BACKGROUND: Prehypertension during pregnancy is currently not considered as a high-risk pregnancy state in existing guidelines despite recent research correlating it with higher rates of morbidity and mortality in both the mother and the fetus. Studies on prehypertension have not been conducted in Africa despite high rates of poor neonatal outcomes.
OBJECTIVE: The study aimed to determine the association between late pregnancy prehypertension and adverse outcomes in newborns of women with late pregnancy prehypertension at Jinja Regional Referral Hospital.
METHODS: Between September 2022 and January 2023, a hospital-based prospective cohort study including 300 pregnant women was conducted. Participants were divided according to third-trimester blood pressure, as determined by the JNC-8 criteria. Following hospital admission for labor and delivery, 150 normotensive women and 150 prehypertensive women were identified and followed until delivery, and their neonates were followed until death or hospital discharge. A p value of ≤ 0.05 was the threshold for statistical significance when comparing the groups using the relative risk, X2, and Mantel-Haenszel adjustment.
RESULTS: Composite adverse neonatal outcomes were more common in prehypertensive women compared to normotensive women (48.67% versus 32.67%), particularly Small-for-Gestation Age (SGA), stillbirth, and composite adverse neonatal outcomes had significantly higher likelihood, with aRRs of 1.63 (95% CI 1.10-2.42, p = 0.037), 9.0 (95% CI 1.15-70.16, p = 0.010), and 1.55 (95% CI 1.16-2.08, p < 0.001), respectively. By a linear model, birthweight decreased by 45.1 g for every 10 mmHg rise in systolic blood pressure (p = 0.041, Pearson correlation of -0.118).
CONCLUSIONS: Prehypertension in late pregnancy increased risks for adverse neonatal outcomes, thus a need to potentially lower pregnancy hypertension cut-off levels possibly through adopting the ACC/AHA blood pressure definitions for pregnant women.

This study was conducted to investigate the association between alcohol consumption in adolescence and the risk of hypertension or prehypertension development in early adulthood. This cohort study included adolescent participants aged 12-18 years from the 2000-2011 China Health and Nutrition Survey. Cox proportional risk regression models were used to analyze the associations of the frequency of alcohol consumption, alcohol intake, and type of alcohol with the risk of developing hypertension or prehypertension. Restricted cubic spline analysis was used to assess the dose-response relationships for alcohol intake and their hazard ratios (HRs). A total of 1556 participants were included in the final analysis. Among the overall population, 448 (30.81%) and 35 (34.31%) participants developed hypertension or prehypertension, respectively. Compared with no alcohol consumption, alcohol consumption ≥ 2 times/week and consumption of ≥2 types of alcohol were associated with an increased risk of hypertension and prehypertension, with HRs of 1.97 (95% confidence interval [CI] 1.17-3.34; p = 0.011) and 1.77 (95% CI 1.01-3.09; p = 0.046), respectively. Alcohol intake of > 96 mL/week was associated with an increased risk of hypertension and prehypertension, with HRs of 2.09 (95% CI 1.12-3.90; p = 0.020) and 2.07 (95% CI 1.11-3.84; p = 0.021), respectively. The restricted cubic spline analysis showed that the risk of developing high blood pressure or prehypertension tends to increase with increasing alcohol consumption. Heavy alcohol consumption in adolescence increased the risk of developing hypertension and prehypertension in early adulthood.

