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Hypertension in Adults: Current Updates on Diagnosis, Treatment and Management
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Hypertension in Adults: Current Updates on Diagnosis, Treatment and Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Vascular Medicine".

Deadline for manuscript submissions: 20 November 2025 | Viewed by 4645

Special Issue Editors

Dr. Emelina Stambolliu

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Guest Editor
Nephrology Department, Hippokration General Hospital, 11527 Athens, Greece
Interests: internal medicine; hypertension; clinical medicine; kidney disease; blood pressure
Dr. Antonios A. Argyris

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Guest Editor
Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, P.O. Box 11528 Athens, Greece
Interests: internal medicine; hypertension; clinical medicine; kidney disease; blood pressure

Special Issue Information

Dear Colleagues,

It is widely known that hypertension in the adult population is a leading cause of morbidity and mortality, mainly due to its key role in cardiovascular disease. Therefore, the scientific community has focused on, first, its accurate diagnosis and then on the management of this complex problem. Lately, new drug categories have come into light, showing a favorable cardiovascular effect—including an effect on blood pressure, such as SGLT2 inhibitors, as well as other novel agents that are not yet available commercially. These novelties could offer new perspectives in the management of hypertension, especially after many years of limited progress in the field. Moreover, the diagnostic thresholds for hypertension still remain a matter of debate. However, some interesting and new information may be contained in the ESH 2024 Clinical Practice Guidelines. Lastly, as climate change shows its effect more and more on every aspect of our lives, a need for an investigation of its footprint on blood pressure is emerging.

In this Special Issue, we welcome authors to submit papers on the current updates in hypertension in adults in terms of diagnosis, management and potential future perspectives. Our aim is to gather all the current, updated knowledge on hypertension and explore new therapeutic options that may be available.

Dr. Emelina Stambolliu
Dr. Antonios A. Argyris
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. Journal of Clinical Medicine 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

  • essential hypertension
  • nighttime blood pressure
  • blood pressure measurement
  • blood pressure management
  • blood pressure medical treatment
  • hypertension thresholds

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Published Papers (5 papers)

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Research

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13 pages, 1475 KiB  
Article
Prevalence of Hypertension in Adolescents: Differences Between 2016 ESH and 2017 AAP Guidelines
by Caterina Carollo, Luigi Peritore, Alessandra Sorce, Emanuele Cirafici, Miriam Bennici, Luca Tortorici, Riccardo Polosa, Giuseppe Mulè and Giulio Geraci
J. Clin. Med. 2025, 14(6), 1911; https://doi.org/10.3390/jcm14061911 - 12 Mar 2025
Viewed by 493
Abstract
Introduction: The American Academy of Pediatrics (AAP) published in 2017 new guidelines for the screening and management of hypertension in children containing different nomograms compared to the European guidelines, leading to a reclassification of blood pressure values, the consequences of which are still [...] Read more.
Introduction: The American Academy of Pediatrics (AAP) published in 2017 new guidelines for the screening and management of hypertension in children containing different nomograms compared to the European guidelines, leading to a reclassification of blood pressure values, the consequences of which are still little investigated. The aim of our study was to evaluate the prevalence of high blood pressure values estimated with both the most recent American and European guidelines and to analyze the relationship of blood pressure increases with lifestyles and potentially risky behaviors in a school population in Western Sicily. Methods: On the occasion of the XV World Hypertension Day, blood pressure values of 1301 students aged between 13 and 18 were measured. Two questionnaires were administered, one relating to anamnestic data and anthropometric parameters and a second aimed at investigating lifestyle. For the diagnosis of increased blood pressure, both ESH and AAP criteria were considered. Results: The prevalence of elevated blood pressure was 7.5% according to ESH criteria and nearly twice as high using AAP criteria, with a more pronounced discrepancy in females. Individuals with elevated blood pressure were younger, exhibited higher body weight and BMI, and had an increased prevalence of overweight and obesity. Classification based on ESH criteria revealed higher alcohol and drug consumption among normotensive individuals. AAP criteria identified a higher proportion of males and greater height in the hypertensive group. Systolic blood pressure correlated significantly with height, weight, and BMI, with stronger associations in males, while diastolic pressure correlated with weight and BMI. Conclusions: To the best of our knowledge, our study is the only one to analyze the prevalence of increased blood pressure and its relationship with lifestyle factors and anthropometric data in adolescence in our region. Our study confirms that elevated blood pressure is common in adolescence, with higher prevalence using the 2017 AAP criteria than ESH guidelines. Full article
(This article belongs to the Special Issue Hypertension in Adults: Current Updates on Diagnosis, Treatment and Management)
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Review

