Special Interview for World Hypertension Day: Conversation with Prof. Ruan Kruger, Editorial Board Member of Reviews in Cardiovascular Medicine — Early Prevention of Childhood Hypertension and Global Health Perspectives

14 May 2026

As World Hypertension Day on May 17 approaches, Reviews in Cardiovascular Medicine (RCM) has launched a special interview series under this year’s theme, “Controlling Hypertension Together!” focusing on global advances in hypertension research and clinical practice, to enhance public awareness and promote academic exchange.

 

	Ruan Kruger, PhD, ISHF, FESC
	Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa; SAMRC Extramural Research Unit for Cardiovascular Disease and Hypertension, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
	Interests: primary prevention of CVD; paediatric hypertension

 

In this issue, we are honored to invite Prof. Ruan Kruger, Editorial Board Member of RCM. He is Professor of Physiology and Cardiovascular Research at North-West University (South Africa) and the CEO of the South African Heart (SA Heart) Association, the President of CHCAfrica, and serves on the Board of the Southern African Hypertension Society (SAHS) as well as numerous committees for the International Society of Hypertension (ISH) and International Pediatric Hypertension Association (IPHA). He is a fellow of the European Society of Cardiology (FESC) and ISH (ISHF). His research focuses on early-onset hypertension and cardiovascular disease in children and young adults, with over 140 publications since 2011. He leads several pediatric research studies in South Africa, including the ExAMIN Youth SA study, and contributes to global health awareness campaigns aimed at preventing hypertension and cardiovascular disease in young populations.

 

1. Could you briefly introduce your academic background and your current research focus? What motivated you to specialize in hypertension research?

I completed my PhD in Physiology in 2012 and am now a professor specializing in childhood hypertension and early heart disease in Africa. I lead the strategic planning of the Hypertension in Africa Research Team (HART). What motivated me is the clear evidence that hypertension tracks from childhood into later heart and kidney disease, making early detection crucial. I authored a recent ISH pediatric hypertension position paper emphasizing that pediatric blood pressure management is an investment in lifelong health. Early experiences, including a fellowship in Denmark, reinforced my commitment to preventive cardiology in younger patients. Since hypertension remains the most prominent modifiable risk factor for cardiovascular disease, research in this field will always be important and meaningful.

 

2. From your perspective, what have been the most significant developments and paradigm shifts in hypertension research throughout your career?

There have been several important developments. The realization that hypertension begins in childhood—that it is no longer just an adult problem—is by far the most significant paradigm shift. Second, we have translated this understanding into global consensus papers, such as the ISH position paper and the definition of early vascular aging in youth. We have also improved global blood pressure screening to identify children at risk and started addressing validated devices for use in pediatrics. Another major development is the use of big data approaches, including genetics, metabolomics, and imaging, in pediatric cohorts—a significant shift from focusing solely on treating adults.

 

3. The core goal of World Hypertension Day is to raise public awareness of blood pressure management. From your experience, is there a "translational gap" between current academic research and public education? How can we bridge it?

Translational communication is critical. Our pediatric position paper is an example of turning evidence into practice. Research informs guidelines, which must then be shared with clinicians and communities. For instance, I lead a community screening project through CHCAfrica that links schools and clinics for blood pressure checks, educating families about risks, and informing policy change. Academic findings must be packaged into simple messages via media or outreach—for example, the fact that a healthy lifestyle prevents childhood hypertension. There is definitely a gap, but I believe it can be bridged if we simplify the message and involve the community.

 

4. World Hypertension Day also draws attention to hypertension in children and adolescents. Do you see a polarization of "over-medicalization" or "under-recognition" in current pediatric hypertension screening and treatment strategies?

Absolutely. Traditionally, screening has targeted adults 18 years and older. Some international and national guidelines now recommend routine blood pressure checks in children from age three, especially for at-risk youth. However, screening must use validated automated cuffs, appropriate sizes, and percentile charts for children, which makes general screening practices difficult. Most children with mildly elevated blood pressure are first managed with lifestyle changes; only those with persistently high levels or comorbidities are referred for medication. I believe that in global screening efforts like World Hypertension Day or May Measurement Month, we must start including children and adolescents, because blood pressure tracks from childhood into adulthood, and if not identified early, it can lead to fatal or non‑fatal consequences in early adulthood.

