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Role of the Immune System in Hypertension

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Rodriguez-Iturbe, Bernardo, Pons, Hector, Johnson, Richard J.·2017·Physiological Reviews

DOI 10.1152/physrev.00031.2016

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Abstract

High blood pressure is present in more than one billion adults worldwide and is the most important modifiable risk factor of death resulting from cardiovascular disease. While many factors contribute to the pathogenesis of hypertension, a role of the immune system has been firmly established by a large number of investigations from many laboratories around the world. Immunosuppressive drugs and inhibition of individual cytokines prevent or ameliorate experimental hypertension, and studies in genetically-modified mouse strains have demonstrated that lymphocytes are necessary participants in the development of hypertension and in hypertensive organ injury. Furthermore, immune reactivity may be the driving force of hypertension in autoimmune diseases. Infiltration of immune cells, oxidative stress, and stimulation of the intrarenal angiotensin system are induced by activation of the innate and adaptive immunity. High blood pressure results from the combined effects of inflammation-induced impairment in the pressure natriuresis relationship, dysfunctional vascular relaxation, and overactivity of the sympathetic nervous system. Imbalances between proinflammatory effector responses and anti-inflammatory responses of regulatory T cells to a large extent determine the severity of inflammation. Experimental and human studies have uncovered autoantigens (isoketal-modified proteins and heat shock protein 70) of potential clinical relevance. Further investigations on the immune reactivity in hypertension may result in the identification of new strategies for the treatment of the disease.

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Self-citation

Association of inpatient use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers with mortality among patients with hypertension hospitalized with COVID-19
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Vascular Inflammation and Oxidative Stress: Major Triggers for Cardiovascular Disease
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Renal and hypothalamic inflammation in renovascular hypertension: role of afferent renal nerves
Lauar, M. R., Evans, L. C., Van Helden, D., Fink, G. D., Banek, C. T., Menani, J. V., & Osborn, J. W. (2023) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00072.2023 · Cited by 23
The Genetics of Blood Pressure Regulation
Lin, H. J., Guo, X., & Rotter, J. I. (2020) · Emery and Rimoin's Principles and Practice of Medical Genetics and Genomics · doi:10.1016/b978-0-12-812532-8.00006-9 · Cited by 3

See all 391

Authors: Rodriguez-Iturbe, B., Pons, H., & Johnson, R. J.
Venue: Physiological Reviews
Publisher: American Physiological Society
Published: 2017-07-01
Volume: 97
Issue: 3
Pages: 1127-1164
ISSN: 0031-9333 (ISSN-L)
1522-1210
DOI: 10.1152/physrev.00031.2016
OpenAlex: W2619810380
Cited by: 391
References: 294
FWCI: 7.98
Type: journal article
Language: en
Open access: green

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Role of the Immune System in Hypertension

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