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Hypertension and Cardiovascular Disease: Clinical Updates and Perspectives
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Hypertension and Cardiovascular Disease: Clinical Updates and Perspectives

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

Deadline for manuscript submissions: 30 April 2025 | Viewed by 5078

Special Issue Editors

Dr. Valeria Visco

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Guest Editor
Department of Medicine and Surgery, University of Salerno, 84081 Baronissi, Italy
Interests: heart failure; arterial hypertension; telemonitoring; cardiovascular diseases; echocardiography
Special Issues, Collections and Topics in MDPI journals
Dr. Michele Ciccarelli

E-Mail Website
Guest Editor
Department of Medicine and Surgery, University of Salerno, 84081 Baronissi, Italy
Interests: molecular and clinical cardiology; new approaches for treatment of cardiovascular diseases
Special Issues, Collections and Topics in MDPI journals
Dr. Costantino Mancusi

E-Mail Website
Guest Editor
Department of Advanced Biomedical Sciences, Federico II University of Naples, Via S. Pansini 5, 80131 Napoli, Italy
Interests: cardiovascular disease; hypertension; heart failure
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue aims to provide a comprehensive overview of the latest advancements, research findings, and clinical perspectives in the field. Hypertension and cardiovascular disease continue to be significant health concerns worldwide, necessitating continuous updates and insights into their diagnosis, management, and prevention.

This Special Issue invites original research articles, review papers, and case studies that address various aspects of hypertension and cardiovascular disease within the clinical scope. We welcome submissions focusing on emerging diagnostic techniques, novel treatment approaches, risk assessment models, and preventive strategies. Additionally, articles exploring the impact of lifestyle modifications, pharmacological interventions, and personalized medicine in managing hypertension and cardiovascular disease are encouraged.

Authors are encouraged to contribute articles that shed light on the pathophysiology, epidemiology, and genetic factors associated with these conditions. Furthermore, we encourage submissions that explore the intersection between hypertension, cardiovascular disease, and other comorbidities such as diabetes, obesity, and renal disorders.

By bringing together diverse perspectives and up-to-date research, this Special Issue aims to enhance our understanding of hypertension and cardiovascular disease and contribute to improved patient care and outcomes.

Dr. Valeria Visco
Dr. Michele Ciccarelli
Dr. Costantino Mancusi
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

  • hypertension management
  • cardiovascular risk assessment
  • novel antihypertensive therapies
  • hypertension in pregnancy
  • hypertensive emergencies
  • cardiovascular disease prevention
  • pharmacological interventions for cardiovascular disease

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Published Papers (5 papers)

