Interventions for older adults with NCDs and depression should be relevant to the risk factors for NCDs in non-WEIRD populations. We conducted a single-group pilot study of the Ziba Ufa intervention, consisting of problem-solving therapy and health education over 6 weekly sessions delivered by lay counsellors; there was no control group. Participants were opportunistically sampled through outpatient NCD clinics in four sites in Kilimanjaro, Tanzania. We conducted exploratory analyses of the clinical relevance of the health education using self-report survey data, and perceived relevance using qualitative interviews. Thirty-two participants enrolled (88% with hypertension and 44% with type 2 diabetes). Of the 21 participants with height and weight data, 12 (57%) were obese. Advice on weight loss, a sleep routine, and increasing fruit and vegetable consumption may be clinically relevant, but alcohol and tobacco consumption, levels of physical activity and consumption of processed foods with added sugar or salt were self-reported as meeting recommendations; therefore, they may be less clinically relevant. Participants reported acting on the sleep advice more than on the dietary and physical activity advice. This may indicate that sleep advice was perceived as relevant, but dietary and physical activity advice was not.

Previous studies have suggested that a high intake of nuts may reduce the risk of hypertension; however, the available data have been limited. Several additional studies have recently been published on the topic. We therefore conducted a systematic review and meta-analysis of cohort studies on nut consumption and hypertension to provide an updated assessment of the evidence. PubMed and Embase databases were searched up to 4 April 2026 for prospective cohort studies with adjusted relative risk (RR) estimates published in English on the association between nut consumption and hypertension risk. Random-effects models were used to estimate summary RRs and 95 % CIs. We used World Cancer Research Fund (WCRF) criteria to assess the strength of the evidence. Eight studies (20 665 cases, 143 380 participants) were included in the meta-analysis. The summary RR for the highest v. lowest category of nut intake was 0·84 (95 % CI 0·77–0·91, I2 = 50 %, pheterogeneity = 0·05, n 8) and per 28 g/d was 0·80 (95 % CI 0·71–0·89, I2 = 75 %, pheterogeneity < 0·0001, n 8). There was no indication of publication bias. There was some indication of non-linearity (pnon-linearity = 0·07), and there was a 26 % reduction in risk when comparing 30 g/d v. 0 g/d. Using WCRF criteria to assess the strength of evidence, we graded the likelihood of causality as probable. In this meta-analysis of prospective cohort studies, we found further evidence for a reduced risk of hypertension with higher intake of nuts. These findings support dietary guideline recommendations to include a serving of nuts per day.

Middle aortic syndrome is a rare cause of aortic coarctation, characterised by progressive segmental or diffuse narrowing of the distal thoracic aorta and/or abdominal aorta, often involving the renal arteries and other visceral arteries. The syndrome is predominantly seen in children and young adults, typically presenting with severe hypertension, congestive heart failure, renal failure, or severe leg claudication. Diagnostic imaging by angiography of the descending and abdominal aorta is the preferred evaluative modality. Here, we report a case of a young man who was admitted to our Cardiology Department with severe hypertension and middle aortic syndrome diagnosed by renal Doppler scan and CT angiography. An adequate blood pressure control was achieved with antihypertensive treatment and surgery.

Multidimensional metabolic dysregulation is implicated in hypertension development, but the utility of comprehensive metabolic vulnerability indices for assessing hypertension risk associations remains unclear. This prospective cohort study analysed 150 591 participants from the United Kingdom Biobank. The metabolic vulnerability index and its components – inflammation vulnerability index (IVX) and metabolic malnutrition index (MMX) – were calculated from six metabolites (GlycA, small HDL particles, leucine, valine, isoleucine and citrate) measured by NMR spectroscopy. Cox proportional hazards models assessed associations with incident hypertension, adjusting for demographic, lifestyle and clinical factors. Restricted cubic spline analyses examined dose–response relationships, and subgroup analyses explored effect modifications by polygenic risk score, BMI and C-reactive protein levels. During follow-up, 32 198 participants developed hypertension. After comprehensive adjustment, IVX and metabolic vulnerability index (MVX) showed significant positive associations with hypertension risk (highest v. lowest quartile: hazard ratio (HR) = 1·25 (95 % CI: 1·20, 1·31) and HR = 1·19 (95 % CI: 1·15, 1·24), respectively, P < 0·001). Each standard deviation increase in IVX and MVX was associated with 9 % and 7 % higher hypertension risk, respectively. Conversely, MMX demonstrated a slight protective effect (HR = 0·96 (95 % CI: 0·92, 0·99), P = 0·016) and exhibited a U-shaped relationship with hypertension risk. Notably, associations between IVX/MVX and hypertension were significantly stronger in non-obese individuals (BMI < 30) compared with obese participants (BMI ≥ 30) (P-interaction < 0·001 and P = 0·007, respectively). Results remained robust in sensitivity analyses excluding extreme values and early hypertension cases. Metabolic vulnerability, particularly its inflammatory component, is independently associated with hypertension risk beyond traditional risk factors. These findings highlight the potential utility of comprehensive metabolomic profiling for early identification of individuals at elevated hypertension risk.

