Immune System and Inflammation in Hypertension

Abstract

Hypertension is a widely prevalent and a major modifiable risk factor for cardiovascular diseases. Despite the available long list of anti-hypertension drugs and lifestyle modification strategies for blood pressure control, a large number of hypertensive patients fail to achieve adequate blood pressure control even when prescribed a combination of drugs from three or more classes. Thus, identifying and targeting of further mechanisms that underlie hypertension is decisive in alleviating burden of this disorder. In recent decades research have shown that perturbed immune system and inflammation contribute to hypertension. Experimental studies on animal models have shown that immune cells such as dendritic cells, macrophages, and lymphocytes contribute for the development and/or sustaining of hypertension. In hypertension, inflammatory immune cells that infiltrated the kidney cause retention of sodium, renal fibrosis, glomerular injury, and chronic kidney disease, all of them contribute for elevated blood pressure. Similarly, immune cells and inflammatory cytokines are involved in blood vessels structural and functional changes associated with hypertension. Perturbed immune system and chronic low-grade systemic inflammation enhance SNS activity and this contributes to elevated blood pressure by its effect on blood vessels tone, on the kidneys, and on immune system.