 

5. In your opinion, what are the most critical areas for future breakthroughs and in-depth research in early screening technologies and risk prediction systems for hypertension?

We are entering an era where wearable technology is becoming part of everyday life. Point‑of‑care and wearable blood pressure devices that are validated for children could revolutionize screening and help mitigate risk if abnormalities are detected early. In the next decade, combining smartphone‑based monitoring with AI‑driven risk algorithms could personalize prevention. However, we need robust pediatric reference data to extrapolate these algorithms to children. This is especially critical in African populations, where we have a massive data gap in blood pressure. Also, policy‑level interventions to promote cardiovascular health preservation represent another key area for future breakthroughs.

 

6. The application of artificial intelligence and big data technology in hypertension risk prediction, diagnosis, and treatment plan optimization, remote management, and other aspects is increasing. Do you think the AI-driven hypertension management model will become mainstream in the future, and what challenges still face its application in current clinical practice?

Machine learning can help us uncover subtle risk patterns—for example, diet‑blood pressure links from large cohorts. AI tools might assist in interpreting ambulatory blood pressure trends or even microvascular retinal images to improve early risk detection. However, these algorithms require high‑quality, representative data. In Africa and other parts of the world, such big datasets are still emerging. Challenges include data privacy, the need for clinical validation of these models, and ensuring digital tools are accessible to resource‑limited clinics. I believe interdisciplinary collaboration—clinicians and data scientists working together—is essential to advance this field responsibly.

 

7. How did you first get in touch with Reviews in Cardiovascular Medicine (RCM) and become a member of the editorial board?

About five years ago, I was invited to handle peer reviews for some pediatric topics in Reviews in Cardiovascular Medicine. That led to a formal role on the editorial board, especially in relation to the pediatric content of the journal.

 

8. As World Hypertension Day approaches, RCM plans to launch hypertension-themed content. As an editorial board member, what forms do you think the journal can adopt (such as special issues, review collections, young scholar forums, etc.) to better build an academic exchange platform for hypertension research?

I would suggest focusing on cardiovascular health preservation and early detection and prevention of non‑communicable diseases, with hypertension as a key risk factor. I would include invited reviews on the epidemiology of child and adolescent hypertension school‑based screening programs across the globe, and the impact of diet, especially in low‑ and middle‑income countries. I would also recommend topics on digital health, AI, telemedicine, and genetics in hypertension, particularly from underrepresented populations such as those in Africa. A mix of clinical perspectives and global health policy would strengthen such a special issue.

 

9. In which aspects of RCM – such as peer review, article quality, internationalization of scholars, promotion of journal platforms, etc. – do you suggest further optimization or improvement?

I would recommend better promotion of published work via social media or press releases on the various platforms where the journal is visible. For authors, I would suggest providing language editing support, especially for non‑native English speakers, which would improve the quality of published articles. I also encourage the journal to solicit more submissions on emerging topics such as pediatric hypertension in underrepresented settings and to broaden its international impact by achieving more global geographic representation.

 

We sincerely thank Prof. Ruan Kruger for taking the time to participate in RCM’s World Hypertension Day special interview. In this conversation, Prof. Kruger shared profound insights ranging from the early origins of childhood hypertension to the urgent need to include children and adolescents in global screening efforts, from wearable technologies and AI-driven risk prediction to policy-level interventions. His emphasis on bridging the gap between academic research and public education, as well as his concrete suggestions for improving the promotion of the journal, language support, and global representation, will greatly benefit our readers and the cardiovascular community. RCM remains committed to building a high‑quality, international platform for cardiovascular medicine, facilitating the translation of cutting‑edge hypertension research into clinical practice and public education. We extend our gratitude to Prof. Kruger for his valuable contributions and thank all our readers for their attention.

 

Journal Homepage: Reviews in Cardiovascular Medicine