Displaced persons with non-communicable diseases (NCD) face challenges in disease management and increased risk of mental health problems. This randomized controlled trial assessed the impact of psychotherapy treatment (Common Elements Treatment Approach [CETA]) on hypertension and diabetes mellitus medication adherence (primary) and mental and physical health outcomes (secondary) among displaced Myanmar adults with poor medication adherence in a Thai shelter community. Treatment participants received weekly CETA for 4–12 weeks; comparison participants had access to routine psychosocial support. Eligible participants were chronic disease patients with <70% medication adherence over prior month. Data were collected at baseline, 3 and 6 months. Of 650 adults screened, 283 (43.5%) met eligibility criteria and 224 consented (CETA n = 112, comparison n = 112) to participate; 73 (32.6%) reported elevated mental health symptoms. At 6-month follow-up, medication adherence improved in both arms, with greater improvements among CETA participants (MARS-5: 0.55, 95% CI: 0.07 to 1.02, p = 0.023). CETA significantly reduced mental health symptoms among those with elevated symptoms at baseline (−3.06, 95% CI: −5.19 to −0.93, p = 0.005). The high rate of mental health symptoms and the impact of CETA on NCD medication adherence supports integration of mental health services into NCD care systems.

Prenatal and early-life exposures may contribute to lifelong hypertension risk. We examined the relationships between an individual’s birth weight or preterm birth status with their 1) risk for hypertension and 2) related quantitative blood pressure measures [mean systolic blood pressure (SBP), diastolic blood pressure (DBP), and 30-second pulse] among post-menopausal women from the Women’s Health Initiative observational cohort. At study entry, birth weight and preterm birth status were self-reported by category (<6 lbs., 6–7 lbs. 15 oz., 8–9 lbs. 15 oz., or ≥10 lbs.; ≥4 weeks premature or full term). Prevalent and incident hypertension status were self-reported; baseline SBP, DBP, and 30-second pulse were measured by trained study staff. Linear, logistic, and Cox-proportional hazards regression models were used to estimate associations between birth weight and preterm birth and blood pressure outcomes. After adjustments, participants born weighing <6 lbs. had a higher mean SBP and were at increased risk for prevalent and incident hypertension compared to participants born at a normal birth weight (6–7 lbs. 15 oz.). Women born weighing ≥10 lbs. had a lower mean SBP and were at lower risk for prevalent and incident hypertension when compared to participants born at a normal birth weight. Compared to participants born full term, those born preterm were at increased risk for prevalent and incident hypertension; however, this relationship was weaker when stratifying by birth weight. Long-term follow-up or targeted counseling may be required for individuals born prematurely or at lower birth weights to prevent hypertension and associated cardiovascular outcomes.

A high sodium intake is a major risk factor for raised blood pressure. Consumption of fish fillet is associated with lower blood pressure in humans and other animals, whereas the effects of consuming fish residuals are less explored. To obtain high-quality fishmeal with acceptable sensory properties, the fish residuals may be washed with seawater onboard factory trawlers. This will increase the sodium content in the residuals, and whether this affects blood pressure has not yet been investigated. The primary objective of the present study was to investigate if the increased sodium content in Atlantic cod (Gadus morhua) residuals after washing with saltwater affected the development of high blood pressure in male obese Zucker fa/fa rats which spontaneously develop hypertension. Rats were fed diets containing cod protein powders prepared from unwashed or saltwater-washed backbone or head fractions (n 6/group) as 25% of total protein with the remaining 75% as casein, or casein as the sole protein source (Control group, n 6) for six weeks. Blood pressure was measured on day 0 and 40. The diets containing backbone protein powder, independent of whether this fraction was washed with saltwater or not, attenuated the blood pressure increase compared to the Control group, whereas diets containing washed or unwashed head protein powder did not affect the blood pressure development. To conclude, a diet containing cod backbone protein powder attenuated the blood pressure increase in obese Zucker fa/fa rats, and this effect was not compromised by the higher sodium content in backbones washed with saltwater.

