Search Results (416)

Background/Objectives: Modifiable lifestyle factors, particularly diet, are important for preventing type 2 diabetes (T2D); however, the evidence regarding this from prospective studies is limited in the Asian population. We therefore evaluated whether a diet-inclusive healthy lifestyle score (HLS) predicts incident T2D in a community-based cohort. Methods: We analyzed 7185 T2D-free adults from the KoGES Ansan–Ansung cohort, constructing the HLS (range: 0–5) based on five lifestyle factors: non-smoking, ≥30 min/day of moderate-to-vigorous physical activity, low-risk alcohol consumption (≤40 g/day for men; ≤20 g/day for women), BMI of 18.5–24.9 kg/m², and a healthy diet, defined as a healthy plant-based diet index within the top 40th percentile. Cox proportional hazards regression models were employed to examine the association between HLS and incident T2D risk. Results: During a median follow-up of 17.5 years, 1223 cases of T2D were identified. Compared to individuals with a score of 0 or 1, those with a score of 5 had a 56% lower risk of T2D after adjustment for potential confounders (HR: 0.44, 95% CI: 0.32–0.62), and these associations remained consistent across subgroups stratified by age, sex, family history of T2D, hypertension, and residential area. However, the association was stronger among non-users of anti-diabetic medication than among users. Conclusions: Adherence to a healthier lifestyle, as indicated by a higher HLS, was significantly associated with a reduced risk of developing T2D among Korean adults. These findings underscore the importance of promoting integrated healthy lifestyle behaviors to prevent T2D. Full article

Background and Objectives: Hypertension affects more than 27% of adults in China, and despite ongoing public health efforts, substantial gaps remain in awareness, treatment, and blood pressure control, particularly among older adults and patients with multiple comorbidities. Conventional clinic-based care often provides limited opportunity for frequent monitoring and timely treatment adjustment, which may contribute to persistent poor control in routine practice. The objective of this study was to evaluate changes in blood pressure control and related clinical indicators during implementation of a mobile-enhanced remote patient monitoring (RPM)–supported care model among hypertensive patients with comorbidities, including patterns of medication adjustment, adherence, and selected cardiometabolic parameters. Methods: We conducted a multicenter, pre–post evaluation of a mobile-enhanced remote patient monitoring (RPM) program among 6874 adults with hypertension managed at six hospitals in Chongqing, China. Participants received usual care during the pre-RPM phase (April–September 2024; clinic blood pressure measured using an Omron HEM-7136 device), followed by an RPM-supported phase (October 2024–March 2025; home blood pressure measured twice daily using connected A666G monitors with automated transmission via WeChat, medication reminders, and clinician follow-up). Given the use of different devices and measurement settings, blood pressure comparisons may be influenced by device- and setting-related measurement differences. Monthly blood pressure averages were calculated from all available readings. Subgroup analyses explored patterns by sex, age, baseline BP category, and comorbidity status. Results: The cohort was 48.9% male with a mean age of 66.9 ± 13.7 years. During the RPM-supported care period, the proportion meeting the study’s blood pressure control threshold increased from 62.4% (pre-RPM) to 90.1%. Mean systolic blood pressure decreased from 140 mmHg at baseline to 116–118 mmHg at 6 months during the more frequent monitoring and active treatment adjustment period supported by RPM (p < 0.001), alongside modest reductions in fasting blood glucose and total cholesterol. These achieved SBP levels are below commonly recommended office targets for many older adults (typically <140 mmHg for ages 65–79, with individualized lower targets only if well tolerated; and less stringent targets for adults ≥80 years) and therefore warrant cautious interpretation and safety contextualization. Medication adherence improved, and antihypertensive regimen intensity increased during follow-up, suggesting that more frequent monitoring and active treatment adjustment contributed to the early blood pressure decline. Subgroup patterns were broadly similar across age and baseline BP categories; observed differences by sex and comorbidity groups were exploratory. Conclusions: In this large multicenter pre–post study, implementation of an RPM-supported hypertension care model was associated with substantial improvements in blood pressure control and concurrent intensification of guideline-concordant therapy. Given the absence of a concurrent control group, clinic-to-home measurement differences, and concurrent medication changes, findings should be interpreted as associations observed during an intensified monitoring and treatment period rather than definitive causal effects of RPM technology alone. Pragmatic randomized evaluations with standardized measurement protocols, longer follow-up, and cost-effectiveness analyses are warranted. Full article

