• RAHUL MEHRA Department of Pharmacology, CT Institute of Pharmaceutical Sciences, CT Group Institutions, Jalandhar, India 144020
  • AANCHAL Department of Pharmacology, CT Institute of Pharmaceutical Sciences, CT Group Institutions, Jalandhar, India 144020
  • SHAINA KALSI Department of Pharmacology, CT Institute of Pharmaceutical Sciences, CT Group Institutions, Jalandhar, India 144020
  • SURYA P. GAUTAM Department of Pharmacology, CT Institute of Pharmaceutical Sciences, CT Group Institutions, Jalandhar, India 144020




Hypertension, Immune system, Treatment


The objective of the review is to explain the pathophysiology, different causes and various treatments involved in hypertension. This article discusses the disease's pathogenesis, etiology, diagnosis, and immunity. This review looks at the main significant epidemiological and clinical studies on the role of several lifestyle factors in hypertension development. This review examines the numerous mechanisms that cause hypertension in order to discover new treatments. In addition, it covers the many types of hypertension therapy. According to different studies, lifestyle habits may have an impact on blood pressure levels.

Moreover, the importance of chronic inflammation in hypertension and its repercussions has been confirmed in genetically engineered mice lacking components of innate and/or adaptive immunity. Immune cell depletion enhances endothelial function, lowers oxidative stress, lowers the vascular tone, and protects against renal interstitial infiltrates, salt retention, and kidney injury. Based on existing literature, there is strong evidence that lifestyle variables can affect blood pressure levels. Then, in hypertensive people, lifestyle changes can help by lowering overall cardiovascular risk and death from any cause. The involvement of immunity as a common thread in the hypertension processes of many organ systems.


Download data is not yet available.


World Health Organization. A global brief on hypertension; April 2013. Contract No.: WHO/DCO/WHD/2013.

Carretero OA, Oparil S. Essential hypertension. part I: Definition and etiology. Circulation. 2000;101(3):329-35. doi: 10.1161/01.cir.101.3.329. PMID 10645931.

Oparil S, Zaman MA, Calhoun DA. Pathogenesis of hypertension. Ann Intern Med. 2003;139(9):761-76. doi: 10.7326/0003-4819-139-9-200311040-00011, PMID 14597461.

Hall JE, Guyton AC. Textbook of medical physiology. St. Louis: Elsevier Saunders. ISBN 0-7216-0240-1; 2006. p. 228.

Nandhini S. Hypertension: eMedicine nephrology; 2009.

Bhor RJ, Kotade KB, Wagh VD. Essential hypertension: the Lancet; 2009.

Anderson KM, Odell PM, Wilson PWF, Kannel WB. Cardiovascular disease risk profiles. Am Heart J. 1991;121(1 Pt 2):293-8. doi: 10.1016/0002-8703(91)90861-b, PMID 1985385.

Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG, Flack JM, Carter BL, Materson BJ, Ram CV, Cohen DL, Cadet JC, Jean-Charles RR, Taler S, Kountz D, Townsend RR, Chalmers J, Ramirez AJ, Bakris GL, Wang J, Schutte AE, Bisognano JD, Touyz RM, Sica D, Harrap SB. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the international society of hypertension. J Clin Hypertens (Greenwich). 2014;16(1):14-26. doi: 10.1111/jch.12237, PMID 24341872.

Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG, Flack JM, Carter BL, Materson BJ, Ram CV, Cohen DL, Cadet JC, Jean-Charles RR, Taler S, Kountz D, Townsend RR, Chalmers J, Ramirez AJ, Bakris GL, Wang J, Schutte AE, Bisognano JD, Touyz RM, Sica D, Harrap SB. Clinical practice guidelines for the management of hypertension in the community A statement by the American Society of Hypertension and the International Society of Hypertension. J Hypertens. 2014;32(1):3-15. doi: 10.1097/ HJH.0000000000000065, PMID 24270181.

Carretero OA, Oparil S. Essential hypertension: part II: Treatment. See comment in PubMed Commons below Circulation. 2000;101(4):446-53. doi: 10.1161/ 01.cir.101.4.446, PMID 10653838.

Beevers G, Lip GY, O’Brien E. ABC of hypertension: the pathophysiology of hypertension. BMJ. 2001;322(7291):912-6. doi: 10.1136/bmj.322.7291.912, PMID 11302910.

Bartosh SM, Aronson AJ. Childhood hypertension. An update on etiology, diagnosis, and treatment. Pediatr Clin North Am. 1999;46(2):235-52. doi: 10.1016/s0031-3955(05)70115-2, PMID 10218072.

Osmond C, Barker DJ. Fetal, infant, and childhood growth are predictors of coronary heart disease, diabetes, and hypertension in adult men and women. Environ Health Perspect. 2000;108;Suppl 3:545-53. doi: 10.1289/ ehp.00108s3545, PMID 10852853.

The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. Pediatrics. 2004;114(2):555-76. doi: 10.1542/peds.114.2.S2.555.

Contreras F, Rivera M, Vasquez J, De la Parte MA, Velasco M. Diabetes and hypertension physiopathology and therapeutics. J Hum Hypertens. 2000;14;Suppl 1:S26-31. doi: 10.1038/ sj.jhh.1000983, PMID 10854077.