Hypertension is currently highly prevalent worldwide and serves as one of the significant risk factors for chronic diseases and mortality. Adult hypertension can be traced back to, as well as prevented starting in, childhood and adolescence. However, due to the lack of surveillance among children and adolescents, the prevalence and influencing factors of hypertension-related conditions have not been well described. Hence, a total of 67,947 children and adolescents aged 6 to 17 from China Nutrition and Health Surveillance (2015-2017) were enrolled to describe the weighted average blood pressure level and the weighted prevalence of hypertension, pre-hypertension, and their distribution and to analyze the risk factors for hypertension and pre-hypertension among Chinese children and adolescents at a nationwide level. In summary, the weighted mean values of systolic blood pressure and diastolic blood pressure were 111.8 (95% CI, 111.2-112.5) mmHg and 66.5 (95% CI, 66.0-67.0) mmHg, respectively. The weighted prevalence of hypertension and pre-hypertension was 24.9% and 17.1%, respectively. Moreover, general obesity, overweight, and central obesity served as risk factors for hypertension and pre-hypertension among Chinese children and adolescents. The current study indicated that the prevalence of hypertension and pre-hypertension in Chinese children and adolescents was at a high level. Moreover, blood pressure screening should be further intensified for children and adolescents at a high risk of being overweight or obese.

BACKGROUND: Puerarin is an isoflavone compound isolated from the roots of a leguminous plant, the wild kudzu. Various functional activities of this compound in multiple diseases have been reported. However, the effect and mechanism of puerarin in improving blood pressure remain non-elucidated.
OBJECTIVE: The current study was designed to assess the preventive effects of puerarin on the onset and progression of hypertension and to verify the hypothesis that puerarin alleviates blood pressure by inhibiting the ROS/TLR4/NLRP3 inflammasome signaling pathway in the hypothalamic paraventricular nucleus (PVN) of salt-induced prehypertensive rats.
METHODS: Male Dahl salt-sensitive rats were fed low NaCl salt (3% in drinking water) for the control (NS) group or 8% (HS) to induce prehypertension. Each batch was divided into two group and treated by bilateral PVN microinjection with either artificial cerebrospinal fluid or puerarin through a micro-osmotic pump for 6 weeks. The mean arterial pressure (MAP) was recorded, and samples were collected and analyzed.
RESULTS: We concluded that puerarin significantly prevented the elevation of blood pressure and effectively alleviated the increase in heart rate caused by high salt. Norepinephrine (NE) in the plasma of salt-induced prehypertensive rats also decreased upon puerarin chronic infusion. Additionally, analysis of the PVN sample revealed that puerarin pretreatment decreased the positive cells and gene level of TLR4 (Toll-like receptor 4), NLRP3, Caspase-1 p10, NOX2, MyD88, NOX4, and proinflammatory cytokines in the PVN. Puerarin pretreatment also decreased NF-κBp65 activity, inhibited oxidative stress, and alleviated inflammatory responses in the PVN.
CONCLUSIONS: We conclude that puerarin alleviated blood pressure via inhibition of the ROS/TLR4/NLRP3 inflammasome signaling pathway in the PVN, suggesting the therapeutic potential of puerarin in the prevention of hypertension.

Although the relationship between hypertension and hyperuricemia is widely recognized, there is still a relative lack of research on prehypertensive individuals and the individual associations of systolic and diastolic blood pressure with the risk of hyperuricemia. From 2011 to 2016, we conducted a study on 53,323 individuals at Wuhu City Hospital in China. Based on initial blood pressure readings, participants were categorized into normal, prehypertension, or hypertension groups. We used Cox regression to analyze the associations with baseline factors. In subgroup analyses, systolic and diastolic pressures were treated as continuous variables, and their relationship with the risk of hyperuricemia was examined using restricted cubic spline analysis. The risk increased in the prehypertension and hypertension groups compared to the normal blood pressure group, with hazard ratios of 1.192 and 1.350, respectively. For each unit increase in blood pressure, the risk of hyperuricemia rose by 0.8% (systolic) and 0.9% (diastolic), especially when blood pressure levels exceeded 115/78 mmHg. Additionally, we observed that factors such as gender, alcohol consumption habits, obesity, and dyslipidemia might further influence this association. These findings emphasize the importance of early risk assessment and intervention in these patient populations in clinical practice.