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18 pages, 613 KiB  
Review
Managing Hypertension in Chronic Kidney Disease: The Role of Diet and Guideline Recommendations
by Emelina Stambolliu, Panagiotis Iliakis, Konstantinos Tsioufis and Aikaterini Damianaki
J. Clin. Med. 2025, 14(11), 3755; https://doi.org/10.3390/jcm14113755 - 27 May 2025
Abstract
Lifestyle and dietary modifications are unanimously suggested as the initial step to treat hypertension in the general population and in patients with chronic kidney disease (CKD). Limiting sodium intake constitutes the cornerstone of dietary interventions, but augmenting dietary potassium intake has also been [...] Read more.
Lifestyle and dietary modifications are unanimously suggested as the initial step to treat hypertension in the general population and in patients with chronic kidney disease (CKD). Limiting sodium intake constitutes the cornerstone of dietary interventions, but augmenting dietary potassium intake has also been associated with a significant blood pressure (BP)-lowering effect. Although there may be a consensus about restraining the daily sodium intake to <2 g per day, the target for optimal potassium intake is vague. In hypertensive patients with CKD, the desired amount of potassium in the diet remains a controversial issue, as evidence from studies concerning the effect on CKD progression is contradictory. Hence, medical societies and food authorities worldwide do not share a joint recommendation. Other dietary components, including calcium, magnesium, protein, phosphorus, zinc, and alcohol intake may play a role in BP control, but the evidence in the CKD population so far is inconclusive. Further studies are needed to establish solid evidence about the safety and efficacy of dietary interventions, particularly in CKD patients, the majority of whom suffer from hypertension. The purpose of this review is to summarize the existing recommendations and evidence concerning dietary interventions in hypertensives with CKD, with a primary focus on sodium and potassium intake. Additionally, we briefly address other dietary components that may play a role in BP regulation or kidney function. Full article
(This article belongs to the Special Issue Hypertension in Adults: Current Updates on Diagnosis, Treatment and Management)
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14 pages, 365 KiB  
Review
Renal Denervation After USA FDA Approval: An Update from an Interventional Cardiologist’s Perspective
by Jiandong Zhang, Peter M. Belford and George A. Stouffer
J. Clin. Med. 2025, 14(10), 3554; https://doi.org/10.3390/jcm14103554 - 19 May 2025
Viewed by 213
Abstract
In late 2023, the U.S. Food and Drug Administration (FDA) approved two renal denervation (RDN) systems for the treatment of hypertension. Several professional societies, including the Society of Cardiovascular Angiography and Intervention (SCAI), the American Heart Association (AHA), and numerous European associations, have [...] Read more.
In late 2023, the U.S. Food and Drug Administration (FDA) approved two renal denervation (RDN) systems for the treatment of hypertension. Several professional societies, including the Society of Cardiovascular Angiography and Intervention (SCAI), the American Heart Association (AHA), and numerous European associations, have recognized the potential role of RDN in managing hypertension. Despite widespread enthusiasm from clinicians, patients, and the industry, the American Medical Association’s Current Procedural Terminology (CPT) panel rejected the introduction of new codes for renal denervation at its September 2024 meeting. This article analyzes the latest evidence from clinical trials and registries, reviews current challenges in clinical practice, and explores the role of contemporary hypertension treatment from the perspective of interventional cardiologists. Full article
(This article belongs to the Special Issue Hypertension in Adults: Current Updates on Diagnosis, Treatment and Management)
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18 pages, 1188 KiB  
Review
The Particularities of Arterial Hypertension in Female Sex: From Pathophysiology to Therapeutic Management
by Antonios Lazaridis, Anastasia Malliora and Eugenia Gkaliagkousi
J. Clin. Med. 2025, 14(9), 3137; https://doi.org/10.3390/jcm14093137 - 1 May 2025
Viewed by 3038
Abstract
Arterial hypertension is the most important modifiable cardiovascular risk factor and a major cause of cardiovascular mortality worldwide. In daily clinical practice, the hypertensive patient is often treated in a uniform way, thus ignoring the significant effects of sex on several aspects of [...] Read more.
Arterial hypertension is the most important modifiable cardiovascular risk factor and a major cause of cardiovascular mortality worldwide. In daily clinical practice, the hypertensive patient is often treated in a uniform way, thus ignoring the significant effects of sex on several aspects of hypertension, including its prevalence, pathophysiology, response to antihypertensive treatment, and outcomes. Along with the immune response and several cardiometabolic risk factors that frequently coexist, the substantial hormonal changes during a woman’s life cycle are among the main pathophysiological mechanisms driving hypertension in women. Concurrently, women exhibit increased cardiovascular risk at lower blood pressure (BP) levels compared to age-matched men and present certain disparities in the incidence of cardiovascular events and subsequent hypertension-related cardiovascular prognosis. In addition, women respond differently to antihypertensive treatment, experience more drug-related side effects, and exhibit lower rates of BP control compared to men. Currently, international guidelines propose the same targets and the same therapeutic algorithms for the treatment of hypertension in both sexes without taking into account the sex differences that exist. In this review, we aim to describe certain particularities of arterial hypertension in the female sex, moving from pathophysiological aspects to clinical and therapeutical management. Full article
(This article belongs to the Special Issue Hypertension in Adults: Current Updates on Diagnosis, Treatment and Management)
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Other