Federation of Associated Societies for Experimental Biology. Third report on nutrition monitoring in the United States. Vol. 1. Washington, DC: US Government Printing Office; 1995.

Joseph L, Fauci AS, Eugene B, Kasper DL, Hauser Stephen L, Longo Dan L. Harrison’s principles of internal medicine. McGraw-Hill Medical; 2008.

Dustan HR, Tarazi RC, Bravo EL. Diuretic and diet treatment of hypertension. Arch Intern Med. 1974;133(6):1007-13, PMID 4829750.

Haffner SM, Lehto S, Ronnemaa T, Pyorala K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med. 1998;339(4):229-34. doi: 10.1056/NEJM199807233390404, PMID 9673301.

Lindhorst J, Alexander N, Blignaut J, Rayner B. Differences in hypertension between blacks and whites: an overview. Cardiovasc J Afr. 2007;18(4):241-7. PMID 17940670.

Burt VL, Whelton P, Roccella EJ, Brown C, Cutler JA, Higgins M, Horan MJ, Labarthe D. Prevalence of hypertension in the US adult population. Results from the third National Health and nutrition Examination Survey, 1988-1991. Hypertension. 1995;25(3):305-13. doi: 10.1161/01.hyp.25.3.305. PMID 7875754.

Haslam DW, James WPT. Obesity. Lancet. 2005;366(9492):1197-209. doi: 10.1016/S0140-6736(05)67483-1.

Katori M, Majima M. A missing link between a high salt intake and blood pressure increase, Japan February; 2006.

Jurgens G, Graudal NA. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride. In Graudal, Niel Albert. Cochrane Database Syst Rev. 2004;1:pub2: CD004022:CD004022. doi: 10.1002/14651858.

Aburto NJ, Ziolkovska A, Hooper L, Elliott P, Cappuccio FP, Meerpohl JJ. Effect of lower sodium intake on health: systematic review and meta-analyses. BMJ. 2013;346:f1326. doi: 10.1136/bmj.f1326. PMID 23558163.

He FJ, Li J, Macgregor GA. Effect of longer term modest salt reduction on blood pressure: cochrane systematic review and meta-analysis of randomised trials. BMJ. 2013;346:f1325. doi: 10.1136/bmj.f1325. PMID 23558162.

Neter JE, Stam BE, Kok FJ, Grobbee DE, Geleijnse JM. Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2003;42:878-84. doi: 10.1161/01. HYP.0000094221.86888. AE.

Cornelissen VA, Smart NA. Exercise training for blood pressure: A systematic review and meta-analysis. J Am Heart Assoc. 2013;2(1):e004473. doi: 10.1161/JAHA.112.004473, PMID 23525435.

Carlson DJ, Dieberg G, Hess NC, Millar PJ, Smart NA. Isometric exercise training for blood pressure management: A systematic review and meta-analysis. Mayo Clin Proc. 2014;89(3):327-34. doi: 10.1016/j.mayocp.2013.10.030, PMID 24582191. mayocp.2013.10.030.

Whelton PK, HE J, Cutler JA, Brancati FL, Appel LJ, Follmann D, Klag MJ. Effects of oral potassium on blood pressure. Meta-analysis of randomized controlled clinical trials. JAMA. 1997;277(20):1624-32. doi: 10.1001/jama.1997.03540440058033, PMID 9168293.

31. Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Himmelfarb CD, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin KJ, Muntner P, Ovbiagele B, Smith SC, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Williams KA, Williamson JD, Wright JT. Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice guidelines. J Am Coll Cardiol. 2018;71:e127-248. doi: 10.1016/j. jacc.2017.11.006.

Goit N, Yang SN. The antihypertensive and lipid-lowering treatment to prevent heart attack trial (ALLHAT). Major outcomes in high-risk hypertensive patients Rando-L. JAMA. 2002;288:119. doi: 10.1001/jama.288.23.2981.

Law MR, Morris JK, Wald NJ. Use of blood pressure lowering drugs in the prevention of cardiovascular disease: meta-analysis of 147 randomised trials in the context of expectations from prospective epidemiological studies. BMJ. 2009;338:b1665. doi: 10.1136/bmj.b1665. PMID 19454737.

Aronow WS, Fleg JL, Pepine CJ, Artinian NT, Bakris G, Brown AS, Ferdinand KC, Forciea MA, Frishman WH, Jaigobin C, Kostis JB, Mancia G, Oparil S, Ortiz E, Reisin E, Rich MW, Schocken DD, Weber MA, Wesley DJ, Harrington RA, ACCF Task Force. ACCF/AHA 2011 expert consensus document on hypertension in the elderly: A report of the American college of cardiology foundation task force on clinical expert consensus documents. Circulation. 2011;123(21):2434-506. doi: 10.1161/ CIR.0b013e31821daaf6, PMID 21518977.

Emdin CA, Rahimi K, Neal B, Callender T, Perkovic V, Patel A. Blood pressure lowering in Type 2 diabetes: A systematic review and meta-analysis. JAMA. 2015;313(6):603-15. doi: 10.1001/jama.2014.18574, PMID 25668264.