Objective: Current data on the association between attention-deficit/hyperactivity disorder (ADHD) and essential hypertension (EH) in pediatric populations are very limited, as most research has focused on adults. This study investigated the long-term prevalence of EH in Israeli youth aged 5–18 years with ADHD, examining also trends in antihypertensive medication use. Methods: A retrospective cohort study was conducted using data from Leumit Health Services. The ADHD cohort (N = 18,558) was compared in a 1:2 ratio to controls (N = 37,116), who were strictly matched for age, gender, birth year and quarter, socioeconomic status (SES), sectors, region, and cumulative years of LHS membership up to the index date. Diagnoses of ADHD and EH were identified using ICD-9/10 codes, depending on the year of diagnosis. Logistic regression analyses were used to assess the associations between ADHD, EH and the use of antihypertensive medications over a 20-year follow-up. Results: ADHD-diagnosed children had a higher prevalence of EH, with odds ratios (ORs) of 3.17 (95% CI: 1.46–7.16, p = 0.0017) at 5 years, 2.94 (95% CI: 1.45–6.09, p = 0.0013) at 10 years, and 1.92 (95% CI: 1.26–2.93, p = 0.0015) at 20 years. ADHD patients showed a greater use of antihypertensive medications, including calcium channel blockers (OR 1.85, 95% CI: 1.02–3.35, p = 0.035), renin angiotensin system blockers (OR 2.20, 95% CI: 1.15–4.25, p = 0.013), and diuretics (OR 1.77, 95% CI: 1.21–2.60, p = 0.0028). Conclusions: These findings highlight an association between ADHD diagnosis and EH, suggesting regular cardiovascular monitoring of children with ADHD. Further studies are needed to uncover the role of stimulant medications and shared biological and behavioral factors involved in the pathogenesis. Full article

Background/Objectives: Population aging increases the healthcare burden of chronic diseases. We aimed to characterize the sociodemographic and clinical characteristics of Aged Madrid, a cohort comprising 98.6% of the population aged 75 years and older in Madrid, Spain. Methods: Observational study with a five-year retrospective baseline period (2015–2019) to assess baseline vascular and metabolic risk. Data were taken from primary care electronic medical records, hospital discharge summaries, and pharmacy records. Results: 587,603 individuals (mean age: 84 years ± 5.8 years, 61.3% women) were analysed. Obesity affected 31.3% (more frequent in women), while type 2 diabetes occurred in 23.8% (predominantly in men). Hypertension (52.8%), dyslipidaemia (61.6%), and chronic kidney disease (21.7%) were more frequent in women. Atrial fibrillation was the leading cardiovascular condition in women (15.1%), while acute myocardial infarction predominated in men (8.2%). The most prescribed drug classes were antihypertensives (53.8%), statins (44.2%), and oral antidiabetics (26.4%). Among antihypertensives, diuretics (53.9%), ACE inhibitors (27.4%), and ARBs (25.3%) were most used, often in combinations such as diuretics + ACE inhibitors (30.1%). Diabetes treatments favoured metformin and DPP-4 inhibitors; 5.2% received insulin. Conclusions: Sex-based differences emerged in biochemical, anthropometric, and lifestyle variables. Men showed a higher prevalence of cardiovascular diseases and several cardiometabolic risk factors, while women used fewer lipid-lowering and antidiabetic agents. Diuretics were the predominant antihypertensives, and antidiabetic therapy largely followed guideline recommendations. Although 60% of statin users had no prior cardiovascular disease, and their use was concentrated mainly among individuals with major cardiometabolic risk conditions and declined with advancing age, suggesting an age- and risk-sensitive prescribing pattern rather than indiscriminate use. Full article