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14 pages, 528 KiB  
Perspective
Pillars of Blood Pressure Management in Patients with Type 2 Diabetes Mellitus: Insights from Recent Trials and Emerging Perspectives
by Călin Pop, Antoniu Octavian Petriş, Lavinia Pop and Liliana Elisabeta David
J. Clin. Med. 2025, 14(10), 3269; https://doi.org/10.3390/jcm14103269 - 8 May 2025
Viewed by 419
Abstract
Hypertension (HTN) is prevalent among patients with type 2 diabetes mellitus (T2DM), and both conditions are well-established risk factors for cardiovascular diseases (CVDs) and microvascular complications. To mitigate the risk of CVD, a comprehensive management approach for both blood pressure (BP) and glycaemic [...] Read more.
Hypertension (HTN) is prevalent among patients with type 2 diabetes mellitus (T2DM), and both conditions are well-established risk factors for cardiovascular diseases (CVDs) and microvascular complications. To mitigate the risk of CVD, a comprehensive management approach for both blood pressure (BP) and glycaemic control is essential. The current therapeutic strategy should be structured around five pillars aimed at confirming HTN, establishing the 10-year CVD risk and its components and focusing on pharmacological treatment alongside lifestyle interventions to achieve BP targets. In clinical practice, the recommended BP target is 120–129/70–79 mmHg, while an optimal target of ≤120/70 mmHg is being explored under research conditions. Further, BP control should be re-evaluated in cases of resistant or uncontrolled HTN, in conjunction with antidiabetic therapies that have demonstrated cardiovascular and renal protective benefits. This five-pillar approach offers a comprehensive and evolving perspective on BP management in patients with T2DM, although certain aspects continue to be refined as new evidence emerges. Full article
(This article belongs to the Special Issue Hypertension in Adults: Current Updates on Diagnosis, Treatment and Management)
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