Turnbull F, Neal B, Algert C, Chalmers J, Chapman N, Cutler J, Woodward M, MacMahon S, Blood Pressure Lowering Treatment Trialists' Collaboration. Effects of different blood pressure-lowering regimens on major cardiovascular events in individuals with and without diabetes mellitus: results of prospectively designed overviews of randomized trials. Archives of Internal Medicine. 2005;165(12):1410-9. https://doi.org/10.1001/archinte.165.12.1410doi: 10.1001/archinte.165.12.1410, PMID 15983291.

Palmer SC, Mavridis D, Navarese E, Craig JC, Tonelli M, Salanti G, Wiebe N, Ruospo M, Wheeler DC, Strippoli GFM. Comparative efficacy and safety of blood pressure-lowering agents in adults with diabetes and kidney disease: A network meta-analysis. Lancet. 2015;385(9982):2047-56. https://doi.org/10.1016/ S0140-6736(14)62459-4

Schmieder RE, Hilgers KF, Schlaich MP, Schmidt BMW. Renin-angiotensin system and cardiovascular risk. Lancet. 2007;369(9568):1208-19. doi: 10.1016/S0140-6736(07)60242-6.

Pucci M, Sarween N, Knox E, Lipkin G, Martin U. Angiotensin-converting Enzyme Inhibitors and angiotensin receptor blockers in women of childbearing age: risks versus Benefits. Expert Review of Clinical Pharmacology. 2015;8(2):221-31. https://doi.org/10.1586/17512433.2015.1005074

Ferrer RL, Sibai BM, Mulrow CD, Chiquette E, Stevens KR, Cornell J. Management of mild chronic hypertension during pregnancy: a review. Obstetrics and Gynecology. 2000;96(5 Pt 2):849-60. doi: 10.1016/s0029-7844(00)00938-8, PMID 11094241.

Moretti ME, Caprara D, Drehuta I, Yeung E, Cheung S, Federico L, Koren G. The fetal safety of angiotensin converting enzyme inhibitors and angiotensin II receptor blockers. Obstetrics and Gynecology International. 2012. https://doi.org/ 10.1155/2012/658310

James PR, Nelson-Piercy C. Management of hypertension before, during, and after pregnancy. Heart. 2004;90(12):1499-504. https://doi.org/10.1136/hrt.2004.035444doi: 10.1136/ hrt.2004.035444, PMID 15547046.

Graudal NA, Galløe AM, Garred P. Effects of sodium restriction on blood pressure, renin, aldosterone, catecholamines, cholesterols, and triglyceride: A meta-analysis. JAMA. 1998;279(17):1383-91. doi: 10.1001/jama.279.17.1383, PMID 9582047.

Yuan BX, Leenen FH. Dietary sodium intake and left ventricular hypertrophy in normotensive rats. Am J Physiol. 1991;261(5 Pt 2):1397-1401H1397-401. doi: 10.1152/ajpheart.1991.261.5.H1397, PMID 1835307.

Kim S, Ohta K, Hamaguchi A, Yukimura T, Miura K, LIwao H. Angiotensin II induces cardiac phenotypic modulation and remodeling in vivo in rats. Hypertension. 1995;25(6):1252-9. doi: 10.1161/01.hyp.25.6.1252, PMID 7768570.

Matavelli LC, Zhou X, Varagic J, Susic D, Frohlich ED. Salt-loading produces severe renal hemodynamic dysfunction independent of arterial pressure in spontaneously hypertensive rats. Am J Physiol Heart Circ Physiol. 2007;292(2):814-819H814-9. doi: 10.1152/ajpheart.00671.2006, PMID 16997890.

Anh J, Varagic J, Slama M, Susic D, Frohlich ED. Cardiac structural and functional responses to salt loading in SHR. Am J Physiol Heart Circ Physiol. 2004;284:767-72.

Morgan T. Renin, angiotensin, sodium and organ damage. Hypertens Res. 2003;26(5):349-54. doi: 10.1291/hypres.26.349, PMID 12887125.

Dickinson KM, Clifton PM, Keogh JB. A reduction of 3 g/day from a usual 9 g/day salt diet improves endothelial function and decreases endothelin-1 in a randomised cross_over study in normotensive overweight and obese subjects. Atherosclerosis. 2014;233(1):32-8. doi: 10.1016/ j.atherosclerosis.2013.11.078, PMID 24529119.

Gijsbers L, Dower JI, Schalkwijk CG, Kusters YH, Bakker SJ, Hollman PC, Geleijnse JM. Effects of sodium and potassium supplementation on endothelial function: A fully controlled dietary intervention study. Br J Nutr. 2015;114(9):1419-26. doi: 10.1017/S0007114515002986, PMID 26343780.

Jablonski KL, Racine ML, Geolfos CJ, Gates PE, Chonchol M, McQueen MB, Seals DR. Dietary sodium restriction reverses vascular endothelial dysfunction in middle-aged/older adults with moderately elevated systolic blood pressure. J Am Coll Cardiol. 2013;61(3):335-43. doi: 10.1016/j.jacc.2012.09.010, PMID 23141486.

