Blood Pressure

Overview

Blood pressure is the force exerted by circulating blood against the walls of the arteries. It is a fundamental clinical metric used to assess cardiovascular status, vascular resistance, and overall hemodynamic load. In routine practice, blood pressure is typically expressed as systolic pressure and diastolic pressure, and it is central to the diagnosis and management of arterial hypertension, hypotension, and many acute and chronic cardiovascular conditions.

Biologically, blood pressure reflects the integrated effects of cardiac output, vascular tone, blood volume, autonomic regulation, renal sodium handling, and neurohormonal systems such as the renin–angiotensin system. Because it is both a marker and a modifiable determinant of risk, blood pressure is widely used in studies of cardiovascular disease, stroke, type 2 diabetes, obesity, renal outcomes, and aging-related phenotypes. It is also a frequent endpoint in trials of antihypertensive therapy, lifestyle intervention, and mechanistic studies of vascular and metabolic regulation.

Focus of Latest Publications

Recent studies have used blood pressure as a primary target, outcome, or safety endpoint across a broad range of clinical and translational settings. A major theme has been the optimization of blood pressure lowering in acute ischemic stroke. In thrombolysis-treated stroke, the ENCHANTED trial secondary analysis examined whether early intensive blood pressure lowering influenced cerebral oedema, reflecting ongoing controversy about the balance between potential benefit and harm in acute stroke care. Related work in patients undergoing endovascular thrombectomy found that intensive blood pressure targets below 120 mm Hg were associated with worse functional outcomes after EVT, and post-hoc analyses also evaluated Health-Related Quality of Life after thrombectomy under intensive blood pressure lowering. Additional stroke-focused studies assessed delayed intracranial hemorrhage after mechanical thrombectomy and its relationship to elevated systolic blood pressure, as well as functional outcomes following blood pressure drops within 24 hours after successful thrombectomy. Together, these studies reinforce that post-reperfusion blood pressure management remains clinically important but not fully resolved.

Blood pressure has also been studied in uncomplicated hypertension and in treatment intensification strategies. A target trial emulation in 118,271 patients with uncomplicated hypertension compared intensive targets below 130/80 mm Hg with standard targets of 130–140/80–90 mm Hg using a territory-wide public healthcare database in Hong Kong. Other work examined single-pill combination therapy in the Systolic Blood Pressure Reduction Intervention Trial, showing that blood pressure control remains suboptimal among US patients with hypertension, and a separate trial evaluated single-pill low-dose triple combination therapy versus standard-dose monotherapy in mild-to-moderate hypertension as an emerging strategy to improve control. A randomized phase 2 trial of a natriuretic peptide receptor-1 agonist in resistant hypertension investigated whether activation of NPR-1 could lower blood pressure through cyclic guanosine monophosphate signaling. A related trial, COHERENT, was designed to test low-dose colchicine in hypertension, with blood pressure among the secondary endpoints. These studies collectively reflect continued interest in both pharmacologic intensification and novel mechanisms for lowering blood pressure in arterial hypertension.

Several studies linked blood pressure to metabolic disease and cardiometabolic risk. In people with type 2 diabetes, investigators examined factors influencing the blood pressure-lowering effects of sodium-glucose cotransporter 2 inhibitors, highlighting patient-specific variability in response. Another comparison of renal outcomes between SGLT2 inhibitors and glucagon-like peptide-1 receptor agonists in Japanese patients with type 2 diabetes and obesity suggested that superior renal outcomes with SGLT2 inhibitors may be partly due to greater reductions in blood pressure. A study of meal replacement products versus traditional dietary control in obese adults reported advantages in blood pressure and lipid profiles, while another observational study in older adults in Korea examined associations between glycaemic control, blood pressure, lifestyle behaviours, and sarcopenia. Blood pressure was also included in digital quality monitoring for type 2 diabetes in Swiss primary care, where it served as one of the clinical outcomes tracked alongside glycated hemoglobin and diabetes-related complications.

Mechanistic and biomarker-oriented studies have further connected blood pressure with vascular aging, epigenetics, and proteomics. One study assessed the association between blood pressure and proteomic vascular ageing, and its mediation role in incident cardiovascular disease. Another used epigenome-wide association studies to examine age-varying DNA methylation patterns associated with blood pressure in mid-to-late adulthood, indicating that the relationship between methylation and blood pressure may change with age. These findings support the view that blood pressure is not only a clinical measurement but also a phenotype shaped by molecular aging processes and vascular biology.