The interaction between 25-hydroxyvitamin D [25(OH)D] and physical activity (PA) in influencing hypertension remains underexplored. This study aimed to examine their independent and joint associations with hypertension risk among 5327 participants aged ≥ 50 years from the English Longitudinal Study of Ageing. Participants were categorised by 25(OH)D status (sufficient, ≥ 50 nmol/l; insufficient, ≥ 30 to < 50 nmol/l; deficient, < 30 nmol/l) and self-reported PA levels. Multivariable logistic regression, adjusting for the season of measurement and sociodemographic confounders, showed that sufficient 25(OH)D (OR = 0·66, 95 % CI 0·56, 0·78) and higher PA (OR = 0·82, 95 % CI 0·71, 0·94) were independently associated with reduced hypertension prevalence. In joint analyses, the group combining higher PA and sufficient 25(OH)D exhibited the lowest odds of hypertension (OR = 0·55, 95 % CI 0·43, 0·70) compared with the lower PA and deficient group. A significant synergistic interaction was identified, indicating that the combined protective effect of these factors was greater than the sum of their individual associations. These results were corroborated by Mendelian randomisation analysis, which identified inverse causal associations between genetically predicted 25(OH)D, vigorous PA and hypertension risk across independent datasets. These findings emphasise that vitamin D sufficiency acts in synergy with an active lifestyle to enhance cardiovascular protection. This relationship underscores the critical importance in nutritional science of integrating micronutrient status with PA to develop more effective, multifaceted lifestyle-based strategies for hypertension management in middle-aged and older populations.

Middle aortic syndrome is a rare vascular disorder characterised by segmental narrowing of the distal thoracic aorta and/or proximal abdominal aorta, often accompanied by renal artery involvement. The condition may arise from genetic abnormalities, acquired factors, or idiopathic causes. In this study, we report the case of a 9-year-old boy who was found to have hypertension during a routine school health examination. Computed tomography angiography confirmed the diagnosis of middle aortic syndrome, revealing long-segment stenosis of the distal thoracic aorta. Following a comprehensive assessment, the patient underwent descending aortic reconstruction with a 14 mm Intergard knitted vascular graft. At the 6-month follow-up, imaging demonstrated satisfactory graft patency, and the patient’s blood pressure remained well-controlled without the need for antihypertensive medications.

High intake of processed foods, especially those with high sodium content, is a contributor to hypertension and cardiovascular disease. This study aimed to compare the sodium content of packaged foods and beverages in Nigeria to WHO Global Sodium Benchmarks and similar products in Kenya and South Africa. The study examined packaged foods from major retail stores in the capital cities of the Federal Capital Territory, Kano, and Ogun states in Nigeria from November 2020 to March 2021. Benchmark values were based on the 2021 WHO Global Sodium Benchmarks. We used secondary data from packaged food surveys conducted in South Africa (2015, 2016 and Kenya 2019). Approximately 40.0% (n = 36) of subcategories of packaged foods were captured in the WHO global sodium benchmark. Of these, 64.0% (n = 23) exceeded the benchmarks, including ‘processed meat’ (912.0 vs. 250.0 mg/100 g), cheese (776.0 vs. 190 mg/100 g), and ‘wholegrain chips’ (930.0 vs. 470 mg/100 g). Exactly 36.0% (n = 13) had lower sodium content, such as ‘rice-based snacks’ (113.0 vs. 520 mg/100 g) and ‘dried seafood’ (400 vs. 800 mg/100 g). In seven out of eleven main food categories (64%), Nigeria had a higher sodium content compared to Kenya. Similarly, Nigeria exhibited higher sodium content than South Africa in six out of eleven food categories (55.0%). With 64.0% of Nigerian subcategories exceeding WHO benchmarks and higher sodium levels than South Africa and Kenya in most categories. These findings highlight the urgent need for targeted sodium reduction and product reformulation to align Nigeria’s packaged foods with international benchmarks.