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Personalized Medicine in Hypertension
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Personalized Medicine in Hypertension

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Omics/Informatics".

Deadline for manuscript submissions: closed (5 June 2023) | Viewed by 10297

Special Issue Editors

Dr. Davide Agnoletti

E-Mail Website
Guest Editor
Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
Interests: vascular medicine; cardiovascular disease; hypertension; atherosclerosis; metabolic syndrome; arterial stiffness; vascular ageing
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Jacques Blacher

E-Mail Website
Guest Editor
1. AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, 75004 Paris, France
2. UREN (Nutritional Epidemiology Research Unit)—U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
Interests: hypertension; cardiovascular epidemiology; clinical physiology; atherosclerosis; internal medicine

Special Issue Information

Dear Colleagues,

High blood pressure is still the leading risk factor for death and disability worldwide. Patients at high cardiovascular risk require intensive drug therapy for controlling blood pressure and other risk factors. The current therapeutic approach is based on the results of several clinical trials, assuming that subjects have common phenotypes and following algorithms derived from large population studies. This “one size fits all” approach improved hypertension control in the general population, requiring little or no information about individuals, and requires low medical investment. While this is the case, hypertension control is far from being satisfactory globally, and other strategies are required for its management. A personalized approach to hypertension is based on information that integrates data from clinical research, systems biology, ‘omics’ technologies, imaging findings, and e-technology, together with a patient’s involvement in clinical care. This could implement knowledge of the specific disease pathophysiology of patients and peculiar responses to treatment. This Special Issue of the Journal of Personalized Medicine aims to collect clinical and laboratory data, literature reviews, and protocols investigating the contribution of this personalized approach to the control of hypertension and related cardiovascular risk factors.

Dr. Davide Agnoletti
Prof. Dr. Jacques Blacher
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 Personalized Medicine 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

  • hypertension
  • cardiovascular risk
  • blood pressure
  • personalized medicine

Published Papers (5 papers)