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Research

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12 pages, 3304 KiB  
Article
Computed Tomography Evaluation of Extracellular Volume for Predicting Prognosis in Patients with Severe Renal Dysfunction on Dialysis
by Hiroki Goto, Hiroyuki Takaoka, Joji Ota, Yoshitada Noguchi, Yusei Nishikawa, Moe Matsumoto, Kazuki Yoshida, Katsuya Suzuki, Shuhei Aoki, Satomi Yashima, Makiko Kinoshita, Haruka Sasaki, Noriko Suzuki-Eguchi and Yoshio Kobayashi
J. Clin. Med. 2024, 13(24), 7561; https://doi.org/10.3390/jcm13247561 - 12 Dec 2024
Viewed by 593
Abstract
Introduction: Extracellular volume (ECV) analysis using computed tomography is recognized as a potential method for diagnostic application. It is currently the only noninvasive method for quantitatively evaluating myocardial fibrosis in dialysis patients for whom gadolinium contrast agents are contraindicated. In this study, [...] Read more.
Introduction: Extracellular volume (ECV) analysis using computed tomography is recognized as a potential method for diagnostic application. It is currently the only noninvasive method for quantitatively evaluating myocardial fibrosis in dialysis patients for whom gadolinium contrast agents are contraindicated. In this study, we assessed the utility of ECV measurement via CT in the left ventricular (LV) myocardium (LVM) to predict major adverse cardiac events (MACEs) in dialysis patients. Materials and methods: We analyzed 57 dialysis patients who underwent cardiac CT and assessed the utility of LVM ECV (LV-ECV) for predicting MACEs. All the patients were followed for a median of 11 months, and MACEs occurred in 15 cases (26%). Results: LV-ECV and plasma brain natriuretic peptide levels were higher in subjects with MACEs than those without (40.29 ± 8.23% vs. 33.76 ± 4.60% and 1481 ± 997 vs. 807 ± 1109 pg/mL; both p < 0.05). Significant valvular disease was more frequently detected in patients with MACEs than those without (60% vs. 24%; p = 0.023). Serum hematocrit levels were significantly lower in patients with MACEs than those without (29 ± 5 vs. 34 ± 5; p < 0.001). The administration of statin was significantly lower in patients with MACEs than in those without (13% vs. 48%; p = 0.029). A receiver operating characteristic (ROC) curve analysis was performed using LV-ECV for predicting MACEs. The area under the curve was 0.80, and the best cut-off value of LV-ECV was 37.26% (p = 0.0003). In a Cox proportional hazards model, LV-ECV ≥ 37.26% was the only significant independent predictor of MACEs (p = 0.020). Conclusions: LV-ECV measured using CT is a useful predictor of MACEs in dialysis patients. Full article
(This article belongs to the Special Issue Hypertension and Cardiovascular Disease: Clinical Updates and Perspectives)
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11 pages, 289 KiB  
Article
Protective Influence of SGLT-2 Inhibitors Against Heart Failure in Type 2 Diabetes Mellitus Through Longitudinal Clinical Database Analysis
by Attila Csaba Nagy, Ágnes Tóth, Natália Bak, Battamir Ulambayar, Amr Sayed Ghanem and Ferenc Sztanek
J. Clin. Med. 2024, 13(23), 7093; https://doi.org/10.3390/jcm13237093 - 24 Nov 2024
Viewed by 1179
Abstract
Background: Sodium–glucose co-transporter 2 (SGLT-2) inhibitors, initially designed for type 2 diabetes, promote glucose excretion and lower blood glucose. Newer analogs like empagliflozin and dapagliflozin improve cardiovascular outcomes through mechanisms other than glycemic control, including blood pressure reduction and anti-inflammatory effects. Given [...] Read more.
Background: Sodium–glucose co-transporter 2 (SGLT-2) inhibitors, initially designed for type 2 diabetes, promote glucose excretion and lower blood glucose. Newer analogs like empagliflozin and dapagliflozin improve cardiovascular outcomes through mechanisms other than glycemic control, including blood pressure reduction and anti-inflammatory effects. Given the high cardiovascular risk present in diabetes, our study aims to emphasize the cardioprotective benefits of SGLT-2 inhibitors as a preventive therapy for heart failure (HF) in high-risk T2DM patients. Methods: Using data from 2542 patients identified by the ICD-10 E11 code from 2016 to 2020, this longitudinal study excluded those with E10 codes or those undergoing insulin treatment to focus on non-insulin-dependent T2DM. a multiple logistic regression model assessed HF incidence while adjusting for demographics and HbA1c. Results: SGLT-2 inhibitor use significantly lowered the odds of heart failure events (OR = 0.55, 95% CI: 0.31–0.99, p = 0.046), with a significant difference by gender (OR = 0.45, 95% CI: 0.28–0.71, p = 0.001) and eGFR (OR = 0.98, 95% CI: 0.97–0.99, p = 0.004). Conclusions: The real-world data highlight SGLT-2 inhibitors as promising for HF prevention and broader cardiometabolic health in T2DM, with potential value in managing complex comorbid profiles. Full article
(This article belongs to the Special Issue Hypertension and Cardiovascular Disease: Clinical Updates and Perspectives)
11 pages, 686 KiB  
Article
Exploring the Impact of Blood Draws on the Intraocular Pressure of Older Adults: A Focus on Physiological Responses