Background: There is no standardized definition for metabolic health. Overweight and obesity are often linked to metabolic dysfunction. Bariatric surgery promotes body weight loss and cardiometabolic health improvement. Objective: We aim to characterize metabolic health using distinct definitions and evaluate anthropometric and cardiometabolic features, both before and after different surgery procedures. Methods: We studied 3313 individuals from CRI-O [Porto, PT; BMI 39.56 (42.60; 46.20) kg/m²; 36 (43; 51) y; 82.7% women] who underwent Roux-en-Y gastric bypass (RYGB; 61.7%), sleeve gastrectomy (30.9%), or gastric band (7.5%) surgery. Anthropometric and cardiometabolic features were assessed at baseline and at yearly follow-ups, up to 4 years; the same for cardiometabolic dysfunction characterization using NCEP ATP III, Karelis, Meigs, Khan, Pluemacher, and Schulze definitions. Results: Baseline metabolic health classification and metabolically unhealthy phenotype (MUH) post-surgery prevalence decrease show substantial variability depending on the definition used. Unlike relative body weight loss, the altered metabolic feature number in MUH remains unchanged. Changes in MUH prevalence do not reflect body weight loss, nor does the variation in MUH percentage fully align with changes in altered metabolic features. Blood pressure, C-reactive protein, antihypertensive medication, and HOMA-IR are key contributors to baseline MUH. Post-surgical changes in body weight, lipid profile, and C-reactive protein vary by procedure. RYGB yields greater weight loss and more often improves cardiometabolic markers. However, post-operative metabolic phenotype is independent of surgery type. Conclusions: Metabolic health phenotypes pre- and post-surgery vary by definition, and the latter are not solely driven by weight loss or surgery type. In this cohort, RYGB shows the strongest beneficial impact. Full article

Background/Objectives: Hypertension (HTN) remains a major global concern despite the availability of many antihypertensive medications, each with its own side effects. Lifestyle interventions, such as aerobic exercise and antioxidant-rich foods, represent promising non-pharmacological strategies for hypertension management. This study investigated the combined effects of exercise and vitamin C on anthropometric parameters, blood pressure, gut histology, biochemical markers, hematological profile, inflammatory gene expression, redox status, and stress hormones in L-nitroarginine methyl ester (L-NAME)-induced hypertensive rats. Methods: Male Wistar rats (n = 30) were randomly divided into five groups (n = 6/group): control, hypertensive (HTN), hypertensive + exercise (HTN + EX), hypertensive + vitamin C (HTN + VC), and hypertensive + exercise + vitamin C (HTN + EX + VC). Exercise consisted of treadmill training at a low intensity (50 ft/min) for 60 min daily, while vitamin C was administered orally (200 mg/kg/day) for four weeks. Blood pressure, anthropometric parameters, gut histology, inflammatory gene expression, hematological indices, serum biochemistry, oxidative stress markers, and hormonal assays were measured. Results: Both exercise and vitamin C individually reduced blood pressure (p < 0.05) and increased villi length (p < 0.05), upregulated anti-inflammatory cytokine expression in the gut, lowered oxidative stress (assessed through CRP, MDA, and catalase), and reduced stress hormones (cortisol and norepinephrine). The combined intervention (HTN + EX + VC) showed the most pronounced effects, resulting in a greater reduction in blood pressure and reversal of the changes induced by hypertension when compared to the HTN group. Conclusions: Exercise and vitamin C were beneficial in lowering blood pressure and improving the adverse changes associated with hypertension. Full article