Dickinson KM, Keogh JB, Clifton PM. Effects of a low-salt diet on flow-mediated dilatation in humans. Am J Clin Nutr. 2009;89(2):485-90. doi: 10.3945/ajcn.2008.26856, PMID 19106240.

Strazzullo P, D’Elia L, Kandala NB, Cappuccio FP. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ. 2009;339:b4567. doi: 10.1136/bmj.b4567, PMID 19934192.

Ezzati M, Henley SJ, Thun MJ, Lopez AD. Role of smoking in global and regional cardiovascular mortality. Circulation. 2005;112(4):489-97. doi: 10.1161/circulationaha.104.521708, PMID 16027251.

Neunteufl T, Heher S, Kostner K, Mitulovic G, Lehr S, Khoschsorur G, Schmid RW, Maurer G, Stefenelli T. Contribution of nicotine to acute endothelial dysfunction in long-term smokers. J Am Coll Cardiol. 2002;39(2):251-6. doi: 10.1016/s0735-1097(01)01732-6, PMID 11788216.

Celermajer DS, Adams MR, Clarkson P, Robinson J, McCredie R, Donald A, Deanfield JE. Passive smoking and impaired endothelium-dependent arterial dilatation in healthy young adults. N Engl J Med. 1996;334(3):150-4. doi: 10.1056/NEJM199601183340303, PMID 8531969.

Strong JP, Richards ML. Cigarette smoking and atherosclerosis in autopsied men. Atherosclerosis. 1976;23(3):451-76. doi: 10.1016/0021-9150(76)90007-1, PMID 1267863.

Castardeli E, Duarte DR, Minicucci MF, Azevedo PS, Matsubara BB, Matsubara LS, Campana AO, Paiva SA, Zornoff LA. Exposure time and ventricular remodeling induced by tobacco smoke exposure in rats. Med Sci Monit. 2008;14(3):BR62-66. PMID 18301351.

Strachan DP. Predictors of death from aortic aneurysm among middle-aged men: the Whitehall study. Br J Surg. 1991;78(4):401-4. doi: 10.1002/bjs.1800780407, PMID 2032097.

Hughes K, Leong WP, Sothy SP, Lun KC, Yeo PP. Relationships between cigarette smoking, blood pressure and serum lipids in the Singapore general population. Int J Epidemiol. 1993;22(4):637-43. doi: 10.1093/ije/22.4.637, PMID 8225737.

Mahmud A, Feely J. Effects of passive smoking on blood pressure and aortic pressure waveform in healthy young adults--influence of gender. Br J Clin Pharmacol. 2004;57(1):37-43. doi: 10.1046/j.1365-2125.2003.01958.x, PMID 14678338.

Yarlioglues M, Kaya MG, Ardic I, Calapkorur B, Dogdu O, Akpek M, Ozdogru M, Kalay N, Dogan A, Ozdogru I, Oguzhan A. Acute effects of passive smoking on blood pressure and heart rate in healthy females. Blood Press Monit. 2010;15(5):251-6. doi: 10.1097/MBP.0b013e32833e439f, PMID 20729727.

Bowman TS, Gaziano JM, Buring JE, Sesso HD. A prospective study of cigarette smoking and risk of incident hypertension in women. J Am Coll Cardiol. 2007;50(21):2085-92. doi: 10.1016/j.jacc.2007.08.017, PMID 18021879.

Polosa R, Morjaria JB, Caponnetto P, Battaglia E, Russo C, Ciampi C, Adams G, Bruno CM. Blood pressure control in smokers with arterial hypertension who switched to electronic cigarettes. Int J Environ Res Public Health. 2016;13(11). doi: 10.3390/ijerph13111123, PMID 27845734.

Abe H, Kawano Y, Kojima S, Ashida T, Kuramochi M, Matsuoka H, Omae T. Biphasic effects of repeated alcohol intake on 24-hour blood pressure in hypertensive patients. Circulation. 1994;89(6):2626-33. doi: 10.1161/01.cir.89.6.2626, PMID 8205674.

Klatsky AL. Alcohol and cardiovascular disease--more than one paradox to consider. Alcohol and hypertension: does it matter? Yes J Cardiovasc Risk. 2003;10(1):21-4. doi: 10.1097/ 01.hjr.0000051960.68260.79, PMID 12569233.

Puddey IB, Beilin LJ, Rakic V. Alcohol, hypertension and the cardiovascular system: A critical appraisal. Addict Biol. 1997;2(2):159-70. doi: 10.1080/13556219772705, PMID 26735633.

Puddey IB, Beilin LJ. Alcohol is bad for blood pressure. Clin Exp Pharmacol Physiol. 2006;33(9):847-52. doi: 10.1111/j.1440-1681.2006.04452.x, PMID 16922819.

Okubo Y, Suwazono Y, Kobayashi E, Nogawa K. Alcohol consumption and blood pressure change: 5-year follow-up study of the association in normotensive workers. J Hum Hypertens. 2001;15(6):367-72. doi: 10.1038/sj.jhh.1001191, PMID 11439310.