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Research

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10 pages, 607 KiB  
Article
Non-Invasive Estimation of Central Systolic Blood Pressure by Radial Tonometry: A Simplified Approach
by Denis Chemla, Davide Agnoletti, Mathieu Jozwiak, Yi Zhang, Athanase D. Protogerou, Sandrine Millasseau and Jacques Blacher
J. Pers. Med. 2023, 13(8), 1244; https://doi.org/10.3390/jpm13081244 - 10 Aug 2023
Cited by 3 | Viewed by 977
Abstract
Backround. Central systolic blood pressure (cSBP) provides valuable clinical and physiological information. A recent invasive study showed that cSBP can be reliably estimated from mean (MBP) and diastolic (DBP) blood pressure. In this non-invasive study, we compared cSBP calculated using a Direct Central [...] Read more.
Backround. Central systolic blood pressure (cSBP) provides valuable clinical and physiological information. A recent invasive study showed that cSBP can be reliably estimated from mean (MBP) and diastolic (DBP) blood pressure. In this non-invasive study, we compared cSBP calculated using a Direct Central Blood Pressure estimation (DCBP = MBP2/DBP) with cSBP estimated by radial tonometry. Methods. Consecutive patients referred for cardiovascular assessment and prevention were prospectively included. Using applanation tonometry with SphygmoCor device, cSBP was estimated using an inbuilt generalized transfer function derived from radial pressure waveform, which was calibrated to oscillometric brachial SBP and DBP. The time-averaged MBP was calculated from the radial pulse waveform. The minimum acceptable error (DCBP-cSBP) was set at ≤5 (mean) and ≤8 mmHg (SD). Results. We included 160 patients (58 years, 54%men). The cSBP was 123.1 ± 18.3 mmHg (range 86–181 mmHg). The (DCBP-cSBP) error was −1.4 ± 4.9 mmHg. There was a linear relationship between cSBP and DCBP (R2 = 0.93). Forty-seven patients (29%) had cSBP values ≥ 130 mmHg, and a DCBP value > 126 mmHg exhibited a sensitivity of 91.5% and specificity of 94.7% in discriminating this threshold (Youden index = 0.86; AUC = 0.965). Conclusions. Using the DCBP formula, radial tonometry allows for the robust estimation of cSBP without the need for a generalized transfer function. This finding may have implications for risk stratification. Full article
(This article belongs to the Special Issue Personalized Medicine in Hypertension)
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12 pages, 1474 KiB  
Article
Effect of Arabic Qahwa on Blood Pressure in Patients with Stage One Hypertension in the Eastern Region of Saudi Arabia
by Sahbanathul Missiriya Jalal, Saad Hamoud Alsebeiy, Hamida Ali Aleid and Sukinah Ali Alhamad
J. Pers. Med. 2023, 13(6), 1011; https://doi.org/10.3390/jpm13061011 - 18 Jun 2023
Viewed by 2510
Abstract
Hypertension (HT), which is a condition of increased blood pressure (BP), is a major health problem globally. In Saudi Arabia, morbidity and mortality rates are increasing due to HT. Arabic Qahwa (AQ) is a commonly consumed beverage in Saudi Arabia and has numerous [...] Read more.
Hypertension (HT), which is a condition of increased blood pressure (BP), is a major health problem globally. In Saudi Arabia, morbidity and mortality rates are increasing due to HT. Arabic Qahwa (AQ) is a commonly consumed beverage in Saudi Arabia and has numerous health benefits. We conducted a randomized control trial to investigate the effect of AQ on BP among patients with HT (Stage 1). Based on the inclusion criteria, 140 patients were randomly selected, and 126 patients were followed up. After obtaining demographic information, we assessed the BP, heart rate, and lipid profile before and after the intervention of consuming four cups of AQ daily for four weeks. A paired ‘t’ test was used with a significance level of 5%. In the AQ group, there were significant changes (p = 0.009) in systolic blood pressure (SBP), with means of 134.72 ± 3.23 and 133.14 ± 3.69 observed pre and post-test, respectively. Similarly, the diastolic blood pressure (DBP) pre- and post-test mean scores were 87.08 ± 1.8 and 85.98 ± 1.95, respectively, which also showed significance (p = 0.001). There were also significant changes (p = 0.001) observed in the lipid profile of the AQ group. In conclusion, AQ is effective in reducing SBP and DBP in patients with stage one HT. Full article
(This article belongs to the Special Issue Personalized Medicine in Hypertension)
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12 pages, 2667 KiB  
Article
Cost-Effectiveness Analysis of Personalized Hypertension Prevention
by Sen-Te Wang, Ting-Yu Lin, Tony Hsiu-Hsi Chen, Sam Li-Sheng Chen and Jean Ching-Yuan Fann
J. Pers. Med. 2023, 13(6), 1001; https://doi.org/10.3390/jpm13061001 - 15 Jun 2023
Viewed by 1239
Abstract
Background: While a population-wide strategy involving lifestyle changes and a high-risk strategy involving pharmacological interventions have been described, the recently proposed personalized medicine approach combining both strategies for the prevention of hypertension has increasingly gained attention. However, a cost-effectiveness analysis has been hardly [...] Read more.
Background: While a population-wide strategy involving lifestyle changes and a high-risk strategy involving pharmacological interventions have been described, the recently proposed personalized medicine approach combining both strategies for the prevention of hypertension has increasingly gained attention. However, a cost-effectiveness analysis has been hardly addressed. This study was set out to build a Markov analytical decision model with a variety of prevention strategies in order to conduct an economic analysis for tailored preventative methods. Methods: The Markov decision model was used to perform an economic analysis of four preventative strategies: usual care, a population-based universal approach, a population-based high-risk approach, and a personalized strategy. In all decisions, the cohort in each prevention method was tracked throughout time to clarify the four-state model-based natural history of hypertension. Utilizing the Monte Carlo simulation, a probabilistic cost-effectiveness analysis was carried out. The incremental cost-effectiveness ratio was calculated to estimate the additional cost to save an additional life year. Results: The incremental cost-effectiveness ratios (ICER) for the personalized preventive strategy versus those for standard care were -USD 3317 per QALY gained, whereas they were, respectively, USD 120,781 and USD 53,223 per Quality-Adjusted Life Year (QALY) gained for the population-wide universal approach and the population-based high-risk approach. When the ceiling ratio of willingness to pay was USD 300,000, the probability of being cost-effective reached 74% for the universal approach and was almost certain for the personalized preventive strategy. The equivalent analysis for the personalized strategy against a general plan showed that the former was still cost-effective. Conclusions: To support a health economic decision model for the financial evaluation of hypertension preventative measures, a personalized four-state natural history of hypertension model was created. The personalized preventive treatment appeared more cost-effective than population-based conventional care. These findings are extremely valuable for making hypertension-based health decisions based on precise preventive medication. Full article
(This article belongs to the Special Issue Personalized Medicine in Hypertension)
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12 pages, 1386 KiB  
Article
Factors That May Impact the Noninvasive Measurement of Central Blood Pressure Compared to Invasive Measurement: The MATCHY Study
by Chen Chi, Yi Lu, Yiwu Zhou, Jiaxin Li, Yawei Xu and Yi Zhang
J. Pers. Med. 2022, 12(9), 1482; https://doi.org/10.3390/jpm12091482 - 10 Sep 2022
Cited by 3 | Viewed by 1539
Abstract
Calibration affects central blood pressure (BP) estimation accuracy. Factors influencing the accuracy of noninvasive central BP measurement, type of calibration method implemented (systolic/diastolic BP or mean/diastolic BP), and type of BP measurement device used (devices using the transfer function method, directly measurement from [...] Read more.
Calibration affects central blood pressure (BP) estimation accuracy. Factors influencing the accuracy of noninvasive central BP measurement, type of calibration method implemented (systolic/diastolic BP or mean/diastolic BP), and type of BP measurement device used (devices using the transfer function method, directly measurement from the carotid artery, and the transfer function-like method), were investigated. Fifty participants (aged 62.4 ± 8.9 years) without overt heart diseases were recruited. Invasive aortic and radial BP was measured. Simultaneously, noninvasive central BP was measured using three types of devices. The mean invasive aortic BP was 127 ± 19/95 ± 14 mmHg. Noninvasive central BP tended to be slightly lower than invasive BP, though without statistical significance. The type of calibration method did not significantly influence the noninvasive cSBP measurements (p ≥ 0.24). Results from cuff-based devices were significantly lower than invasive measurements (p = 0.04). Multiple regression analyses showed that gender was significantly correlated with the accuracy of noninvasive cSBP measurement. In conclusion, noninvasive cSBP measurements are comparable to invasive measurements but might underestimate true cSBP. The type of device may affect the accuracy of measurement. Either of the two calibration methods is acceptable. Full article
(This article belongs to the Special Issue Personalized Medicine in Hypertension)
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Review