Objectives: To evaluate clinical and biochemical outcomes of robotic-assisted laparoscopic adrenalectomy in patients with primary aldosteronism (PA) due to small aldosterone-producing adenomas, with emphasis on blood pressure (BP) control, antihypertensive medication burden, hormonal normalization, and safety. Methods: We prospectively enrolled PA patients (aldosterone >10 ng/dL, renin <2 μU/mL) undergoing robotic adrenalectomy by a single surgeon. Exclusions included suspected pheochromocytoma, other adrenal pathologies, or malignancy. Outcomes were classified per PASO criteria at 6 months: complete success (BP <140/90 mmHg without medications + normalized aldosterone (<10 ng/dL) and renin (>2 μU/mL)), partial success (improvement in BP control with reduced medication and/or partial biochemical improvement), and failure (persistent hypertension and abnormal hormone levels). Results: From 2019 to present, 18 patients (median age 53 years; 13 male) with a median adenoma size of 15 mm (IQR 10–19.8) underwent robotic adrenalectomy (12 left, 6 right). Three (16.7%) with bilateral imaging findings had adrenal vein sampling to confirm unilateral disease. At 6 months, complete clinical success was achieved in 10 (55.5%) patients, partial success in 7 (38.9%), and failure in 1 (5.6%). Biochemically, 12 achieved complete normalization, 3 achieved partial improvement, and 3 did not complete testing. Median operative time was 110 min (IQR 100–120); median hospital stay was 3 days (IQR 3–4). No intra- or postoperative complications, transfusions, infections, or readmissions occurred. Conclusions: Robotic adrenalectomy for small aldosterone-producing adenomas in PA is safe, with high rates of BP normalization and hormonal remission and significantly reduced antihypertensive medication burden. Full article

The renin–angiotensin–aldosterone system (RAAS) is essential for controlling blood pressure and maintaining fluid balance, driving significant structural changes throughout the cardiovascular system, including the heart and blood vessels. As a result, the RAAS is a key therapeutic target for various chronic cardiovascular diseases, ranging from arterial hypertension (AH) to heart failure (HF). In this review, one of our objectives is to describe the new evidence over the last 4 years regarding the RAAS. Moreover, we pay attention to the structure and function of the angiotensin II type 1 receptor (AT1R) and its role in hypertension, as well as define its active site. Later, we discuss the most potent, selective inhibitors of AT1 receptors, based on in vitro and in vivo experiments, from 2020 to 2024. Large peptide molecules, small non-peptide-like molecules, and sartan derivatives are analyzed. The low IC₅₀ values of the entities that do not resemble sartans showcase the vast chemical space that can be explored for the creation of more potent antihypertensive medications. We have also employed computational chemistry tools in order to identify key molecular interactions between the compounds of the literature studied in order to elucidate the underlying reasons why these different molecules exhibit variations in their binding energies and overall potency. Full article

Background/Objectives: Among survivors of cancer diagnosed in childhood, adolescence, or young adulthood (C-AYAs), cardiotoxic therapies combined with acquired cardiovascular risk factors (CVRFs) increase the risk for cardiovascular events. To our knowledge, no prior analysis has examined CVRFs among C-AYAs < 20 years old or compared CVRFs among younger and older C-AYAs. Methods: In this single-center study, individuals diagnosed with cancer at ≤39 years, treated with anthracycline-based chemotherapy (2010–2023), and with a post-treatment lipid panel and ≥2 post-treatment ambulatory blood pressure measurements were included. The CVRF prevalence was assessed among C-AYAs < 20 and ≥20 years old, using age-appropriate AAP and ACC/AHA guidelines. These prevalences were compared with the ICD-9/10 code prevalence. The prescription of medications with antihypertensive effects (MAHEs) and lipid-lowering therapy was assessed. Results: Among 276 C-AYAs, the median age was 28.1 years (IQR 18.1–38.3) at dyslipidemia screening and 29.3 (IQR 20.0–38.7) at hypertension screening. Dyslipidemia was present in 52.9% (146/276) and hypertension in 56.2% (155/276) of C-AYAs. C-AYAs < 20 years old had a high prevalence of dyslipidemia, 51.7% (45/87), and hypertension, 31.9% (29/91). CVRFs were frequently underdiagnosed, particularly dyslipidemia, among C-AYAs < 20 years old, with only 12.6% (11/87) having a diagnosis via the ICD code. C-AYAs < 20 years old with diagnoses of dyslipidemia and hypertension were significantly less likely to receive lipid-lowering therapy (2.2% vs. 14.9%) and trended toward less MAHEs (13.8% vs. 31.0%) compared to C-AYAs ≥ 20. Conclusions: Among C-AYAs treated with anthracyclines, dyslipidemia and hypertension were highly prevalent even at a young age (<20 years). Younger survivors with dyslipidemia and hypertension were less frequently prescribed lipid-lowering therapy or MAHEs. Full article