by Aida Ramón-Campillo, Inmaculada Bueno-Gimeno, Javier Gene-Morales, Pablo Jiménez-Martínez, Oscar Caballero-Luna and Andrés Gené-Sampedro
J. Clin. Med. 2024, 13(21), 6554; https://doi.org/10.3390/jcm13216554 - 31 Oct 2024
Viewed by 734
Abstract
Background/Objectives: This study investigated intraocular pressure (IOP) changes after a blood draw in older adults considering sex, age, and baseline IOP. Methods: Fifty-three subjects (54.7% females; age: 68.50 ± 4.46 years; Visual Function Index [VF14]: 94.50 ± 7.50 points; mean contrast [...] Read more.
Background/Objectives: This study investigated intraocular pressure (IOP) changes after a blood draw in older adults considering sex, age, and baseline IOP. Methods: Fifty-three subjects (54.7% females; age: 68.50 ± 4.46 years; Visual Function Index [VF14]: 94.50 ± 7.50 points; mean contrast sensitivity function (CSF) for both eyes in each spatial frequency [cdp]: 1.5 cdp [1.41 ± 0.20 log], 3 cdp [1.57 ± 0.29 log], 6 cdp [1.45 ± 0.39 log], 12 cdp [1.04 ± 0.40 log], 18 cdp [0.63 ± 0.31 log]) voluntarily participated. Subjects fasted for at least 8 h before attending the laboratory. First, IOP was measured in a seated position using a portable rebound tonometer. Ten minutes after the initial measurement, two 10 mL tubes of blood were drawn. Five minutes after the blood draw IOP was measured again following the same procedure as the initial measurement. We evaluated the differences using an analysis of variance. Results: Significant, but not clinically relevant, decreases were found in the right eye, with small effect sizes (p = 0.013–0.079, d = 0.35). Only males and subjects older than 68 years showed trends toward IOP reduction in the right eye. Subjects with baseline IOP ≥ 14 mmHg experienced significant IOP reductions in both eyes, with moderate effect sizes (p = 0.001–0.002, d = 0.56–0.69). Conclusions: Our findings suggest that a blood draw of 20 mL is safe for the IOP levels of older adults with baseline IOP between 11 and 21 mmHg. Variations in IOP were observed based on baseline IOP, sex, and age, suggesting the importance of personalized clinical assessments. The primary factor influencing IOP changes appears to be the baseline IOP level. Full article
(This article belongs to the Special Issue Hypertension and Cardiovascular Disease: Clinical Updates and Perspectives)
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11 pages, 252 KiB  
Article
Validation of the Novel Web-Based Application HUMTELEMED for a Comprehensive Assessment of Cardiovascular Risk Based on the 2021 European Society of Cardiology Guidelines
by Matteo Landolfo, Francesco Spannella, Alessandro Gezzi, Federico Giulietti, Lucia Sabbatini, Isabella Bari, Romina Alessandroni, Angelica Di Agostini, Paolo Turri, Francesco Alborino, Lorenzo Scoppolini Massini and Riccardo Sarzani
J. Clin. Med. 2024, 13(8), 2295; https://doi.org/10.3390/jcm13082295 - 16 Apr 2024
Viewed by 1517
Abstract
Background and aims: SCORE2/SCORE2-OP cardiovascular risk (CVR) charts and online calculators do not apply to patients with comorbidities, target organ damage, or atherosclerotic cardiovascular disease, for whom the assessment relies on the conventional consultation of the 2021 ESC guidelines (qualitative approach). To simplify [...] Read more.
Background and aims: SCORE2/SCORE2-OP cardiovascular risk (CVR) charts and online calculators do not apply to patients with comorbidities, target organ damage, or atherosclerotic cardiovascular disease, for whom the assessment relies on the conventional consultation of the 2021 ESC guidelines (qualitative approach). To simplify the CVR evaluation, we developed an integrated multi-language and free-to-use web application. This study assessed the agreement between the conventional method versus our web app. Methods: A cross-sectional study was carried out on 1306 consecutive patients aged 40+ years referred to our center for the diagnosis and management of hypertension and dyslipidemia. Two double-blind operators performed the CVR assessment and classified each patient into low–moderate-, high-, and very-high-risk categories by using the conventional method (SCORE2/SCORE2-OP charts and consultation of the 2021 ESC guidelines) and the web app. The Kappa statistics were used to compare the two methods. Results: The mean age was 60.3 ± 11.9 years, with male prevalence (51.4%). Patients in primary prevention were 77.0%. According to the SCORE2/SCORE2-OP charts and 2021 ESC guideline consultation, the CVR was low–moderate in 18.6% (n° 243), high in 36.8% (n° 480), and very high in 44.6% (n° 583). According to the web app, individual CVR was low–moderate in 19.5% (n° 255), high in 35.4% (n° 462), and very high in 45.1% (n° 589). The two methods strongly agreed (Kappa = 0.960, p < 0.001), with a 97.5% concordance. Conclusions: our application has excellent reliability in a broad “real life” population and may help non-expert users and busy clinicians to assess individual CVR appropriately, representing a free-to-use, simple, time-sparing and widely available alternative to the conventional CVR evaluation using SCORE2/SCORE2-OP and 2021 ESC guideline charts. Full article
(This article belongs to the Special Issue Hypertension and Cardiovascular Disease: Clinical Updates and Perspectives)