Fuchs FD, Chambless LE, Whelton PK, Nieto FJ, Heiss G. Alcohol consumption and the incidence of hypertension: the Atherosclerosis Risk in Communities Study. Hypertension. 2001;37(5):1242-50. doi: 10.1161/01.hyp.37.5.1242, PMID 11358935.

Bell RA, Mayer Davis EJ, Martin MA, D’Agostino RB Jr, Haffner SM. Associations between alcohol consumption and insulin sensitivity and cardiovascular disease risk factors: the insulin Resistance and Atherosclerosis Study. Diabetes Care. 2000;23(11):1630-6. doi: 10.2337/diacare.23.11.1630, PMID 11092284.

Koppes LL, Dekker JM, Hendriks HF, Bouter LM, Heine RJ. Moderate alcohol consumption lowers the risk of type 2 diabetes: A meta-analysis of prospective observational studies. Diabetes Care. 2005;28(3):719-25. doi: 10.2337/diacare.28.3.719, PMID 15735217.

Beulens JW, Rimm EB, Hendriks HF, Hu FB, Manson JE, Hunter DJ, Mukamal KJ. Alcohol consumption and type 2 diabetes: influence of genetic variation in alcohol dehydrogenase. Diabetes. 2007;56(9):2388-94. doi: 10.2337/db07-0181, PMID 17563066.

Thijssen DH, Dawson EA, van den Munckhof IC, Birk GK, Timothy Cable NT, Green DJ. Local and systemic effects of leg cycling training on arterial wall thickness in healthy humans. Atherosclerosis. 2013;229(2):282-6. doi: 10.1016/j.atherosclerosis.2013.05.013, PMID 23880177.

Hoier B, Hellsten Y. Exercise-induced capillary growth in human skeletal muscle and the dynamics of VEGF. Microcirculation. 2014;21(4):301-14. doi: 10.1111/micc.12117, PMID 24450403.

Gliemann L, Buess R, Nyberg M, Hoppeler H, Odriozola A, Thaning P, Hellsten Y, Baum O, Mortensen SP. Capillary growth, ultrastructure remodelling and exercise training in skeletal muscle of essential hypertensive patients. Acta Physiol (Oxf). 2015;214(2):210-20. doi: 10.1111/apha.12501, PMID 25846822.

Blair SN, Goodyear NN, Gibbons LW, Cooper KH. Physical fitness and incidence of hypertension in healthy normotensive men and women. JAMA. 1984;252(4):487-90, PMID 6737638.

Haapanen N, Miilunpalo S, Vuori I, Oja P, Pasanen M. Association of leisure time physical activity with the risk of coronary heart disease, hypertension and diabetes in middle-aged men and women. Int J Epidemiol. 1997;26(4):739-47. doi: 10.1093/ije/26.4.739, PMID 9279605.

Paffenbarger Jr RS, Wing AL, Hyde RT, Jung DL. Physical activity and incidence of hypertension in college alumni. Am J Epidemiol. 1983;117(3):245-57. doi: 10.1093/oxfordjournals.aje.a113537, PMID 6829553.

Leitzmann MF, Park Y, Blair A, Ballard-Barbash R, Mouw T, Hollenbeck AR, Schatzkin A. Physical activity recommendations and decreased risk of mortality. Arch Intern Med. 2007;167(22):2453-60. doi: 10.1001/archinte.167.22.2453, PMID 18071167.

Rossi A, Dikareva A, Bacon SL, Daskalopoulou SS. The impact of physical activity on mortality in patients with high blood pressure: A systematic review. J Hypertens. 2012;30(7):1277-88. doi: 10.1097/HJH.0b013e3283544669, PMID 22573122.

James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, Lackland DT, LeFevre ML, MacKenzie TD, Ogedegbe O, Smith SC, Svetkey LP, Taler SJ, Townsend RR, Wright JT, Narva AS, Ortiz E. Evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-20. doi: 10.1001/jama.2013.284427, PMID 24352797.

Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Bohm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F, Task Force Members. ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2013;31(7):1281-357. doi: 10.1097/ 01.hjh.0000431740.32696.cc, PMID 23817082.

Stevens VJ, Corrigan SA, Obarzanek E, Bernauer E, Cook NR, Hebert P, Mattfeldt-Beman M, Oberman A, Sugars C, Dalcin AT. Weight loss intervention in phase 1 of the trials of hypertension prevention. The TOHP Collaborative Research Group. Arch Intern Med. 1993;153(7):849-58. doi: 10.1001/archinte.153.7.849, PMID 8466377.

Stevens VJ, Obarzanek E, Cook NR, Lee IM, Appel LJ, Smith West D, Milas NC, Mattfeldt-Beman M, Belden L, Bragg C, Millstone M, Raczynski J, Brewer A, Singh B, Cohen J. Trials for the hypertension prevention research group. Long-term weight loss and changes in blood pressure: results of the trials of hypertension prevention, phase II. Ann Intern Med. 2001;134(1):1-11. doi: 10.7326/0003-4819-134-1-200101020-00007, PMID 11187414.

