Should Renal Inflammation Be Targeted While Treating Hypertension?

Abstract

Despite extensive research and a plethora of therapeutic options, hypertension continues to be a global burden. Understanding of the pathological roles of known and underexplored cellular and molecular pathways in the development and maintenance of hypertension is critical to advance the field. Immune system overactivation and inflammation in the kidneys are proposed alternative mechanisms of hypertension, and resistant hypertension. Consideration of the pathophysiology of hypertension in chronic inflammatory conditions such as autoimmune diseases, in which patients present with autoimmune-mediated kidney inflammation as well as hypertension, may reveal possible contributors and novel therapeutic targets. In this review, we 1) summarize current therapies used to control blood pressure and their known effects on inflammation; 2) provide evidence on the need to target renal inflammation, specifically, and especially when first-line and combinatory treatment efforts fail; and 3) discuss the efficacy of therapies used to treat autoimmune diseases with a hypertension/renal component. We aim to elucidate the potential of targeting renal inflammation in certain subsets of patients resistant to current therapies.

Metabolic Modulators in Cardiovascular Complications of Systemic Lupus Erythematosus

“…In both female humans with SLE and the NZBWF1 mouse model, lupus nephritis precedes hypertension. This provides an opportunity to study the contributing factors to hypertension in the context of chronic renal inflammation [25]. However, like humans, it exists a disparity between nephritis and blood pressure in animal models of SLE.…”