Review

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16 pages, 1442 KiB  
Review
The Balance Between the Natriuretic Peptides and the Renin-Angiotensin-Aldosterone System in the Preservation of Ideal Cardiovascular Health
by Speranza Rubattu, Giovanna Gallo and Massimo Volpe
J. Clin. Med. 2025, 14(2), 626; https://doi.org/10.3390/jcm14020626 - 19 Jan 2025
Viewed by 440
Abstract
A healthy lifestyle plays a key role for maintaining the cardiovascular health (CVH) status and prevent cardiovascular disease occurrence. In fact, a healthy lifestyle was included in the AHA Cardiovascular Health score (Life’s Simple 7 [LS7]), subsequently updated to Life’s Simple 8 [LS8]. [...] Read more.
A healthy lifestyle plays a key role for maintaining the cardiovascular health (CVH) status and prevent cardiovascular disease occurrence. In fact, a healthy lifestyle was included in the AHA Cardiovascular Health score (Life’s Simple 7 [LS7]), subsequently updated to Life’s Simple 8 [LS8]. Apart from the importance of controlling conventional cardiovascular risk factors, increasing evidence supports the contributory role of cardiovascular hormones. Higher levels of natriuretic peptides (NPs) and lower levels of renin and aldosterone were significantly associated to CVH. NT-proBNP levels showed a direct relationship with CVH scores in large general Caucasian populations, being also a marker of CVH changes and a predictor of future adverse events. On the other hand, renin and aldosterone were inversely related to CVH scores. In contrast, the counter-regulatory angiotensins [Ang (1-7) acting through Mas receptor, Ang (1-9) acting through Angiotensin Type 2 receptor, and alamandine] strengthen the beneficial properties of NPs. This evidence can be explained by both the effects on systemic hemodynamic and possible pleiotropic local functions regulating different pathways involved in the maintenance of CVH. Based on the current evidence, circulating levels of NT-proBNP, renin and aldosterone may affect CVH in apparently asymptomatic individuals and represent additional markers of residual cardiovascular risk. Full article
(This article belongs to the Special Issue Hypertension and Cardiovascular Disease: Clinical Updates and Perspectives)
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