Metabolites and Hypertension: Insights into Hypertension as a Metabolic Disorder: 2019 Harriet Dustan Award

Abstract

For over 100 years, essential hypertension has been researched from different perspectives ranging from genetics, physiology, and immunology to more recent ones encompassing microbiology (microbiota) as a previously underappreciated field of study contributing to the cause of hypertension. Each field of study in isolation has uniquely contributed to a variety of underlying mechanisms of blood pressure regulation. Even so, clinical management of essential hypertension has remained somewhat static. We, therefore, asked if there are any converging lines of evidence from these individual fields that could be amenable for a better clinical prognosis. Accordingly, here we present converging evidence which support the view that metabolic dysfunction underlies essential hypertension.

Keywords: blood pressure; cardiovascular disease; hypertension; hyperuricemia; mitochondria.

Figure 1:. Evidence for convergence of metabolic pathways with blood pressure regulation.

Blue and Red arrows indicate the downregulation and upregulation, respectively, of metabolites associated with elevated blood pressure. PMID: Pubmed Identifier numbers of manuscripts evidencing metabolites in blood pressure regulation. T: Inhibitory process resulting in lowering of blood pressure. a. PMID: 24971531, b. PMID: 28538181, c. PMID: 31928175, d. PMID: 30332647, e. PMID: 17954369, f. PMID: 19546378, g. PMID: 26607702, h. PMID: 28408634, i. PMID: 26787705, j. PMID: 20696994, j. PMID: 5568229, k. Unpublished data presented at the 2019 council on hypertension meeting as part of the Harriet Dustan lecture.

Figure 2:. Current status of the knowledge about the metabolites regulating blood pressure.

*: metabolites that are reported to regulate blood pressure. AA: Amino acid, FA: Fatty acids, MUFA: Mono-unsaturated Fatty acids, PUFA: Poly-unsaturated Fatty acids, SCFA: Short-chain Fatty acids, TMA- Trimethylamine, TMAO- Trimethylamine N-oxide.