The impact of the COVID-19 pandemic on cardiovascular disease (CVD) prevention and management has been significant, with a notable decrease in the use of lipid-lowering medications by 16,744 patients per month during the first half of 2021 compared to 2019. Conversely, there was an increase in the use of medications for type 2 diabetes, suggesting a shift in treatment priorities during the pandemic (ref: Dale doi.org/10.1038/s41591-022-02158-7/). Genetic factors also play a crucial role in medication use patterns for cardiometabolic diseases, as demonstrated in a large-scale study involving over 567,000 individuals, which identified 333 independent loci associated with medication use in conditions like hypertension and hyperlipidemia (ref: Kiiskinen doi.org/10.1038/s41591-022-02122-5/). Furthermore, primary aldosteronism, a common cause of hypertension, can be effectively treated through adrenal surgery, yet less than 1% of patients are offered this option due to the invasive nature of pre-surgical investigations (ref: Wu doi.org/10.1038/s41591-022-02114-5/). The association between hypertension and CVD risk is particularly pronounced among individuals with HIV, where the hazard ratio for CVD associated with hypertension was higher compared to those without HIV, emphasizing the need for targeted interventions in this population (ref: Siddiqui doi.org/10.1161/HYPERTENSIONAHA.122.19889/).

Research into the genetic determinants of hypertension has revealed significant insights, particularly through the FinnGen study, which analyzed medication use patterns in a large cohort. This study identified 333 genetic loci associated with lifelong medication use for conditions like hypertension, highlighting the role of genetics in treatment adherence and disease management (ref: Kiiskinen doi.org/10.1038/s41591-022-02122-5/). Additionally, primary aldosteronism, a genetic condition leading to hypertension, can be cured through adrenal surgery, yet the complexity of pre-surgical evaluations limits treatment opportunities for many patients (ref: Wu doi.org/10.1038/s41591-022-02114-5/). The exploration of biomarkers in systemic sclerosis-associated pulmonary arterial hypertension has also provided insights into the genetic underpinnings of hypertension-related complications, suggesting that serum proteome analysis could aid in earlier diagnosis and treatment (ref: Sanges doi.org/10.1136/ard-2022-223237/). Overall, these studies underscore the intricate relationship between genetic factors and hypertension, paving the way for personalized medicine approaches in managing this condition.

The interplay between diabetes and hypertension is critical, particularly in understanding how modifiable risk factors influence glycemic status in individuals with prediabetes. A study found that factors such as BMI, abdominal obesity, and hypertension were associated with a lower likelihood of reverting to normoglycemia, indicating the importance of managing these conditions concurrently (ref: Nabila doi.org/10.2337/dc22-1042/). Furthermore, lifestyle behaviors significantly impact the risk of microvascular complications in type 2 diabetes patients, with a cohort study revealing that healthy lifestyle choices could mitigate these risks, potentially through metabolic biomarkers (ref: Geng doi.org/10.1371/journal.pmed.1004135/). Additionally, SGLT2 inhibitors have shown promise in addressing kidney health issues in youth-onset type 2 diabetes, suggesting that these agents may help alleviate metabolic disturbances associated with diabetes (ref: Schaub doi.org/10.1172/JCI164486/). Collectively, these findings highlight the necessity of integrated approaches in managing diabetes and hypertension to improve patient outcomes.

Kidney health is intricately linked to hypertension, as evidenced by a multicenter trial investigating the effects of sodium bicarbonate on kidney transplant recipients with metabolic acidosis. The study concluded that sodium bicarbonate treatment does not significantly preserve graft function, suggesting that alternative strategies are needed to manage hypertension in this population (ref: Mohebbi doi.org/10.1016/S0140-6736(22)02606-X/). Furthermore, the relationship between coronary plaque characteristics and statin therapy outcomes indicates that baseline plaque burden can predict atherosclerotic nonresponse, which is crucial for managing cardiovascular risks associated with hypertension (ref: van Rosendael doi.org/10.1016/j.jcmg.2022.10.017/). Additionally, the association between hypertension and cardiovascular disease risk is amplified in individuals with HIV, where the hazard ratios for various cardiovascular events are notably higher compared to those without HIV (ref: Siddiqui doi.org/10.1161/HYPERTENSIONAHA.122.19889/). These studies underscore the importance of addressing kidney health in the context of hypertension management.

Lifestyle factors play a significant role in the management of hypertension, as highlighted by a systematic analysis of health trends in Pakistan, which showed that improvements in health indicators are uneven across regions, impacting hypertension prevalence and management (ref: doi.org/10.1016/S2214-109X(22)00497-1/). The influence of lifestyle behaviors on hypertension is further supported by findings that link modifiable risk factors to glycemic status changes in individuals with prediabetes, emphasizing the need for lifestyle interventions to prevent hypertension and diabetes (ref: Nabila doi.org/10.2337/dc22-1042/). Moreover, the effects of SGLT2 inhibitors on metabolic and kidney health in youth-onset type 2 diabetes illustrate how lifestyle and pharmacological interventions can be synergistic in managing hypertension (ref: Schaub doi.org/10.1172/JCI164486/). These insights suggest that comprehensive lifestyle modifications, alongside medical treatments, are essential for effective hypertension management.

Public health initiatives are crucial in addressing hypertension management, as evidenced by a national survey in China that assessed trends in hypertension prevalence, awareness, treatment, and control from 2004 to 2018. The study revealed that while awareness and treatment rates have improved, control rates remain suboptimal, indicating a need for enhanced public health strategies to manage hypertension effectively (ref: Zhang doi.org/10.1136/bmj-2022-071952/). Additionally, the association between socioeconomic status (SES) and hypertension incidence highlights the disparities in health outcomes, particularly among women, suggesting that targeted interventions are necessary to address these inequalities (ref: Ma doi.org/10.1161/HYPERTENSIONAHA.122.20061/). Furthermore, the increased cardiovascular disease risk associated with hypertension in individuals with HIV underscores the importance of tailored public health approaches to manage hypertension in vulnerable populations (ref: Siddiqui doi.org/10.1161/HYPERTENSIONAHA.122.19889/). These findings emphasize the need for comprehensive public health strategies that incorporate education, access to care, and targeted interventions to improve hypertension management.

Hypertension management in special populations, such as individuals with HIV, requires careful consideration of associated cardiovascular risks. A study found that hypertension significantly increases the risk of cardiovascular disease, acute myocardial infarction, and stroke among individuals with HIV, with a stronger association observed compared to those without HIV (ref: Siddiqui doi.org/10.1161/HYPERTENSIONAHA.122.19889/). Additionally, the effects of a polypill on cognitive and functional outcomes in individuals with vascular risk factors highlight the potential for integrated treatment approaches in managing hypertension and its complications (ref: Bosch doi.org/10.1001/jamaneurol.2022.5088/). Furthermore, the examination of sex differences in the impact of socioeconomic status on hypertension incidence among Chinese adults reveals that lower SES adversely affects women more significantly, indicating the need for gender-sensitive approaches in hypertension management (ref: Ma doi.org/10.1161/HYPERTENSIONAHA.122.20061/). These studies collectively underscore the importance of tailored interventions for managing hypertension in diverse populations.