Prevalence of Angiotensin II Type 1 Receptor Antibodies in Persons With Hypertension and Relation to Blood Pressure and Medication

Abstract

BACKGROUND We aimed to determine the prevalence of antibodies against angiotensin II type 1 receptor (AT1RAb) in hypertensive adults and elucidate the relation of antihypertensive medication type to blood pressure (BP) among persons with and without AT1RAb. METHODS Sera from participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study with hypertension were tested for AT1RAb using a commercial Enzyme-linked immunosorbent assay (ELISA) (One Lambda; positive ≥17 units/ml). BP measurements, uncontrolled BP (systolic BP ≥140 and/or diastolic BP ≥90 mm Hg), and effect of BP medication type were compared for AT1RAb positive (+) vs. negative (−) participants using descriptive statistics and multivariable regression. RESULTS One hundred and thirty-two (13.1%) participants were AT1RAb+. Compared with AT1RAb−, AT1RAb+ persons were more likely to be white (47% vs. 36.7%; P = 0.03) but had similar comorbid disease burden. In models adjusting for age, sex, and race, AT1RAb+ persons had higher diastolic BP (β = 2.61 mm Hg; SE = 1.03; P = 0.01) compared with AT1RAb− participants. Rates of uncontrolled BP were similar between the groups. AT1RAb+ persons on an angiotensin receptor blocker (ARB; n = 21) had a mean of 10.5 mm Hg higher systolic BP (SE = 4.56; P = 0.02) compared with AT1RAb+ persons using other BP medications. The odds of uncontrolled BP among AT1RAb+ participants on an ARB was 2.05 times that of those on other medications. AT1RAb− persons prescribed an angiotensin-converting enzyme inhibitor (ACEi) had 1.8 mm Hg lower diastolic BP (SE = 0.81; P = 0.03) than AT1RAb− persons not prescribed an ACEi. CONCLUSIONS AT1RAb was prevalent among hypertensive adults and was associated with higher BP among persons on an ARB.

Peripheral Immune Cell Composition is Altered in Women Before and After a Hypertension Diagnosis

“…44–49 First described decades ago, individuals with hypertension have higher serum concentrations of total immunoglobulin G. 45–47 More recent evidence suggests that autoantibodies targeting the angiotensin II type I receptor are associated with elevated blood pressure. 49 Hypertension associations with antibody concentrations could reflect differences in B cell abundance. Compared to B cells obtained from normotensive individuals, immortalized B cells from hypertensive individuals are reported to have higher proliferative potential.…”

“…Although few studies of hypertension in humans have directly measured circulating B cell subsets, several studies have identified associations with antibody production. 44–49 First described decades ago, individuals with hypertension have higher serum concentrations of total immunoglobulin G. 45–47 More recent evidence suggests that autoantibodies targeting the angiotensin II type I receptor are associated with elevated blood pressure. 49 Hypertension associations with antibody concentrations could reflect differences in B cell abundance.…”

“…targeting the angiotensin II type I receptor are associated with elevated blood pressure. 49 Hypertension associations with antibody concentrations could reflect differences in B cell abundance. Compared to B cells obtained from normotensive individuals, immortalized B cells from hypertensive individuals are reported to have higher proliferative potential.…”

“…Although few studies of hypertension in humans have directly measured circulating B cell subsets, several studies have identified associations with antibody production. [44][45][46][47][48][49] First described decades ago, individuals with hypertension have higher serum concentrations of total immunoglobulin G. [45][46][47] More recent evidence suggests that autoantibodies Hypertension incidence associations estimated using weighted Cox regression models treating new-onset hypertension as the outcome. All models treat age as the timescale and adjust for self-reported race, household income, educational attainment, menopause status, exogenous hormone use, parity, and DNAm platform.…”

Angiotensin II Type 1 Receptor Antibodies Are Higher in Lupus Nephritis and Vasculitis than Other Glomerulonephritis Patients

“…Some data also indicate that these antibodies are implicated in the pathogenesis of focal and segmental glomerulosclerosis after kidney transplantation (Abuzeineh et al 2020 ) AT1R antibodies were also prevalent in patients with hypertension (Philogene et al 2020 )], and these antibodies are considered to have some significance in the pathogenesis of primary aldosteronism (Sabbadin et al 2018 ). These antibodies are also involved in the pathogenesis of preeclampsia (Zhou et al 2008 ).…”