Huang Z, Willett WC, Manson JE, Rosner B, Stampfer MJ, Speizer FE, Colditz GA. Body weight, weight change, and risk for hypertension in women. Ann Intern Med. 1998;128(2):81-8. doi: 10.7326/0003-4819-128-2-199801150-00001, PMID 9441586.

Effects of weight loss and sodium reduction intervention on blood pressure and hypertension incidence in overweight people with high-normal blood pressure. The trials of hypertension prevention, phase II. The Trials of hypertension Prevention Collaborative Research Group. Arch Intern Med. 1997;157(6):657-67. doi: 10.1001/archinte.157.6.657, PMID 9080920.

Langford HG, Blaufox MD, Oberman A, Hawkins CM, Curb JD, Cutter GR, Wassertheil-Smoller S, Pressel S, Babcock C, Abernethy JD. Dietary therapy slows the return of hypertension after stopping prolonged medication. JAMA. 1985;253(5):657-64, PMID 3881608.

Whelton PK, Appel LJ, Espeland MA, Applegate WB, Ettinger WH Jr, Kostis JB, Kumanyika S, Lacy CR, Johnson KC, Folmar S, Cutler JA. Sodium reduction and weight loss in the treatment of hypertension in older persons: A randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). TONE Collaborative Research Group. JAMA. 1998;279(11):839-46. doi: 10.1001/jama.279.11.839, PMID 9515998.

Cappuccio FP, MacGregor GA. Does potassium supplementation lower blood pressure? A meta-analysis of published trials. J Hypertens. 1991;9(5):465-73. doi: 10.1097/00004872-199105000-00011, PMID 1649867.

Geleijnse JM, Kok FJ, Grobbee DE. Blood pressure response to changes in sodium and potassium intake: a metaregression analysis of randomised trials. J Hum Hypertens. 2003;17(7):471-80. doi: 10.1038/sj.jhh.1001575, PMID 12821954.

Lavie CJ, Milani RV, Mehra MR, Ventura HO. Omega-3 polyunsaturated fatty acids and cardiovascular diseases. J Am Coll Cardiol. 2009;54(7):585-94. doi: 10.1016/j.jacc.2009.02.084, PMID 19660687.

Tousoulis D, Plastiras A, Siasos G, Oikonomou E, Verveniotis A, Kokkou E, Maniatis K, Gouliopoulos N, Miliou A, Paraskevopoulos T, Stefanadis C. Omega-3 PUFAs improved endothelial function and arterial stiffness with a parallel antiinflammatory effect in adults with metabolic syndrome. Atherosclerosis. 2014;232(1):10-6. doi: 10.1016/j.atherosclerosis.2013.10.014, PMID 24401211.

Bønaa KH, Bjerve KS, Straume B, Gram IT, Thelle D. Effect of eicosapentaenoic and docosahexaenoic acids on blood pressure in hypertension. A population-based intervention trial from the Tromsø study. N Engl J Med. 1990;322(12):795-801. doi: 10.1056/NEJM199003223221202, PMID 2137901.

Prisco D, Paniccia R, Bandinelli B, Filippini M, Francalanci I, Giusti B, Giurlani L, Gensini GF, Abbate R, Neri Serneri GG. Effect of medium-term supplementation with a moderate dose of n-3 polyunsaturated fatty acids on blood pressure in mild hypertensive patients. Thromb Res. 1998;91(3):105-112. doi: 10.1016/s0049-3848(98)00046-2, PMID 9733153.

Miller PE, Van Elswyk M, Alexander DD. Long-chain Oomega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid and blood pressure: A meta-analysis of randomized controlled trials. Am J Hypertens. 2014;27(7):885-96. doi: 10.1093/ajh/hpu024, PMID 24610882.

Yang B, Shi MQ, Li ZH, Yang JJ, Li D. Fish, long-chain n-3 PUFA and incidence of elevated blood pressure: A meta-analysis of prospective cohort studies. Nutrients. 2016;8(1). doi: 10.3390/nu8010058, PMID 26805877.

Fuhrman B, Aviram M. Flavonoids protect LDL from oxidation and attenuate atherosclerosis. Curr Opin Lipidol. 2001;12(1):41-8. doi: 10.1097/00041433-200102000-00008, PMID 11176202.

Excellence NIFC. NICE CG 107 hypertension-in-pregnancy-diagnosis-and-management-pdf-35109334011877.pdf; 2011.

Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F, Redon J, Dominiczak A, Narkiewicz K, Nilsson PM, Burnier M, Viigimaa M, Ambrosioni E, Caufield M, Coca A, Olsen MH, Schmieder RE, Tsioufis C, van de Borne P, Zamorano JL, Achenbach S, Baumgartner H, Bax JJ, Bueno H, Dean V, Deaton C, Erol C, Fagard R, Ferrari R, Hasdai D, Hoes AW, Kirchhof P, Knuuti J, Kolh P, Lancellotti P, Linhart A, Nihoyannopoulos P, Piepoli MF, Ponikowski P, Sirnes PA, Tamargo JL, Tendera M, Torbicki A, Wijns W, Windecker S, Clement DL, Coca A, Gillebert TC, Rosei EA, Ambrosioni E, Anker SD, Bauersachs J, Hitij JB, Caulfield M, De Buyzere M, De Geest S, Derumeaux GA, Erdine S, Farsang C, Funck-Brentano C, Gerc V, Germano G, Gielen S, Haller H, Hoes AW, Jordan J, Kahan T, Komajda M, Lovic D, Mahrholdt H, Olsen MH, Ostergren J, Parati G, Perk J, Polonia J, Popescu BA, Reiner Z, Ryden L, Sirenko Y, Stanton A, Struijker-Boudier H, Tsioufis C, van de Borne P, Vlachopoulos C, Volpe M, Wood DA. ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34(28):2159-219. doi: 10.1093/eurheartj/eht151. PMID 23771844.

