Will we change our view of the causes of the arterial hypertension development?
Authors:
Eva Honsová 1; Olga Snížková 1; Karolína Krátká 2
Authors‘ workplace:
Unilabs Patologie, Praha
1; Interní klinika Fakultní nemocnice Královské Vinohrady, Praha
2
Published in:
Čes.-slov. Patol., 60, 2024, No. 3, p. 139-143
Category:
Reviews Article
Overview
Arterial hypertension is one of the most common chronic diseases in the world. It is reported that it affects a third of the adult population and that in 2025 it will become the most common chronic disease. Hypertension does not have attacks and remissions; and if it occurs, it usually does not disappear and requires long-term lifelong treatment. Despite extensive and numerous studies of risk factors, we do not know the cause of hypertension. There are thousands of studies focused on various risk factors for the development of arterial hypertension. None of them apply in general and do not clarify the reasons for the development and progression of the disease. Recent experimental data strongly support a role for complement in all stages of arterial hypertension. Evidence that in a significant proportion of patients with so-called malignant hypertension, thrombotic microangiopathy is a manifestation of atypical hemolytic-uremic syndrome; conclusively shows that the disease is part of complement dysregulation. These facts shift our view of the role of complement, which is much more important in many diseases, including hypertension, than we previously thought.
Keywords:
hypertension – thrombotic microangiopathies – Complement Alternative complement pathway
Sources
- Kearney PM, Whelton M, Reynolds K, et al. Global burden of hypertension: analysis of worldwide data. Lancet 2005; (365): 217-223.
- Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2018; (71): e127-e248.
- Rettig R, Folberth CG, Graf C, et al. Post-transplantation hypertension in recipients of renal graft from hypertensive donor rats. Clin Investig Med 1991; (14): 492-498.
- Curtis J, Luke RG, Dustan HP, et al. Remission of essential hypertension after renal transplantation. N Engl J Med 1983; (3): 1009-1015.
- Solak Y, Afsar B, Vaziri ND, et al. Hypertension as an autoimmune and inflammatory disease. Hypertension Research 2016; (39):567–573.
- Denton KM. Progress towards improving blood pressure control. Nat Rev Nephrol 2024; (20): 73-74.
- Meneton P, Jeunemaitre X, de Wardener HE, et al. Links between dietary salt intake, renal salt handling, blood pressure, and cardiovascular disease. Physiol Rev. 2005; (85): 679-715.
- DiNicolantonio JJ, Mehta V, O’Keefe JH. Is salt a culprit or an innocent bystander in hypertension? A hypothesis challenging the ancient paradigm. Am J Med 2017; (130): 893-899.
- Suckling RJ, He FJ, Markandu ND, et al. Dietary salt influences postprandial plasma sodium concentration and systolic blood pressure. Kidney Int 2012; (81): 407-411.
- Kleinewietfeld M, Manzel A, Titze J, et al. Sodium chloride drives autoimmune disease by the induction of pathogenic TH17 cells. Nature 2013; (496): 518-522.
- Graudal NA, Hubeck-Graudal T, Jurgens G. Effect of low sodium diet versus high sodium diet on blood presure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Am J Hypertens 2012; (25): 1-15.
- DiNicolantonio JJ, O’Keefe JH. Hypertension Due to Toxic White Crystals in the Diet: Should We Blame Salt or Sugar? Prog Cardiovasc Dis 2016; (59): 219-225.
- Madero M, Perez-Pozo SE, Jalal D et al. Dietary fructose and hypertension. Curr Hypertens Rep 2011; (13): 29-35.
- Titze J, and Luft FC. Speculations on salt and genesis of arterial hypertension. Kidney Int 2017; (91): 1324-1335.
- Jhee JH, Park HC, Choi HY. Skin Sodium and Blood Pressure Regulation. Electrolyte Blood Press 2022; (20): 1-9.
- Keller G, Zimmer G, Mall G, et al. Nephron number in patients with primary hypertension. N Engl J Med 2003; (348): 101-108.
- Hommos MS, Glassock RJ, Rule AD. Structural and Functional Changes in Human Kidneys with Healthy Aging. J Am Soc Nephrol 2017; (28): 2838-2844.
- Copur S, Peltek IB, Mutlu A, et al. A new immune disease: systemic hypertension. Clin Kidney J 2023; (16): 1403-1419.
- Jobin K, Muller DN, Jantsch J, et al. Sodium and its manyfold impact on our immune system. Trends Immunol 2021; (42): 469-479.
- Jorg S, Kissel J, Manzel A, et al. High salt drives Th17 responses in experimental autoimunne encephalomyelitis without impacting myeloid dendritic cells. Exp Neurol 2016; (279): 212-222.
- Miyauchi H, Geisberger S, Luft FC, et al. Sodium as an important regulator of immunometabolism. Hypertension 2024; (81):
- Hoffmann TJ, Ehret GB, Nandakumar P, et al. Genome-wide association analyses using electronic health records identify new loci influencing blood pressure variation. Nat Genet 2017; (49): 54–64.
- Vaura F, Kauko A, Suvila K, et al. Polygenic risk scores predict hypertension onset and cardovascular risk. Hypertension 2021; (77):1119-1127.
- Wu J, Fang S, Lu K-T et al. Endothelial Cullin3 mutation impairs nitric oxide-mediated vasodilation and promotes salt-induced hypertension. Function 2022; 3(3).
- Chang A. Thrombotic microangiopathy and the kidney. Diagnostic Histopathology 2017;(23): 101-108.
- Wenzel U, Turner JE, Krebs C, et al. Immune mechanisms in arterial hypertension. J Am Soc Nephrol 2016; (27): 677-686.
- Timmermans S, Abdul-Hamid MA, Vanderlocht J, et al. Patients with hypertension-associated thrombotic microangiopathy may present with complement abnormalities. Kidney Int 2017; (91): 1420-1425.
- Timmermans S, Abdul-Hamid MA, Potjewijd J, et al. C5b-9 formation on endothelial cells reflects complement defects among patients with thrombotic microangiopathy and severe hypertension. J Am Soc Nephrol 2018;(29): 2234-2243.
- Zuckerman JE and Chang A. Complement and thrombotic microangiopathy associated with hypertension and scleroderma. Adv Chronic Kidney Dis 2020; (27): 149-154.
- Gallan AJ and Chang A. A new paradigm for renal thrombotic microangiopathy. Sem Diag Pathol 2020; (37): 121-126.
Labels
Anatomical pathology Forensic medical examiner ToxicologyArticle was published in
Czecho-Slovak Pathology
Most read in this issue
- ANCA-associated vasculitis from a clinical perspective
- What a pathologist needs to know about disorders of the complement system
- -
- Will we change our view of the causes of the arterial hypertension development?