Background: Intestinal angioedema is an important drug-induced adverse effect that is often misdiagnosed due to vague and nonspecific symptoms. This study aimed to identify drugs with potential to cause intestinal angioedema by performing a disproportionality analysis, supplemented with literature review. Methods: Using OpenVigil, we extracted relevant individual case safety reports from the United States Food and Drug Administration Adverse Event Reporting System (FAERS) database. Drugs with signal of disproportionate reporting (SDR) of intestinal angioedema were identified. A literature review was performed using PubMed and Embase databases to identify potential suspect drugs. Results: During 2004–2024, 303 cases of intestinal angioedema were reported to FAERS. Fourteen suspect medications showed SDR; of these, seven drugs were also reported in the literature to have caused intestinal angioedema, including angiotensin-converting enzyme inhibitors, losartan, and acetylsalicyclic acid. A literature search identified 89 relevant articles, providing details of 121 cases. Some drugs linked to intestinal angioedema in the literature did not show SDR. Conclusions: Disproportionality analysis as well as a literature review showed that most patients were middle-aged females on antihypertensive therapy. The results will assist health professionals in determining the temporal association of acute abdomen with the suspected drug, potentially avoiding unnecessary interventions and their attendant complications. Full article

Objectives: Lung transplantation (LT) is a rescue therapy for end-stage pulmonary diseases, including systemic autoimmune diseases. The aim of this study was to analyse the evolution of patients with systemic sclerosis (SSc) who, after undergoing LT, become negative for antinuclear antibodies (ANA) and to assess whether they have different clinical and prognostic characteristics than patients who do not become negative. Material and Methods: A retrospective, descriptive analysis was performed over a cohort of patients with a diagnosis of SSc, who underwent unilateral or bilateral LT between 2006 and 2021 at the Vall d’Hebron University Hospital. Clinical and analytical data were obtained from these patients by reviewing their electronic medical records. Two groups of patients were compared: those who tested negative for ANA after LT and those who did not. Statistical analysis was performed with SPSS Statistics 20.0. Results: Eighteen patients were included. The most frequent indication for LT was interstitial lung disease (ILD) combined with pulmonary hypertension (PH), in 13 (72%) patients. All had ANA before the LT (n = 18), and regarding specific SSc autoantibodies, anti-topoisomerase I was presented in 44% (n = 8), anti-U11/U12RNP in 17% (n = 3), anti-RNA Polymerase III in 11.1% (n = 2), anti-Ro52 in 11% (n = 2) and anti-centromere in 6% of individuals (n = 1). 39% (n = 7) of the patients had negative post-LT ANA, 44% (n = 8) had declining titres, and 17% (n = 3) had stable ANA titres. Titres did not increase in any case after LT. Those patients who became ANA-negative after LT were those who had significantly lower titres before LT. No statistically significant differences between groups were found related to pre-LT clinical characteristics, immunosuppressive regimen applied after LT, or in post-LT outcomes. A non-significant trend towards better survival was observed in patients who became ANA negative, with a cumulative survival at 5 years of 85.7% compared to 72.7% among those who remained ANA-positive. Conclusions: Most patients with SSc clear ANA or reduce their levels after LT. A trend towards better survival was observed in this group, compared to the group of transplanted patients who remained positive. Full article