Whelton PK, Carey RM, Aronow WS, Casey DE, Jr, Collins KJ, Dennison Himmelfarb C, DePalma SM, Gidding S, Jamerson KA, Jones DW, MacLaughlin EJ, Muntner P, Ovbiagele B, Smith SC, Spencer CC, Stafford RS, Taler SJ, Thomas RJ, Sr, Williams KA, Williamson JD, Jr, Wright JT. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017;138(17):e426-e83.

Hinderliter AL, Voora RA, Viera AJ. Implementing ABPM into clinical practice. Curr Hypertens Rep. 2018;20(1):5. doi: 10.1007/s11906-018-0805-y, PMID 29404785.

Wood S, Greenfield SM, Sayeed Haque M, Martin U, Gill PS, Mant J, Mohammed MA, Heer G, Johal A, Kaur R, Schwartz C, McManus RJ. Influence of ethnicity on acceptability of method of blood pressure monitoring: a cross-sectional study in primary care. Br J Gen Pract. 2016;66(649):e577-86. doi: 10.3399/bjgp16X685717, PMID 27266860.

Little P, Barnett J, Barnsley L, Marjoram J, Fitzgerald-Barron A, Mant D. Comparison of acceptability of and preferences for different methods of measuring blood pressure in primary care. BMJ. 2002;325(7358):258-9. doi: 10.1136/bmj.325.7358.258, PMID 12153924.

Stojanova A, Koceski S, Koceska N. Continuous blood pressure monitoring as a basis for ambient assisted living (AAL)—review of methodologies and devices. J Med Syst. 2019;43(2):24. doi: 10.1007/s10916-018-1138-8, PMID 30603777.

Nemati S, Lehman LW, Adams RP, Malhotra A. Discovering shared cardiovascular dynamics within a patient cohort. Annu Int Conf IEEE Eng Med Biol Soc. Proceedings of the annual international conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Annual Conference. Conference. 2012;2012:6526-9. doi: 10.1109/EMBC.2012.6347489, PMID 23367424.

Zhang Q, Zhou D, Zeng X. Highly wearable cuff-less blood pressure and heart rate monitoring with single-arm electrocardiogram and photoplethysmogram signals. Biomed Eng OnLine. 2017;16(1):23. doi: 10.1186/s12938-017-0317-z, PMID 28166774.

Kim J, Park J, Kim K, Chee Y, Lim Y, Park K. Development of a nonintrusive blood pressure estimation system for computer users. Telemed J E Health. 2007;13(1):57-64. doi: 10.1089/tmj.2006.0034, PMID 17309356.

Jamaladin H, van de Belt TH, Luijpers LC, de Graaff FR, Bredie SJ, Roeleveld N, van Gelder MM. Mobile apps for blood pressure monitoring: systematic search in app stores and content analysis. JMIR mHealth uHealth. 2018;6(11):e187. doi: 10.2196/mhealth.9888, PMID 30429116.

Burke LE, Ma J, Azar KM, Bennett GG, Peterson ED, Zheng Y, Riley W, Stephens J, Shah SH, Suffoletto B, Turan TN, Spring B, Steinberger J, Quinn CC, American Heart Association Publications Committee of the Council on Epidemiology and Prevention, Behavior Change Committee of the Council on Cardiometabolic Health, Council on Cardiovascular and Stroke Nursing, Council on Functional Genomics and Translational Biology, Council on Quality of Care and Outcomes Research, and Stroke Council C. Current science on consumer use of Mobile health for cardiovascular disease prevention: a scientific statement from the American Heart Association. Circulation. 2015;132(12):1157-213. doi: 10.1161/CIR.0000000000000232, PMID 26271892.

Matzinger P. The danger model: a renewed sense of self. Science. 2002;296(5566):301-5. doi: 10.1126/science.1071059, PMID 11951032.

Matzinger P. Tolerance, danger, and the extended family. Annu Rev Immunol. 1994;12:991-1045. doi: 10.1146/annurev.iy.12.040194.005015, PMID 8011301.

Akira S, Uematsu S, Takeuchi O. Pathogen recognition and innate immunity. Cell. 2006;124(4):783-801. doi: 10.1016/j.cell.2006.02.015, PMID 16497588.

Takeuchi O, Akira S. Pattern recognition receptors and inflammation. Cell. 2010;140(6):805-20. doi: 10.1016/j.cell.2010.01.022, PMID 20303872.