BACKGROUND: The distinction between normal and high blood pressure remains a debated topic, with varying guidelines on when to start medication. Contemporary guidelines advocate for the initiation of antihypertensive therapy in individuals who present with high-normal blood pressure, particularly those exhibiting elevated 10-year atherosclerotic cardiovascular disease (ASCVD) risk scores. Despite these recommendations, there is a notable lack of direct evidence supporting the efficacy of treating high-normal blood pressure to prevent major adverse cardiovascular events (MACE).
METHODS: The PRINT-TAHA9 trial, a unicentric, randomized, open-label, controlled, parallel clinical study, seeks to explore the effects of intensive blood pressure control on MACE in participants with high-normal blood pressure. We will enroll 1620 adults aged 18 years and above with a systolic blood pressure range of 130-140 mmHg, diastolic blood pressure under 90 mmHg, and atherosclerotic cardiovascular disease (ASCVD) risk score exceeding 7.5%. The study will be executed in five distinct phases, with each phase enrolling between 300 and 400 participants. Participants will be randomly assigned to either the treatment group receiving antihypertensive medication (amlodipine/valsartan) and a low-salt/low-fat diet or to the control group receiving a similar diet. Follow-up visits are scheduled every 6 months over a 3-year period to monitor blood pressure, evaluate medication adherence, document any adverse events, and adjust the intervention as necessary. Cox proportional hazards regression analysis will be employed to examine the disparities between the two arms.
CONCLUSIONS: Despite guidelines promoting early treatment of elevated blood pressure, the debate continues due to insufficient evidence that such interventions significantly reduce the occurrence of MACE. This trial seeks to address this critical evidence gap.
BACKGROUND: The PRINT-TAHA9 trial was registered in October 2019 with the Iranian Registry of Clinical Trials (IRCT.ir) under the registration number IRCT20191002044961N1. https://irct.behdasht.gov.ir/trial/43092 .

UNASSIGNED: The prevalence of prehypertension and hypertension has been increasing over the years, and is closely related to cardiovascular and cerebrovascular diseases. Exercise is an effective method of lifestyle intervention, and it aims to lower blood pressure and control other risks. Studies have shown that different modes of exercise have varying effects on blood pressure, and individuals with prehypertension or hypertension need to carry out this intervention by using personalized modes of exercise.
UNASSIGNED: We conducted a systematic review and meta-analysis to evaluate the effects of different modes of exercise regimens on systolic blood pressure, diastolic blood pressure and heart rate in individuals with high-normal blood pressure and hypertension. We included 27 trials, and 2731 individuals were under 8 exercise regimens. Stata12.0 statistical software was used for statistical analysis.
UNASSIGNED: Heat pools significantly reduced systolic blood pressure (SBP) by 15.62 mmHg (95% confidence interval [CI]: -23.83, -7.41), and cycling reduced SBP by 14.76 mmHg (-17.04, -12.48). Two to three types of aerobic exercise performed at the same time also significantly reduced diastolic blood pressure (DBP) by 5.61 mmHg (-7.71, -3.52), and isometric handgrip training exercise reduced DBP by 5.57 mmHg (-7.48, -3.66). Cycling also significantly reduced heart rate (HR) by 9.57 beats/minute (-11.25, -7.90).
UNASSIGNED: The existing literature suggests that different types of exercise can effectively reduce the levels of SBP, DBP and HR in individuals with prehypertension or hypertension.

Prehypertension, an early stage in the development of hypertension, impacts a substantial segment of the adult population worldwide. Addressing this issue, our study introduces HabitBot, an AI-driven chatbot tailored to encourage physical activity (PA) habits among individuals with prehypertension. HabitBot combines natural language processing with multidisciplinary approaches, drawing from both theoretical frameworks and empirical studies. The chatbot development followed a systematic, five-phase process: comprehensive needs assessment, literature review on behavior change theories, analysis for selecting effective behavior change techniques (BCTs), prototype design through intervention mapping, and refining the intervention based on user feedback. The outcome includes a prototype that integrates the Health Action Process Approach and Habit Formation Theory, utilizing twelve identified BCTs effective in fostering PA habits. User feedback further refined the chatbot across multiple dimensions such as user interface, content accessibility, and privacy. HabitBot exemplifies an innovative integration of behavior change strategies with advanced language model technology, paving the way for digital health interventions in chronic disease prevention. Future studies should assess its long-term efficacy in habit formation and explore its applicability to various demographic groups.

