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Recent Advances in Hypertension, Hypercholesterolemia and Type 2 Diabetes—2nd Edition
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Recent Advances in Hypertension, Hypercholesterolemia and Type 2 Diabetes—2nd Edition

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Endocrinology and Metabolism Research".

Deadline for manuscript submissions: closed (30 April 2026) | Viewed by 2681

Special Issue Editor

Dr. Tomislav Bulum

E-Mail Website
Guest Editor
1. Vuk Vrhovac Univerity Clinic, Merkur University Hospital, Zajčeva 19, 10000 Zagreb, Croatia
2. Medical Faculty, University of Zagreb, Šalata 2, 10000 Zagreb, Croatia
Interests: diabetes type 1; diabetes type 2; metabolic syndrome; diabetic nephropathy; diabetic retinopathy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Diabetes is one of the most challenging health problems of the 21st century, and is projected to affect 700 million people by 2045. The most devastating components of diabetes are its chronic complications, leading to a high risk of morbidity and mortality and the burden of a high cost to health systems. In addition, the risk of developing cardiovascular diseases in patients with diabetes is more than double compared to subjects without diabetes. The majority of patients have type 2 diabetes associated with obesity and metabolic syndrome. In addition to type 2 diabetes, the central components of metabolic syndrome and obesity are hypertension and hypercholesterolemia. In patients with type 2 diabetes, there are also structural changes in low-density lipoprotein (LDL) cholesterol, resulting in the predominance of atherogenic small dense LDL cholesterol. The clustering of hypertension and hypercholesterolemia in patients with type 2 diabetes has a greater effect, leading to worse disease outcomes compared to individual risk factors. Studies have suggested that the optimal control of blood pressure and serum lipids, particularly LDL cholesterol, may reduce the risk of chronic complications of diabetes and cardiovascular diseases.

In view of this, we welcome submissions to this Special Issue on the relationship between hypertension, hypercholesterolemia, and type 2 diabetes. Detailed knowledge of this complex interplay is needed to reduce the cardiovascular morbidity and mortality associated with type 2 diabetes.

Dr. Tomislav Bulum
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. Biomedicines is an international peer-reviewed open access monthly 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

  • type 2 diabetes
  • hypertension
  • LDL-cholesterol
  • serum lipids
  • metabolic syndrome
  • cardiovascular disease
  • chronic complications
  • nephropathy

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Related Special Issue

Published Papers (3 papers)

