Blood Pressure Outcomes Among US Veterans Initiating Hypertension Treatment, 2014 to 2023.

Infection by the protozoan parasite () affects approximately one-third of the global human population []. This intracellular parasite relies on members of the cat family as definitive hosts for sexual reproduction. All warm-blooded animals can potentially serve as intermediate hosts. Uncooked or undercooked food, as well as water and soil, poses high risks for infection in humans. These sources may be contaminated by oocysts originating from the feces of infected felines. Once is ingested by an intermediate host, it first establishes infection as rapidly dividing tachyzoites, which subsequently convert into more slowly replicating bradyzoites enclosed within tissue cysts. These tissue cysts persist for the lifetime of the host and may contribute to alterations of host hormones, neurotransmission within the brain, and neuro-inflammation [], providing a mechanism by which persistent infection or inflammation induced by chronic infection could impact neuropsychiatric disease and the host’s behavior. infection of rodent intermediate hosts influences the behavior of the infected mice, increasing the likelihood of being captured by cats and thus favoring reproduction and transmission []. The most consistent epidemiological association has been observed between infection and schizophrenia. An early case-control study [] reported elevated seroprevalence of anti- IgG antibodies among individuals with first-episode schizophrenia compared with controls. A hypothesis-generating case-control study among U.S. military personnel demonstrated that serological evidence of exposure was associated with increased odds of subsequent schizophrenia diagnosis (OR: 1.24–1.50, depending on the model specifications), suggesting that exposure may precede disease onset []. However, given the observational design, the residual confounding factors, especially by socioeconomic status, environmental exposures, and comorbid infections, cannot be excluded. For bipolar disorder, Rensch et al. [] examined the relationship between seropositivity, serointensity, and cognitive function in euthymic patients. Although overall cognitive performance did not differ between seropositive and seronegative participants, higher IgG antibody levels were associated with poorer verbal memory, suggesting a potential link between latent infection and memory deficits, albeit in a limited sample. Evidence linking infection to obsessive-compulsive disorder is limited and mainly comes from small case-control studies. Miman et al. [] reported a higher seropositivity rate in obsessive-compulsive disorder patients (47.6%) compared with controls (19%), although sample sizes were modest and confounding factors were not fully controlled.