Success in hypertension trials is defined as reduction in office blood pressure, ambulatory blood pressure control, or decreased requirement for antihypertensive medications. Approximately 45–65% of published trial participants achieved meaningful blood-pressure reduction (≥5–10 mmHg systolic decrease) within 2–6 months of MSC or exosome infusion; however, most remained on some antihypertensive therapy. Approximately 20–30% achieved sufficient reduction to permit medication withdrawal or substantial dose reduction. Response is better in patients with preserved vascular function at baseline and in younger age groups. Resistant hypertension (uncontrolled on three or more agents) shows lower response rates than essential hypertension.
Clinical hypertension trials show preliminary promise but remain modest in sample size and follow-up duration. Four actively recruiting trials indicate continuing clinical interest. Published studies document reductions in systolic and diastolic blood pressure (5–15 mmHg average decreases) and improvements in vascular stiffness markers following MSC or exosome infusion. Flow-mediated dilation (endothelial function) showed improvement in responsive cohorts. Left-ventricular mass index decreased in some long-term follow-up assessments. However, heterogeneous patient populations, variable blood-pressure definitions, and concurrent antihypertensive medication use limit interpretation. Mechanism studies suggest paracrine effects driving benefit, but direct in-vivo confirmation remains sparse. Durability of blood-pressure reduction beyond 12 months is incompletely characterised.
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