UNASSIGNED: Although prehypertension and hypertension can be detected at the primary healthcare level and low-cost treatments can effectively control its complications, hypertension is still the world\'s leading preventable risk factor. Therefore, the present study aimed to determine its prevalence and its risk factors among Malaysian adults.
UNASSIGNED: A cross-sectional study involving 7585 adults was performed covering the rural and urban areas. Respondents with systolic blood pressure (SBP) of 120-139 mmHg and/or diastolic blood pressure (DBP) of 80-89 mmHg were categorized as prehypertensive, and hypertensive categorization was used for respondents with an SBP of ≥140 mmHg and/or DBP of ≥90 mmHg.
UNASSIGNED: Respondents reported to have prehypertension and hypertension were 40.7% and 38.0%, respectively. Those residing in a rural area, older age, male, family history of hypertension, and overweight or obese were associated with higher odds of prehypertension and hypertension. Unique to hypertension, the factors included low educational level (AOR: 1.349; 95% CI: 1.146, 1.588), unemployment (1.350; 1.16, 1.572), comorbidity of diabetes (1.474; 1.178, 1.844), and inadequate fruit consumption (1.253; 1.094, 1.436).
UNASSIGNED: As the prehypertensive state may affect the prevalence of hypertension, proactive strategies are needed to increase early detection of the disease among specific group of those residing in a rural area, older age, male, family history of hypertension, and overweight or obese.

UNASSIGNED: Emerging epidemiological data suggest that Hypertension (HTN) has become a significant public health challenge in sub-Saharan Africa. HTN in young adults is a problem lacking relevant attention because it is still erroneously considered a disease of the old. This study aimed to determine the prevalence of hypertension and its associated risk factors in undergraduate medical students at the University of Nigeria, Enugu Campus, Enugu State, Nigeria.
UNASSIGNED: This was a cross-sectional study conducted between March and April 2021. This study recruited 279 consenting medical students (136 males and 143 females) aged 18-35 years. They were administered with a structured questionnaire. Data on sociodemographic information and risk factors for hypertension were collected. Blood pressure, waist circumference, weight, height, and body mass index were measured using standard methods. All data collected were carried out following the Institutional ethical guidelines and that of the Helsinki as revised in 2000. Data were analyzed using IBM Statistical Package for Social Sciences version 25, and statistical tools employed include descriptive statistics and Chi tests. Results were recorded as mean standard deviation, and statistical significance was taken at p<0.05.
UNASSIGNED: This present study has shown a prevalence rate of 19.93% for hypertension. Isolated diastolic hypertension constituted a greater burden with a prevalence of 13.65% than systolic Hypertension (0.74%) and systolic-diastolic Hypertension 5.4%. The prevalence of prehypertension was 48.7%, with a higher incidence observed in females (25.8%), individuals aged 21-25 years (26.4), and those with normal BMI (35.1%). A significant association was observed between the stage of hypertension and gender (p = 0.005), and age category (p = 0.037). Of the examined cohort, 7.75% were underweight, 16.5% overweight, and 2.2% obese. Notably, systolic, and diastolic blood pressure, weight, as well as waist circumference showed significant (p = 0.01, p = 0.007, p =0.01 and p<0.0001 respectively) increases concomitant with advancing age.
UNASSIGNED: There is an increased prevalence of prehypertension and hypertension among young adults. This calls for a comprehensive national screening, public enlightenment, and targeted prevention programs that foster healthy lifestyle behaviours, physical activity, and healthy eating among students.