New Trends in Hypertension: Hormonal Mechanisms and Precision Management

Dear Colleagues,

Hypertension is one of the leading modifiable risk factors for cardiovascular, cerebrovascular, and renal morbidity and mortality worldwide. Despite major advances in antihypertensive therapy, a substantial proportion of patients remain undiagnosed, inadequately treated, or uncontrolled. Increasing recognition of the heterogeneity of hypertension has highlighted the importance of identifying specific underlying mechanisms and potentially reversible causes. In this context, endocrine and hormonal mechanisms are gaining renewed attention, particularly in relation to aldosterone excess, which may contribute not only to overt secondary hypertension but also to apparently “essential” hypertension and increased cardiovascular and renal risk.

Recent developments are challenging traditional approaches to the diagnosis and management of hypertension. Improved diagnostic strategies and emerging concepts such as a continuum of autonomous aldosterone secretion are expanding our understanding of hypertension and revealing the contribution of endocrine pathways to blood pressure dysregulation and target-organ damage. These advances are also reshaping the distinction between primary and secondary forms of hypertension while creating new opportunities for earlier detection, more precise phenotyping, and mechanism-based treatment. Together with the development of novel pharmacological approaches targeting specific hormonal pathways, these concepts may pave the way toward a more personalized approach to hypertension management.

This Special Issue aims to present and disseminate the most recent advances in the clinical management of hypertension, with a particular focus on hormonal and mechanistic perspectives, while extending beyond endocrine hypertension alone. We welcome original research, narrative reviews, and other contributions addressing emerging concepts in hypertension, novel diagnostic strategies, hormonal mechanisms, cardiovascular and renal consequences, and innovative therapeutic approaches. Contributions exploring the interface between endocrine disorders and hypertension, as well as the translation and implementation of new diagnostic and therapeutic strategies into clinical practice, are particularly encouraged.

Topics of interest for publication include, but are not limited to:

1. Primary aldosteronism and autonomous aldosterone secretion: screening, diagnosis, subtyping, adrenal venous sampling, and clinical management.
2. Other endocrine causes of hypertension: pheochromocytoma/paraganglioma, Cushing syndrome, thyroid disorders, mineralocorticoid excess, and related conditions.
3. Emerging hormonal mechanisms in hypertension: aldosterone, cortisol, catecholamines, vasopressin, and other pathways contributing to blood pressure dysregulation and cardiovascular risk.
4. Novel diagnostic and therapeutic strategies: biomarkers, imaging, targeted pharmacological therapies, and individualized treatment.
5. Clinical outcomes and implementation: cardiovascular and renal consequences of endocrine hypertension, resistant hypertension, case-finding strategies, and multidisciplinary models of care.

Dr. Jorge Gabriel Ruiz-Sánchez
Guest Editor

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