Blood pressure has also been investigated in experimental and preclinical models of hypertension and inflammation. In lupus mice, long-term galantamine treatment improved survival, lowered blood pressure, and reduced renal injury markers and fibrosis, suggesting a potential link between autonomic or cholinergic modulation and hypertensive renal damage. In spontaneously hypertensive rats, blood pressure was measured using a non-invasive CODA system in a study of partially defatted house cricket powder, while another animal study in lupus-prone NZBWF1 mice and NZW control mice explored hypertension-related outcomes in the context of dietary or biologic interventions. A separate mechanistic study in ischemic stroke models reported elevated blood pressure alongside autonomic and behavioral dysfunction, implicating a renin–angiotensin system and autophagy-related pathways in sympathetic dysregulation.

Blood pressure measurement itself remains a core clinical and research practice. It is used to monitor treatment response, assess safety in drug studies, and define cardiovascular risk. Across the cited studies, blood pressure served as a central endpoint in trials of colchicine, galantamine, SGLT2 inhibitors, meal replacement products, natriuretic peptide receptor-1 agonism, and combination antihypertensive therapy, as well as in stroke reperfusion studies where blood pressure trajectories were linked to neurological outcomes. The breadth of these investigations underscores blood pressure’s role as both a modifiable therapeutic target and a key integrative biomarker of cardiovascular and metabolic health.

Key Publications

• Jul Early blood pressure lowering and cerebral oedema in thrombolysis-treated stroke: secondary analysis of the ENCHANTED trial. (Stroke and vascular neurology, 2026, PMID 41192975): "Controversy persists over the balance of benefits and harms of early intensive blood pressure (BP) lowering in thrombolysis-treated acute ischaemic stroke (AIS) patients."
• Jun Association of intensive blood pressure lowering with health-related quality of life after endovascular thrombectomy: a post-hoc analysis of the ENCHANTED2/MT trial. (Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2026, PMID 42250116): "Intensive blood pressure (BP) targets of less than 120 mm Hg have been shown to worsen functional outcomes after endovascular thrombectomy (EVT) for acute ischemic stroke."
• Jun Optimal blood pressure target in patients with uncomplicated hypertension: a target trial emulation study. (Nature communications, 2026, PMID 42248898): "Here we conducted a target trial emulation study on 118,271 patients with uncomplicated hypertension to evaluate the effectiveness and safety managed by intensive (below 130/80 mmHg) compared to standard (130-140/80-90 mmHg) BP targets using a territory-wide public healthcare database in Hong Kong."
• Jun Factors That Influence Blood Pressure Changes With the Use of Sodium-Glucose Cotransporter 2 Inhibitors in People With Type 2 Diabetes. (Pharmacotherapy, 2026, PMID 42130462): "Given the variability in the magnitude of blood pressure reduction observed across studies, there is interest in understanding how patient-specific factors influence the blood pressure-lowering effects of SGLT2 inhibitors."
• Jun Glycaemic Control, Blood Pressure and Lifestyle Behaviours in Relation to Sarcopenia Among Older Adults in Korea: A Population-Based Cross-Sectional Study. (Australasian journal on ageing, 2026, PMID 42053025): "The aim of this study was to estimate the prevalence of sarcopenia and examine its associations with glycaemic control, blood pressure and lifestyle behaviours among older adults in Korea."
• Jun A Randomized Trial to Investigate the Effects of Low-Dose Colchicine in Patients with Hypertension: Rationale and Design of the COlchicine and HypERtENsion Trial (COHERENT). (Journal of clinical hypertension (Greenwich, Conn.), 2026, PMID 42210033): "Secondary endpoints included blood pressure, echocardiographic measurements, and cardiac/inflammatory biomarkers."
• Jun Transcranial Direct Current Stimulation Attenuates Ischemic Stroke-Induced Autonomic and Behavioral Dysfunction via a RAS-Autophagy-Iron Axis in the Brainstem. (Journal of neurochemistry, 2026, PMID 42212720): "These molecular abnormalities were accompanied by elevated blood pressure and suggest a mechanistic link to sympathetic dysregulation."
• May Differences in the effects of meal replacement products and traditional dietary control on weight control in obese adults: a 90-day randomized controlled trial. (Food & function, 2026, PMID 42108885): "The MRG also showed advantages in blood pressure and lipid profiles."
• May Delayed Intracranial Hemorrhage after Endovascular Thrombectomy Is Associated With Poor Functional Outcomes and Elevated Systolic Blood Pressure. (Journal of the American Heart Association, 2026, PMID 42132174): "This study aim to investigate the incidence and prognosis of early and delayed ICH and to examine how postprocedural blood pressure (BP) relates to delayed ICH."
• May Osteoprotective effects of partially defatted house cricket (Acheta domesticus) powder in spontaneously hypertensive rats. (PloS one, 2026, PMID 42149928): "Blood pressure was determined by the CODA® non-invasive blood pressure system."