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14 pages, 924 KiB  
Review
Etiological Diagnosis and Personalized Therapy for Hypertension: A Hypothesis of the REASOH Classification
by Chong Xu, Moran Li, Weilun Meng, Jun Han, Song Zhao, Jiamin Tang, Haotian Yang, Rusitanmujiang Maimaitiaili, Jiadela Teliewubai, Shikai Yu, Chen Chi, Ximin Fan, Jing Xiong, Yifan Zhao, Yawei Xu and Yi Zhang
J. Pers. Med. 2023, 13(2), 261; https://doi.org/10.3390/jpm13020261 - 30 Jan 2023
Cited by 1 | Viewed by 3384
Abstract
With the epidemic of risk factors such as unhealthy lifestyle, obesity and mental stress, the prevalence of hypertension continues to rise across the world. Although standardized treatment protocols simplify the selection of antihypertensive drugs and ensure therapeutic efficacy, the pathophysiological state of some [...] Read more.
With the epidemic of risk factors such as unhealthy lifestyle, obesity and mental stress, the prevalence of hypertension continues to rise across the world. Although standardized treatment protocols simplify the selection of antihypertensive drugs and ensure therapeutic efficacy, the pathophysiological state of some patients remains, which may also lead to the development of other cardiovascular diseases. Thus, there is an urgent need to consider the pathogenesis and selection of antihypertensive drug for different type of hypertensive patients in the era of precision medicine. We proposed the REASOH classification, based on the etiology of hypertension, including renin-dependent hypertension, elderly-arteriosclerosis-based hypertension, sympathetic-active hypertension, secondary hypertension, salt-sensitive hypertension and hyperhomocysteinemia hypertension. The aim of this paper is to propose a hypothesis and provide a brief reference for the personalized treatment of hypertensive patients. Full article
(This article belongs to the Special Issue Personalized Medicine in Hypertension)
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