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Research

19 pages, 622 KB  
Article
Vitamin K2 Supplementation Reduces Cardiometabolic Risk Factors in Young Adults with Overweight and Obesity—A Randomized Placebo-Controlled Trial
by Xochitl Citlalli Olivares-Ochoa, Iris Monserrat Llamas-Covarrubias, Sergio Sánchez-Enríquez, Andres López-Quintero, Yahatziri Salinas-Varela, Miriam Partida-Pérez, Monserrat Macías-Carballo and Edgar Alfonso Rivera-Leon
Biomedicines 2026, 14(5), 1011; https://doi.org/10.3390/biomedicines14051011 - 29 Apr 2026
Viewed by 788
Abstract
Background/Objectives: Obesity in young adults is a major public health concern and a key contributor to cardiometabolic risk. Vitamin K2 (VK2) has been proposed as a potential adjuvant therapy; however, evidence from randomized controlled trials remains limited. This study evaluated the effect [...] Read more.
Background/Objectives: Obesity in young adults is a major public health concern and a key contributor to cardiometabolic risk. Vitamin K2 (VK2) has been proposed as a potential adjuvant therapy; however, evidence from randomized controlled trials remains limited. This study evaluated the effect of VK2 supplementation on cardiometabolic risk factors in young adults with overweight or obesity. Methods: In this 12-week randomized, double-blind, placebo-controlled trial (NCT05995522), men and women aged 18–35 years with overweight or obesity (BMI 25–40 kg/m2) were assigned to receive VK2 (menaquinone-4, 100 µg/day) or placebo. Both groups received standardized nutritional counseling. Body composition, blood pressure, glucose homeostasis, lipid profile, and vitamin K-dependent proteins were assessed at baseline and post-intervention. Between-group differences were analyzed using ANCOVA adjusted for baseline values. Results: Forty-six participants completed the study (placebo n = 24; VK2 n = 22). VK2 supplementation significantly reduced total cholesterol (−10.64 mg/dL, p = 0.038) and LDL cholesterol (−6.12 mg/dL, p = 0.005) compared with placebo. A reduction in systolic blood pressure showed a trend toward significance (−5.56 mm Hg, p = 0.067). No significant effects were observed on body composition, glucose metabolism, or vitamin K-dependent proteins. Conclusions: VK2 supplementation resulted in improvements in total and LDL cholesterol levels, with no significant changes in vitamin K-dependent proteins, and may represent a safe and potentially beneficial adjunct to nutritional strategies aimed at early cardiometabolic risk modulation. Full article
(This article belongs to the Special Issue Recent Advances in Hypertension, Hypercholesterolemia and Type 2 Diabetes—2nd Edition)
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17 pages, 768 KB  
Article
Potential of R Wave in aVL Lead in Cardiovascular Risk Assessment
by Juraj Jug, Martina Lovrić Benčić, Tomislav Bulum and Ingrid Prkačin
Biomedicines 2026, 14(4), 905; https://doi.org/10.3390/biomedicines14040905 - 16 Apr 2026
Viewed by 387
Abstract
Background: R wave amplitude in the aVL ECG lead (RaVL) has been identified as a marker of cardiovascular (CV) risk, hypertension-mediated target organ damage (HMOD), and mortality in patients with arterial hypertension (AH), where RaVL > 1.1 mV suggests left [...] Read more.
Background: R wave amplitude in the aVL ECG lead (RaVL) has been identified as a marker of cardiovascular (CV) risk, hypertension-mediated target organ damage (HMOD), and mortality in patients with arterial hypertension (AH), where RaVL > 1.1 mV suggests left ventricular hypertrophy. However, the exact threshold for identifying high-risk patients has yet to be determined. Therefore, we compared RaVL values among hypertensive patients with and without hypertensive urgencies (HUs) and healthy subjects, aiming to identify the predictors of elevated RaVL and to compare its prognostic value with the SCORE 2 model. Methods: This cross-sectional study included 339 participants divided into three groups according to ambulatory blood pressure monitoring results: 100 patients with AH and HU from the emergency department, 134 patients with AH without HU, and 105 healthy subjects recruited from four family medicine practices. Basic laboratory parameters were determined, SCORE 2 risk was calculated, PWV was measured using oscillometry, and a standard 12-lead ECG was recorded in all participants. Results: Participants with AH and HU had the highest RaVL values compared to those with AH without HU and healthy subjects (averages of 0.76 ± 0.24 mV, 0.49 ± 0.27, 0.22 ± 0.25, respectively; p < 0.001). Significantly higher RaVL values were observed in males compared to females (0.56 ± 0.31 vs. 0.41 ± 0.34 mV; p < 0.001) and in non-dippers compared to dippers (0.56 ± 0.34 mV vs. 0.41 ± 0.31 in dippers; p < 0.001). Age, mean arterial pressure, PWV, and SCORE 2 were shown as independent predictors of RaVL. Compared with SCORE 2, individuals with RaVL > 0.40 mV had high CV risk (sensitivity of 58.16%, specificity of 73.68%; p < 0.001). Conclusions: In this study, RaVL demonstrated good prognostic value for CV risk stratification. However, larger studies are needed to determine a precise high-risk threshold to improve CV risk estimation and HMOD detection in patients with marginal SCORE 2 CV risk. Full article
(This article belongs to the Special Issue Recent Advances in Hypertension, Hypercholesterolemia and Type 2 Diabetes—2nd Edition)
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17 pages, 2169 KB  
Article
Stratification of Pro-Atherogenic Phenotypes in Prediabetes Using Machine Learning
by Liana Signorini, Waldemar Volanski, Ademir Luiz do Prado, Glaucio Valdameri, Mauren Isfer Anghebem, Vivian Rotuno Moure, Marcel Henrique Marcondes Sari, Geraldo Picheth and Fabiane Gomes de Moraes Rego
Biomedicines 2026, 14(3), 651; https://doi.org/10.3390/biomedicines14030651 - 13 Mar 2026
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Abstract
Background/Objectives: Prediabetes is a metabolic condition involving various phenotypes of glucose metabolism. Prediabetes increases the risk of heart disease, among other conditions. Hence, we employed machine learning tools to characterize phenotypes associated with cardiovascular disease using routine laboratory biomarkers. Methods: We processed laboratory [...] Read more.
Background/Objectives: Prediabetes is a metabolic condition involving various phenotypes of glucose metabolism. Prediabetes increases the risk of heart disease, among other conditions. Hence, we employed machine learning tools to characterize phenotypes associated with cardiovascular disease using routine laboratory biomarkers. Methods: We processed laboratory records of over 1,000,000 de-identified individuals, resulting in a sample of 3024 individuals classified as prediabetic (fasting blood glucose 100–125 mg/dL combined with HbA1c 5.7–6.4%). Lipid profile parameters (total cholesterol [TC], HDL-C, LDL-C, and triglycerides) and associated indices (atherogenic index of plasma, Log10(TG/HDL-C), triglyceride–glucose index [TyG], TC/HDL-C, and LDL-C/HDL-C, among others) were analyzed using the k-means algorithm. Two groups emerged based on biomarker concentrations, a pro-atherogenic cluster (P-AC; n = 1113) and a less-atherogenic cluster (L-AC; n = 1911) for cardiovascular disease. Results: We assessed the performance of biomarkers in the P-AC and L-AC clusters using a receiver operating characteristic curve. Triglycerides (area under the curve [AUC] 0.977), AIP (AUC 0.978), and triglyceride–glucose index (AUC 0.974) showed sensitivity and specificity >90%. The TC/HDL-C (AUC 0.903) and LDL-C/HDL-C (AUC 0.865) indices also performed well, with sensitivity and specificity of 80%. Binomial logistic regression applied to the groups generated by k-means using the biomarkers AIP and LDL-C/HDL-C showed an AUC of 0.984 and accuracy above 93%. Conclusions: The k-means algorithm enabled the identification of a P-AC for cardiovascular disease among prediabetics using cost-effective laboratory biomarkers that are widely accessible in laboratories. Individuals classified as P-AC may benefit from differentiated treatment to minimize this factor. Full article
(This article belongs to the Special Issue Recent Advances in Hypertension, Hypercholesterolemia and Type 2 Diabetes—2nd Edition)
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