Current Hypertension Reviews - Online First

Sleep problems are increasingly recognized as a factor that may contribute to high blood pressure. Evidence in Asian populations, however, remains limited. This study explored the link between sleep quality and hypertension in middle-aged adults through a mixed-methods design.

A sequential approach was used, beginning with a cross-sectional survey of 492 adults aged 35–60 years who attended the outpatient clinic at Phramongkutklao Hospital. Sleep quality was assessed with the Pittsburgh Sleep Quality Index, while blood pressure was measured by standard procedures. Logistic regression identified predictors of hypertension. In the second phase, 15 participants with poor sleep and/or hypertension were interviewed, and transcripts were analyzed thematically.

Poor sleep quality (PSQI >5) was strongly associated with hypertension (adjusted OR 7.54; 95% CI: 3.33–17.06; p < 0.001). Older age, alcohol use, and a family history of hypertension also emerged as independent risk factors. The qualitative findings highlighted three recurring issues: lifestyle and psychological obstacles to adequate sleep, low awareness of the connection between sleep and blood pressure, and limited counseling on sleep health in routine care.

These results emphasize the importance of sleep as a modifiable risk factor for hypertension. The lack of awareness among patients and insufficient advice from healthcare providers point to gaps in current practice.

Poor sleep quality is a strong predictor of hypertension among middle-aged adults. Incorporating sleep assessment and education into outpatient services may help improve the prevention and management of hypertension.

True isolated systolic hypertension (ISH) in youth must be evaluated by central blood pressure to avoid false or spurious hypertension. The purpose of this study was to perform a reliable assessment to confirm true hypertension and assess target organ damage.

Fifty-eight early diagnosed, untreated systolic hypertensive patients with office BP and 24-h ABPM (25±4, 32 male) underwent central blood pressure evaluation with a non-invasive, validated Mobil-O-Graph device. In all of them, left ventricular mass (LVMi echocardiogram), pulse wave velocity (PWV), cardiac index, peripheral vascular resistance, and urinary albumin excretion were recorded at the beginning of the study.

All spurious systolic hypertensives had normal LVMi, cardiac output, peripheral vascular resistance, and urinary albumin excretion (UE), whereas true hypertensives showed a hyperkinetic behavior (high cardiac output) and early target organ damage (increased LVMi and higher urinary albumin excretion) at the time of observation.

In this study, young patients with elevated cBP had left ventricular mass index and urinary albumin excretion higher than those with normal cBP. This observation suggests that this group of subjects are true hypertensives, contrary to the claim of being spurious hypertensives. Spurious hypertension should not be underestimated because it could be a temporary condition, since other authors have found that ISH and normal cSBP in adolescents may progress to sustained hypertension and hypertensive organ damage, thus requiring close monitoring.

In this study, central blood pressure was able to define true or spurious hypertension and confirm target organ damage in this youth cohort. A multicentric study will be of interest to confirm these preliminary findings.

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The findings were searched in the Google Scholar, Scopus, PubMed, and PubChem databases.

Preclinical and clinical investigations have promoted the safety of flavonoids, such as apigenin and quercetin, for use as nutraceuticals that promote health. Flavonoids and their potential mechanisms of action and clinical applications offer insights for researchers and scientists to explore in the fields of medical and nanomedicine sciences. Nanomedicine, like liposomes, carbon nanotubes, nanosponges, and nanoparticles containing flavonoids, is used for its efficacy, potency, and target delivery.

Flavonols have the potential to regulate vasodilation and prevent apoptosis. Furthermore, their supplementation may reduce the risk of cardiovascular complications. Flavonoids function as antioxidants and exhibit potent anti-inflammatory effects by mediating inflammatory pathways, thereby contributing to the management of cardiovascular complications. Emerging evidence from researchers suggests flavonoids improve endothelial function and reduce blood pressure. Furthermore, flavonoids derived from cocoa, such as catechins, and those found in tea also enhance endothelial function. Nanosystems can enhance the solubility, permeability, and effectiveness of flavonoids as antioxidants, while also promoting controlled drug delivery. Nanoformulations can enhance the effects of morin, rutin, quercetin, and other flavonoids, significantly improving therapeutic outcomes.

These findings offer researchers and scientists a novel technological approach utilizing flavonoids to address metabolic syndromes and related health conditions, thereby supporting personalized care and improving patient outcomes.