Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perspective
  • Published:

Hypertension management in 2030: a kaleidoscopic view

Journal of Human Hypertension volume 35, pages 812–817 (2021)Cite this article

Subjects

Abstract

The last decade has witnessed the healthcare system going paperless with increased use of electronic healthcare records. Artificial intelligence tools including smartphones and smart watches have changed the landscape of day-to-day lives. Digitisation, decentralisation of healthcare and empowerment of allied healthcare providers and patients themselves have made shared clinical decision-making a reality. The year 2020 quickly turned into an unprecedented time in our lives with the entry of COVID-19. Amidst a pandemic, healthcare systems rapidly adapted and transformed, and changes that otherwise would have taken a decade, took a mere few weeks (Webster, Lancet 395:1180–1, 2020). This essay reviews evidence of transformation in the realm of hypertension management, namely diagnosis, lifestyle changes, therapeutics and prevention of hypertension at both individual and population levels, and presents an extrapolation of how this transformation might shape the next decade.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: BIHS Stanley Peart essay award.
Fig. 2: Highlights the key areas which can transform hypertension management.

Similar content being viewed by others

References

  1. Webster P. Virtual health care in the era of COVID-19. Lancet. 2020;395:1180–1.

    Article  CAS  Google Scholar 

  2. Heidenreich Paul A, Trogdon Justin G, Khavjou Olga A, Butler J, Dracup K, Ezekowitz Michael D, et al. Forecasting the future of cardiovascular disease in the United States. Circulation. 2011;123:933–44.

    Article  CAS  Google Scholar 

  3. WHO. https://www.who.int/news-room/fact-sheets/detail/hypertension (2019).

  4. Zhou B, Bentham J, Di Cesare M, Bixby H, Danaei G, Cowan MJ, et al. Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participants. Lancet. 2017;389:37–55.

    Article  Google Scholar 

  5. Turnbull F, Neal B, Ninomiya T, Algert C, Arima H, Barzi F, et al. Blood Pressure Lowering Treatment Trialists’ Collaboration. Effects of different regimens to lower blood pressure on major cardiovascular events in older and younger adults: meta-analysis of randomised trials. BMJ. 2008;336:1121–23.

    CAS  PubMed  Google Scholar 

  6. Kai H, Kai M. Interactions of coronaviruses with ACE2, angiotensin II, and RAS inhibitors—lessons from available evidence and insights into COVID-19. Hypertens Res. 2020;43:648–54.

    Article  CAS  Google Scholar 

  7. Wolley MJ, Stowasser M. New advances in the diagnostic workup of primary aldosteronism. J Endocr Soc 2017;1:149–61.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Pachori AS, Huentelman MJ, Francis CS, Gelband CH, Katovich MJ, Raizada MK. et al. The future of hypertension therapy: sense, antisense, or nonsense?. Hypertension. 2001;37:357–64.

    Article  CAS  Google Scholar 

  9. Mukhtar O, Cheriyan J, Cockcroft JR, Collier D, Coulson JM, Dasgupta I, et al. A randomized controlled crossover trial evaluating differential responses to antihypertensive drugs (used as mono- or dual therapy) on the basis of ethnicity: the comparIsoN oF Optimal Hypertension RegiMens; part of the Ancestry Informative Markers in HYpertension program-AIM-HY INFORM trial. Am Heart J. 2018;204:102–8.

    Article  CAS  Google Scholar 

  10. Hoy SM. Patisiran: first global approval. Drugs. 2018;78:1625–31.

    Article  CAS  Google Scholar 

  11. Ray KK, Landmesser U, Leiter LA, Kallend D, Dufour R, Karakas M, et al. Inclisiran in patients at high cardiovascular risk with elevated LDL cholesterol. N Engl J Med. 2017;376:1430–40.

    Article  CAS  Google Scholar 

  12. Uijl E, Mirabito Colafella Katrina M, Sun Y, Ren L, van Veghel R, Garrelds Ingrid M, et al. Strong and sustained antihypertensive effect of small interfering RNA targeting liver angiotensinogen. Hypertension. 2019;73:1249–57.

    Article  CAS  Google Scholar 

  13. Vazquez J, Correa de Adjounian MF, Sumners C, Gonzalez A, Diez-Freire C, Raizada Mohan K, et al. Selective silencing of angiotensin receptor subtype 1a (AT1aR) by RNA interference. Hypertension. 2005;45:115–9.

  14. Storch U, Forst AL, Philipp M, Gudermann T, Mederos y Schnitzler M. Transient receptor potential channel 1 (TRPC1) reduces calcium permeability in heteromeric channel complexes. J Biol Chem. 2012;287:3530–40.

  15. Hermida RC, Crespo JJ, Dominguez-Sardina M, Otero A, Moya A, Rios MT, et al. Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial. Eur Heart J. 2019:ehz754.

  16. Rorie DA, Flynn RWV, Mackenzie IS, MacDonald TM, Rogers A. The Treatment In Morning versus Evening (TIME) study: analysis of recruitment, follow-up and retention rates post-recruitment. Trials. 2017;18:557.

