Background/Objective: Worldwide, ~45% of hypertensives remain undiagnosed, and ~26% are adequately controlled. The active involvement of all healthcare professionals in diagnosing hypertension at primary health care units (PHCUs) is linked to better blood pressure (BP) control. There is currently no research examining the potential role of senior medical students in the diagnosis of hypertension. This study aimed to evaluate the contribution of final-year medical students’ active participation in the diagnosis of hypertension. The study also examined the prevalence and control of hypertension among health service users in Greek PHCUs. Methods: This is a cross-sectional convenience sample study. During clinical placement in PHC, sixth-year medical students received systematic training and performed BP measurements, according to the guidelines, in private, well-organized spaces. Adult patients and visitors were enlisted for BP measurements. The BP readings were provided to the participants so they could discuss any concerns about their BP with their physician. Statistical analysis was performed with SPSS. Categorical variables are presented as frequencies. Continuous variables were assessed for normality and, based on their distribution, are expressed as mean ± standard deviation or median (interquartile range). Appropriate tests were performed for the comparisons across groups (chi-square for the categorical variables, and two-sample t-test or Mann–Whitney test for continuous variables). A p-value < 0.05 was considered statistically significant. Results: In the present study, 124 medical students performed BP measurements in 68 PHCUs. BP was measured in 704 individuals, aged 61 (IQR: 48.0–73.0) years old; 58.8% were female, 68.3% of whom were patients. The prevalence of hypertension was 56.7%. The control rate was 44.9% (BP < 140 and 90 mmHg among all hypertensives), and the control rate under treatment was 61.0% (BP < 140 and 90 mmHg among treated hypertensives). The involvement of medical students contributed positively, increasing the diagnosis of hypertension in individuals who might not have their BP measured in routine clinical practice. Ninety-nine newly diagnosed hypertensives were detected. Students identified 220 uncontrolled hypertensives and 112 uncontrolled under-treated patients, who were then referred to the consultant physicians. Conclusions: Students played a critical role in diagnosing hypertension and identifying newly diagnosed hypertensive patients. Embracing interprofessional care in the diagnosis and management of hypertension is essential for achieving better outcomes for our patients. Engaging medical students in BP measurements is a practical and feasible approach to improve hypertension diagnosis and control, taking into consideration the increased workload of PHC physicians. While this action has important medical education implications, the impact on the knowledge level of medical students was not evaluated. Limitations of this study include the assessment of BP in one visit without home BP measurements or a second visit, lack of follow-up of newly diagnosed hypertensives, and the low average number of BP measurements per student.

Background: Skin and myocardial microvascular dysfunction in prediabetes remains underexplored, and limited studies have investigated the microcirculation in prediabetes in multiple vascular beds. This study aimed to examine microvascular alterations in patients with prediabetes, patients with type 2 diabetes mellitus (DM), and normoglycemic controls without established cardiovascular disease (CVD). Methods: In this cross-sectional study, the microcirculation was assessed using established and novel noninvasive techniques. The skin microvascular reactivity was evaluated using laser speckle contrast analysis (LASCA). The myocardial perfusion was assessed by the subendocardial viability ratio (SEVR). The retinal microvasculature was evaluated using digital nonmydriatic fundus photography, the renal microvascular damage through the urinary albumin-to-creatinine ratio (ACR), and the peripheral vasculopathy by the augmentation index (AIx). Results: Sixty-seven participants were included (22 controls, 24 with prediabetes, 21 with DM; aged: 55.9 ± 9.4 years). Patients with prediabetes and DM showed significantly reduced baseline-to-peak skin flux responses in LASCA compared with controls (p = 0.006), and lower SEVR values (p = 0.001). Moreover, no significant differences were identified in the retinal, renal, or peripheral microvascular indices. In multivariate analysis, systolic blood pressure and glucose were independently associated with skin microvascular dysfunction, while the heart rate and arteriovenous ratio were associated with the SEVR. Conclusions: In this cross-sectional study, impaired skin and myocardial microvascular function were observed in patients with prediabetes in the absence of overt CVD. These findings suggest that LASCA and the SEVR may serve as sensitive markers for the detection of early, subclinical microvascular dysfunction in prediabetes.

Primary healthcare (PHC) physicians play a pivotal role in the diagnosis and management of hypertension. While guidelines suggest that blood pressure (BP) should be measured in every patient visit at PHC units, the few studies conducted among PHC physicians report a low ratio of BP measurements in PHC settings. Data on PHC physicians’ practices concerning BP measurement in Greece are lacking. This study aimed to investigate the practices of PHC physicians regarding BP measurement in Greece. A cross-sectional web-based survey was conducted among PHC physicians across Greece. A total of 284 PHC physicians completed the questionnaire and 282 responses were included in the analysis, 42.9% male, 92.9% General Practitioners, 89.4% working in the public sector, with a median of 25 (17 – 30) daily patient visits. PHC physicians reported measuring BP in 33.3% (20–50%) of their patients and recommending home BP measurements in 31.1% (SD: 24.3%) of them. Among those who measured BP, 22.3% measured it once, 44.7% measured it twice, and only 21.3% measured it three times, while 54.6% used an electronic upper arm BP monitor. The main barriers reported were high daily patient volume (60.5%), together with limited time available with patients (69.5%), while only 1.3% declared insufficient training. This is the first study in Greece investigating the practices of PHC physicians regarding BP measurements. Our findings underscore the need for targeted interventions to improve BP monitoring practices. Education and motivation of physicians and other primary care team members would be fundamental in addressing the challenge of implementing BP measurement recommendations in clinical practice.

Psychological disorders are highly prevalent in the general population and are associated with increased cardiovascular risk. Vascular aging is associated with changes in the mechanical and structural properties of the vascular wall, leading to the loss of arterial elasticity and reduced arterial compliance. Arterial stiffness (AS) is a powerful predictor of cardiovascular morbidity and mortality in the general population and in high-risk patients, independent of traditional cardiovascular risk factors. A comprehensive understanding of the association between mental health disorders and AS is critical to refine prevention and treatment strategies. The present review article aims to summarize studies examining the association between psychological factors and AS. Most relevant studies have focused on the association of anxiety and depression with AS, with fewer studies analyzing the impact of other, less common mental health disorders on AS. Although not all of them align, most studies point towards a significant link between psychological disorders and AS. While the underlying pathophysiological mechanisms are still not fully understood, the clinical implications of the observed association might pave the way for the development of novel preventive and therapeutic policies for patients with mental health disorders.