Background: Pediatric hypertension is an increasingly recognized health concern and is commonly influenced by modifiable factors such as dietary sodium intake and obesity and non-modifiable factors like family history of hypertension. Urinary sodium excretion provides an objective surrogate marker of sodium consumption and may be associated with blood pressure severity. This study aimed to evaluate urinary sodium excretion in children with primary hypertension (PH) and to test the hypothesis that higher sodium excretion is associated with less favorable clinical, biochemical, and blood pressure parameters. Methods: This retrospective, cross-sectional, single-center study analyzed data from 369 hypertensive patients and 59 healthy children. Patients with a confirmed diagnosis of PH and ambulatory blood pressure monitoring results were included in the study group. Clinical, anthropometric, laboratory, echocardiographic, and blood pressure data were examined, and sodium excretion was evaluated using both the spot urine sodium-to-creatinine ratio and 24-h urinary sodium per kilogram of body weight. Results: Children with hypertension exhibited higher urinary sodium excretion compared to the control group. Sodium excretion of the hypertensive group, measured using the sodium/creatinine ratio and 24 h urinary sodium excretion per kilogram, was positively correlated with 25-hydroxyvitamin D, the urinary potassium/creatinine ratio, and the urinary uric acid/creatinine ratio. Moreover, negative correlations were observed for both parameters with age, body weight, serum uric acid, and left ventricular mass. In the multivariate analysis, weighted Z-score (beta = −0.393), age (beta = −0.293), 25-OHD (beta = 0.182), and arterial hypertension in the father (beta = 0.166) predicted 24 h urinary sodium excretion. Children with excessive sodium excretion had a significantly higher systolic blood pressure load over 24 h. Conclusions: Urinary sodium excretion is elevated in children with PH. Children with a lower weight for their age, who are younger, and who have a father with arterial hypertension might be at higher risk of excessive urine excretion. Our findings underscore the clinical importance of dietary sodium reduction as a non-pharmacological therapeutic target, especially in these patient populations. Prospective studies are needed to evaluate its impact on long-term cardiovascular outcomes in this population. Full article

Pines are edifying woody species for forest habitats, having crucial importance for ecosystems in both cold (boreal or mountainous) and warm (Mediterranean and tropical) areas. Pine trees include about 120 species, many of which have had an important ornamental role. Despite their ecological importance, many pine forests are threatened by increasing deforestation and habitat degradation, leading to progressive declines in species distribution and genetic diversity worldwide. Humans have used pine wood since the Stone Age, gradually discovering their outstanding medical properties. This review synthesizes global knowledge on the medicinal potential of pines. Using a comprehensive literature survey of major international scientific databases, we evaluated documented traditional and modern medical applications across all regions where pines naturally occur. The vast majority (86) of pine species were described as having medicinal properties, and the uses of the main pine species in representative regions of all continents supporting forest vegetation were examined. Various organs or secretions (needles, branches, bark, buds, cones, seeds, pollen, roots, wood, sap, resin, pitch, etc.) have been used to prevent or treat numerous diseases or to strengthen the organism. Their reported therapeutic activities include antioxidant, antimutagenic, antitumor, antimicrobial, skin-protective, antinociceptive, anti-inflammatory, neuroprotective, antiallergenic, laxative, circulatory-enhancing, antihypertensive, anti-atherosclerotic, anti-aging, and antithrombotic effects. Given the remarkable phytochemical diversity and broad pharmacological value of these species, the conservation of pine genetic resources and natural habitats is urgent. Protecting these species is essential not only for maintaining ecosystem resilience but also for preserving their substantial pharmaceutical and industrial potential. Full article