    Article  Google Scholar 

  17. Souto EB, Campos JC, Filho SC, Teixeira MC, Martins-Gomes C, Zielinska A, et al. 3D printing in the design of pharmaceutical dosage forms. Pharm Dev Technol. 2019;24:1044–53.

    Article  CAS  Google Scholar 

  18. Neter Judith E, Stam Bianca E, Kok Frans J, Grobbee Diederick E, Geleijnse Johanna M. Influence of weight reduction on blood pressure. Hypertension. 2003;42:878–84.

    Article  CAS  Google Scholar 

  19. Kent L, Morton D, Rankin P, Ward E, Grant R, Gobble J, et al. The effect of a low-fat, plant-based lifestyle intervention (CHIP) on serum HDL levels and the implications for metabolic syndrome status—a cohort study. Nutr Metab. 2013;10:58.

    Article  Google Scholar 

  20. Alexander S, Ostfeld RJ, Allen K, Williams KA. A plant-based diet and hypertension. J Geriatr Cardiol 2017;14:327–30.

    PubMed  PubMed Central  Google Scholar 

  21. Portune KJ, Benítez-Páez A, Del Pulgar EMG, Cerrudo V, Sanz Y. Gut microbiota, diet, and obesity-related disorders—the good, the bad, and the future challenges. Mol Nutr Food Res. 2017;61:1600252.

    Article  Google Scholar 

  22. Leshem A, Horesh N, Elinav E. Fecal microbial transplantation and its potential application in cardiometabolic syndrome. Front Immunol. 2019;10:1341.

    Article  CAS  Google Scholar 

  23. Ponte Márquez PH, Feliu-Soler A, Solé-Villa MJ, Matas-Pericas L, Filella-Agullo D, Ruiz-Herrerias M, et al. Benefits of mindfulness meditation in reducing blood pressure and stress in patients with arterial hypertension. J Hum Hypertens. 2019;33:237–47.

    Article  Google Scholar 

  24. Cramer H, Sellin C, Schumann D, Dobos G. Yoga in arterial hypertension. Dtsch Arztebl Int. 2018;115:833–9.

    PubMed  PubMed Central  Google Scholar 

  25. Elmer PJ, Obarzanek E, Vollmer WM, Simons-Morton D, Stevens VJ, Young DR, et al.  PREMIER Collaborative Research Group. Effects of comprehensive lifestyle modification on diet, weight, physical fitness, and blood pressure control: 18-month results of a randomized trial. Ann Intern Med. 2006;144:485–95.

  26. Bengtsson U, Kjellgren K, Hallberg I, Lindwall M, Taft C. Improved blood pressure control using an interactive mobile phone support system. J Clin Hypertens. 2016;18:101–8.

    Article  Google Scholar 

  27. Nolan Robert P, Feldman R, Dawes M, Kaczorowski J, Lynn H, Barr Susan I, et al. Randomized controlled trial of e-counseling for hypertension. Circulation. 2018;11:e004420.

    CAS  PubMed  Google Scholar 

  28. Burnier M, Egan, Brent M. Adherence in hypertension. Circ Res. 2019;124:1124–40.

    Article  CAS  Google Scholar 

  29. Thompson D, Mackay T, Matthews M, Edwards J, Peters NS, Connolly SB. Direct adherence measurement using an ingestible sensor compared with self-reporting in high-risk cardiovascular disease patients who knew they were being measured: a prospective intervention. JMIR Mhealth Uhealth. 2017;5:e76.

    Article  Google Scholar 

  30. Ogink PAM, de Jong JM, Koeneman M, Weenk M, Engelen LJ, van Goor H, et al. Feasibility of a new cuffless device for ambulatory blood pressure measurement in patients with hypertension: mixed methods study. J Med Internet Res. 2019;21:e11164.

    Article  Google Scholar 

  31. Omboni S, Caserini M. Effectiveness of pharmacist’s intervention in the management of cardiovascular diseases. Open Heart. 2018;5:e000687.

    Article  Google Scholar 

  32. Change4life. https://www.nhs.uk/change4life (2020).

  33. Beaney T, Burrell LM, Castillo RR, Charchar FJ, Cro S, Damasceno A, et al. May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension. Eur Heart J. 2019;40:2006–17.

    Article  Google Scholar 

  34. Tompson A, Fleming S, Lee M-M, Monahan M, Jowett S, McCartney D, et al. Mixed-methods feasibility study of blood pressure self-screening for hypertension detection. BMJ Open. 2019;9:e027986.

    Article  Google Scholar 

  35. WHO. https://www.who.int/cardiovascular_diseases/global-hearts/en/ (2016).

  36. Dzau VJ, Balatbat CA. Future of hypertension. Hypertension. 2019;74:450–7.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK

    Spoorthy Kulkarni

Authors
  1. Spoorthy Kulkarni
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Spoorthy Kulkarni.

Ethics declarations

Conflict of interest

The author declare no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kulkarni, S. Hypertension management in 2030: a kaleidoscopic view. J Hum Hypertens 35, 812–817 (2021). https://doi.org/10.1038/s41371-020-00438-8

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41371-020-00438-8

This article is cited by

Search

Advanced search

Quick links