193 individuals were included at a Viennese hairdresser. Metric data were described either using mean ± SD given normal distribution or median otherwise. Categorical data were described using absolute frequencies and percentages. For comparison, either independent t-tests or Mann–Whitney U tests or chi² tests were assessed. The staff received expert training on how to measure blood pressure in a guideline-compliant way. All members signed the written and informed consent and received a questionnaire about their demographic data and cardiovascular risk factors. Results: Of the 193 participants in this study, 56.5% (109/193) were female and 43.5% (84/193) were male. The mean age was 54 ± 15.1 years. In the automatically measured office blood pressure (AOBP) measurement, the mean systolic BP was 137.1 ± 17.8 and the mean diastolic BP was 91.6 ± 11.2. Of all participants, 65.8% (127/193) were hypertensive, whereof 74.8% (95/127) had no treatment at all. Among 127 individuals evaluated, 63% (80/127) were unaware of their elevated blood pressure levels, while 28% (44/127) had a prior diagnosis of HTN. The control rate of the individuals with previously diagnosed HTN was very low, with only 18.5% [10.4; 30.9] reaching normotensive values in the current measurement. There was no difference in BP values of patients with previously diagnosed HTN and patients who were unaware of their disease. Antihypertensive treatment was being received by 20.2% (39/193), while 62.2% had not taken their prescribed blood pressure medication on the day of recruitment. Conclusions: This is the first Austrian study to show that screening for HTN in an unconventional non-medical setting is effective to diagnose HTN and raise awareness. Based on the even-higher-than-expected prevalence of HTN, we plan to conduct a cohort study in Vienna, inviting all hairdressers in socially deprived districts to act as gate openers for hypertensive subjects to raise awareness and to contact a regional GP for provision of medical care. An implementation of such a cost-effective and feasible disease management program in Austria might therefore reduce the burden of preventable cardiovascular events associated with HTN. Full article

(This article belongs to the Special Issue Hypertension: Clinical Treatment and Management)

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Open AccessSystematic Review

Efficacy and Safety of Esaxerenone for Essential Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

by Abdelrahman Hafez, Ahmed Abdelaziz, Ahmed Mansour, Ibrahim Kamal, Ali Bakr, Ahmed Farid Gadelmawla, Hanaa Elsayed, Mohamed Reyad Mohamed, Karim Ali and Mohamed Elhelw

J. Clin. Med. 2025, 14(16), 5663; https://doi.org/10.3390/jcm14165663 - 11 Aug 2025

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Abstract

Background/Objectives: Esaxerenone, a novel non-steroidal mineralocorticoid receptor antagonist, has shown promising results in the treatment of essential hypertension (HTN). This study aims to comprehensively analyze the effectiveness of esaxerenone to control BP in patients with essential HTN. Methods: A systematic search was performed on PubMed, Scopus, Web of Science (WOS), and Cochrane Library from inception until January 2025 for randomized controlled trials (RCTs) comparing esaxerenone with standard HTN usual care. The primary outcome of interest was mean changes in sitting systolic (SBP) and diastolic blood pressure (DBP). Other secondary outcomes were mean changes in 24 h-SBP and 24 h-DBP, and target BP achievement. Safety outcomes, such as adverse events and increased levels of potassium/uric acid, were also assessed. Results: Our meta-analysis included four studies with a total of 1981 patients, all conducted in Japan. Esaxerenone demonstrated dose-dependent blood pressure reductions. At 5 mg, sitting DBP decreased by 4.22 mmHg (95% CI −8.72 to 0.29; p = 0.07) and SBP by 9.07 mmHg (95% CI −17.69 to −0.45; p = 0.04), while the 1.25 mg dose showed smaller, non-significant reductions. For 24 h measurements, only the 5 mg dose achieved significant reductions. Target BP achievement increased by 48% overall (RR 1.48, 95% CI 1.11 to 1.96; p = 0.007), with stronger effects at 5 mg (RR 2.05, 95% CI 1.03 to 4.08; p = 0.04). Esaxerenone significantly reduced nocturnal SBP by 10.62 mmHg (95% CI −14.01 to −7.23; p < 0.001). Conclusions: In patients with essential HTN, esaxerenone was shown to be safe and well-tolerated compared with usual care. Long-term data on safety is warranted. Full article

(This article belongs to the Special Issue Hypertension: Clinical Treatment and Management)

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