Background/Objectives: Despite the availability of highly effective medications, hypertension is among the most important risk factors for mortality. Because medication adherence is challenging worldwide, enhancing it to improve the prognosis of hypertension is useful. The aim of this study was to describe the prevalence of antihypertensive medication nonadherence among individuals aged 18–64 years in a deprived Hungarian population and its determinant factors, and to quantify the impact of antihypertensive medication nonadherence on premature mortality. Methods: We used data from a cohort of hypertensive individuals aged 18–64 years linked to the Health Insurance Fund’s medication purchasing data. The antihypertensive treatment adherence appropriateness (ATAP) was computed as the ratio of the observed time when a patient was properly treated to their observed survival time. ATAP was dichotomized by an observed mean of 0.872. Using adjusted odds ratios (AORs) from multivariate logistic regression models with 95% confidence intervals (CIs), we analyzed the factors influencing the mortality risk in 4962 participants over seven years of follow-up. Results: A total of 493 deaths occurred. An extremely high mortality risk was observed among patients with inappropriate adherence (AOR = 56.2, 95%CI: 41.9–75.4), which could be attributed partly to residual confounding. Significant protective factors were female sex and high education attainment. However, older age and all investigated comorbidities (diabetes mellitus, ischemic heart disease, chronic obstructive pulmonary disease, and cancer) were significantly associated with an increased risk of a lethal outcome. Similarly, smoking was also a risk factor. Conclusions: Our investigation revealed the following: (1) in the studied group of patients aged 18–64 years from an extremely disadvantaged Hungarian population, 87.2% of the person-time was covered by the appropriate redemption of medications; (2) nonadherence to medication was more common among younger adults, men, Roma people, current smokers, and COPD patients, whereas the likelihood of appropriate adherence was higher among patients with diabetes mellitus; (3) medication nonadherence was an extremely strong risk factor for a lethal outcome of HTN during the 7-year follow-up period; and (4) methods by which nonadherent patient behavior can be detected should be applied rigorously, and the detected nonadherence should be considered a signal for intervention to improve the prognosis of HTN. Full article

Background and Objectives: Interdialytic blood pressure (BP) better reflects volume status and cardiovascular risk in hemodialysis (HD) patients than peridialytic readings. High-efficiency dialysis techniques—online hemodiafiltration (HDF) in pre-, post-, and mixed-dilution modes, and expanded hemodialysis (HDx) with medium cut-off membranes—aim to improve solute clearance and hemodynamic stability. Their comparative impact on interdialytic BP control remains unclear. This randomized cross-over study compared interdialytic BP profiles across these modalities under standardized treatment conditions. Materials and Methods: Sixteen clinically stable adults with end-stage kidney disease sequentially underwent high-flux HD, HDx, and HDF in pre-, post-, and mixed-dilution configurations, each for one month. Dialysis prescriptions, dry weight, and antihypertensive therapy remained constant. Home BP was measured twice daily on non-dialysis days, yielding ~3600 observations. Systolic (SBP), diastolic (DBP), and mean arterial pressure (MAP) were analyzed by repeated-measures ANOVA with Bonferroni correction. Results: Significant differences were found among modalities for SBP (p = 0.009), DBP (p = 0.004), and MAP (p < 0.001). HDx achieved the lowest mean BP values—SBP 129 (95% CI 127–131) mmHg; DBP 74 (95% CI 73–75) mmHg; MAP 93 (95% CI 91–94) mmHg—significantly lower than high-flux HD and post-dilution HDF (p < 0.05). Differences versus pre- and mixed-HDF did not reach significance. Conclusions: HDx provided modest but consistent reductions in interdialytic BP compared with diffusive and convective high-efficiency modalities. Trial Registration: Ethics Committee of the Medical University of Gdańsk (NKBBN/479-759/2022). Full article