This issue features several papers focused on the Asian hypertensive population, based on a large database.

Eunjin et al. investigated the risk of hypertension in relation to sodium and potassium intake and the effects of genetic factors using calculated the polygenic risk scores (PRS), which was derived from the BioBank Japan Project, a hospital-based registry based on 136,597 individuals [1]. In the test set of 41,351 subjects, high PRS for SBP and DBP, high sodium intake, and low potassium intake assessed by food frequency questionnire were significantly associated with incident hypertension after 4.5 years of follow-up in Asian population.

Tokioka et al. investigated whether depressive symptoms, as evaluated by the Center for Epidemiologic Studies Depression Scale-Japanese version (CES-D), were associated with the risk of hypertension onset assessed by home BP monitoring from the data of the Tohoku Medical Megabank Community-Cohort Study [2]. After a 3.5-year follow-up, individuals with depressive symptoms, indicated by a CES-D score of more than 16, had a 1.37-fold increased risk for morning hypertension and a 1.18-fold increased risk for evening hypertension, respectively.

Kobayashi et al. reported the prevalence and characteristics of unilateral hyperaldostronism in 199 primary aldosteronism patients from the Japan Primary Aldosteronism Study II dataset [3].

Yan et al. investigated the control rate of hypertension across months of the year and hours of the day in a real-world database [4]. In the data of 343,400 hypertensive patients, the control rate of hypertension defined by office BP of ≥140/90 mmHg was lowest in February and highest in August. For hours of the day, the control rate of hypertension was lowest at 7:00 a.m. and highest at 12:00 p.m.

Kitagawa et al. investigated the association between cerebral small vessel disease (SVD) assessed by four brain MRI markers, indicated by white matter hyperintensity, lacunar infarction, cerebral microbleed and enlarged perivascular space, and cardiovascular outcome in 1011 patients from the Tokyo Women’s Medical University Cerebrovascular Disease registry [5]. After a 4.6-year follow-up, the total SVD score was associated with stroke, but not acute coronary syndrome.

Sugawara et al. examined the age-related changes in heart-brachium pulse wave velocity (hbPWV) and compared them with brachial-ankle PWV (baPWV) among a substantial cohort of Japanese workers [6]. Unlike baPWV, hbPWV showed a stronger correlation with age and the Framingham risk score, displaying a steady and consistent increase throughout the lifespan. Moreover, hbPWV proved to be more effective in stratifying cardiovascular risk compared to baPWV.

Himuro et al. investigated the relationship between the combination of birth weight and current body mass index and the risk of developing hypertension in adulthood, utilizing data from 10,688 participants in the Tohoku Medical Megabank Community-based Cohort Study [7]. The findings indicated that low birth weight was linked to an increased risk of hypertension later in life, and there was an inverse relationship between birth weight and systolic blood pressure (SBP) in younger and middle-aged adults.

Choi et al. examined the link between adherence to physical activity guidelines, as determined by a self-reported questionnaire, and mortality rates in individuals with hypertension, using data from 34,990 adults from the Korea National Health and Nutrition Examination Survey [8]. After an average follow-up period of 9.2 years, they found that hypertensive individuals who met aerobic physical activity guidelines, or both aerobic and muscle-strengthening guidelines, experienced a lower risk of all-cause and cardiovascular mortality. However, adherence to only the muscle-strengthening activity guidelines did not show a significant reduction in mortality risk.