Redefining Hypertension Care
Summary
- The University of Miami Comprehensive Hypertension Center is pioneering a smarter, more proactive approach to blood pressure management.
- New research points to resistant hypertension stemming from underlying biological drivers that are not adequately addressed by standard treatments.
- UHealth now offers renal denervation, a minimally invasive procedure that interrupts the electrical signal from the artery, for hard-to-treat high blood pressure.
Hypertension is often the root cause of a number of cardiovascular diseases, which is why care at a comprehensive center such as the University of Miami is essential. At the forefront of this care is the University of Miami Comprehensive Hypertension Center, which is pioneering a smarter, more proactive and personalized approach to blood pressure management.
For decades, hypertension care followed a standard formula: measure, diagnose, prescribe. But that reactive approach is no longer sufficient. Now, UHealth — University of Miami Health System experts are leading the charge in redefining how hypertension is understood and treated, starting with the principle that every patient’s blood pressure has a story.
“We’re creating a new model of care, one that’s smarter, more personalized and far more precise,” said Maria Carolina Delgado-Lelievre, M.D., the founder and director of the Comprehensive Hypertension Center. “In a place as diverse as Florida, this personalized and inclusive approach has been essential, helping us deliver precise, effective care across diverse communities.”
Hypertension Prevention is Preferable to Waiting for a Cure
The Comprehensive Hypertension Center, recognized with the American Heart Association’s Gold-Plus distinction for two consecutive years, is a major component of the University of Miami Miller School of Medicine’s Preventive Cardiac Care program. This June, UHealth’s Cardiology practice expanded to the Doral Medical Center, where Dr. Delgado-Lelievre will see hypertension patients.
“We’re building what is currently the only comprehensive academic preventive cardiology program in the area,” said Yiannis Chatzizisis, M.D., Ph.D., chief of the Miller School’s Division of Cardiovascular Medicine. “Our goal is for every male over 40 and every female over 50 to be screened, because prevention is preferable to cure.”
UHealth is a leader in hypertension care. Dr. Delgado-Lelievre presented on the center’s advances at the Cardiovascular Research Technologies conference in March, underscoring UM’s leadership in this space.
“We were proud to present our experience as a Comprehensive Hypertension Center at the 2025 Cardiovascular Research Technologies conference,” said Dr. Delgado-LeLievre, who presented on building successful hypertension programs, including clinical pathways, infrastructure and the pillars that have contributed to our success. “It was a meaningful opportunity not only to highlight how we’re pushing boundaries in hypertension characterization and control, but also to help educate and inspire others working to develop or strengthen their own hypertension initiatives.”
New Biomarkers and Hard-to-Treat Hypertension
New research points to hard-to-treat or resistant hypertension stemming from underlying biological drivers that are not adequately addressed by standard treatments, which often include as many as four medications.
“Understanding the underlying biology helps us move away from trial-and-error medicine and toward a model that’s biologically driven,” Dr. Delgado-LeLievre said.
Through identifying biomarkers like aldosterone and renin, combined with innovative tools such as a cuff-less wearable device, real-time blood pressure behavior is captured across the circadian rhythm.
“This lets us see how sympathetic tone, sleep and stress influence blood pressure patterns,” Dr. Delgado-LeLievre said. “It’s how we move from guessing to precision medicine—ensuring patients receive therapy that matches their biology, not just a number on a chart.”
Hypertension isn’t just an isolated condition. It’s often linked to genetics, family history, hormones, sleep and stress. The center conducts extensive screening, assessing salt sensitivity, aldosterone levels, genetic predispositions and more. Family members, particularly in cases of early-onset hypertension, are often evaluated, as well.
“At our center, we don’t just educate patients. We empower families,” said Dr. Delgado-Lelievre. “We help them understand the intergenerational risks and give them the tools to change their health trajectory.”
Latest Therapies: Renal Denervation
UHealth now offers renal denervation, a minimally invasive procedure that interrupts the electrical signal from the artery, leading to a reduction in hard-to-treat blood pressure.
UHealth conducted some of the first cases of ultrasound and radiofrequency-based renal denervation in South Florida and the state of Florida, and is still one of only a few centers offering this intervention in the country.
Now considered a leader in renal denervation, UHealth is currently running clinical trials at the center to collect information about real-world use of FDA-approved, next-generation renal denervation devices.
The renal denervation clinical trials being done at UHealth are post-market surveillance trials. They’re open label, meaning that all participants receive treatment. Enrolled patients must have uncontrolled hypertension. Researchers are looking to enroll Hispanics, African Americans, females and people of Asian descent.
“The problem with a lot of trials is that there is not enough female representation in a lot of the invasive trials,” said Eduardo de Marchena, M.D., professor of cardiovascular medicine and associate dean for international medicine at the Miller School. “And so the FDA wants information on women. They want information on underrepresented demographic groups. And the good thing is that, at the University of Miami, we have those cohorts.
Tags: Comprehensive Hypertension Center, Dr. Eduardo de Marchena, Dr. Maria Delgado-Lelievre, Dr. Yiannis Chatzizisis, Hypertension Clinic, precision medicine, preventive care, renal denervation