Schroder K, Tschopp J. The inflammasomes. Cell. 2010;140(6):821-32. doi: 10.1016/j.cell.2010.01.040, PMID 20303873.

McCarthy CG, Goulopoulou S, Wenceslau CF, Spitler K, Matsumoto T, Webb RC. Toll-like receptors and damage-associated molecular patterns: novel links between inflammation and hypertension. Am J Physiol Heart Circ Physiol. 2014;306(2):H184-96. doi: 10.1152/ ajpheart.00328.2013, PMID 24163075.

Kelley N, Jeltema D, Duan Y, He Y. The NLRP3 inflammasome: an overview of mechanisms of activation and regulation. Int J Mol Sci. 2019;20(13):3328. doi: 10.3390/ijms20133328, PMID 31284572.

Serbina NV, Jia T, Hohl TM, Pamer EG. Monocyte-mediated defense against microbial pathogens. Annu Rev Immunol. 2008;26:421-52. doi: 10.1146/annurev.immunol.26.021607. 090326, PMID 18303997.

Olsen F. Transfer of arterial hypertension by splenic cells from DOCA-salt hypertensive and renal hypertensive rats to normotensive recipients. Acta Pathol Microbiol Scand C. 1980;88(1):1-5. doi: 10.1111/j.1699-0463.1980.tb00065.x, PMID 7376880.

Rosales C. Neutrophil: a cell with many roles in inflammation or several cell types? Front Physiol. 2018;9:113. doi: 10.3389/fphys.2018.00113, PMID 29515456.

Nicholls SJ, Hazen SL. Myeloperoxidase and cardiovascular disease. Arterioscler Thromb Vasc Biol. 2005;25(6):1102-11. doi: 10.1161/01.ATV.0000163262.83456.6d, PMID 15790935.

Zhang C, Reiter C, Eiserich JP, Boersma B, Parks DA, Beckman JS, Barnes S, Kirk M, Baldus S, Darley-Usmar VM, White CR. L-arginine chlorination products inhibit endothelial nitric oxide production. J Biol Chem. 2001;276(29):27159-65. doi: 10.1074/jbc.M100191200, PMID 11375389.

Marsche G, Heller R, Fauler G, Kovacevic A, Nuszkowski A, Graier W, Sattler W, Malle E. 2-chlorohexadecanal derived from hypochlorite-modified high-density lipoprotein-associated plasmalogen is a natural inhibitor of endothelial nitric oxide biosynthesis. Arterioscler Thromb Vasc Biol. 2004;24(12):2302-6. doi: 10.1161/01.ATV.0000148703.43429.25, PMID 15514213.

Auchere F, Capeillère Blandin C. NADPH as a co-substrate for studies of the chlorinating activity of myeloperoxidase. Biochem J. 1999;343(3):603-13. doi: 10.1042/bj3430603, PMID 10527939.

Eiserich JP, Baldus S, Brennan ML, Ma W, Zhang C, Tousson A, Castro L, Lusis AJ, Nauseef WM, White CR, Freeman BA. Myeloperoxidase, a leukocyte-derived vascular NO oxidase. Science. 2002;296(5577):2391-4. doi: 10.1126/science.1106830, PMID 12089442.

Rudolph TK, Wipper S, Reiter B, Rudolph V, Coym A, Detter C, Lau D, Klinke A, Friedrichs K, Rau T, Pekarova M, Russ D, Knöll K, Kolk M, Schroeder B, Wegscheider K, Andresen H, Schwedhelm E, Boeger R, Ehmke H, Baldus S. Myeloperoxidase deficiency preserves vasomotor function in humans. Eur Heart J. 2012;33(13):1625-34. doi: 10.1093/eurheartj/ehr193, PMID 21724624.

Collin M, Bigley V. Human dendritic cell subsets: an update. Immunology. 2018;154(1):3-20. doi: 10.1111/imm.12888, PMID 29313948.

Hevia D, Araos P, Prado C, Fuentes Luppichini E, Rojas M, Alzamora R, Cifuentes-Araneda F, Gonzalez AA, Amador CA, Pacheco R, Michea L. Myeloid CD11c+ antigen-presenting cells ablation prevents hypertension in response to angiotensin II plus high-salt diet. Hypertension. 2018;71(4):709-18. doi: 10.1161/hypertensionaha.117.10145. PMID 29378857.

Lu X, Rudemiller NP, Privratsky JR, Ren J, Wen Y, Griffiths R, Crowley SD. Classical dendritic cells mediate hypertension by promoting renal oxidative stress and fluid retention. Hypertension. 2020;75(1):131-8. doi: 10.1161/hypertensionaha.119.13667, PMID 31786985.

Nahmod K, Gentilini C, Vermeulen M, Uharek L, Wang Y, Zhang J, Schultheiss HP, Geffner J, Walther T. Impaired function of dendritic cells deficient in angiotensin II type 1 receptors. J Pharmacol Exp Ther. 2010;334(3):854-62. doi: 10.1124/jpet.109.161760, PMID 20516139.

Vinh A, Chen W, Blinder Y, Weiss D, Taylor WR, Goronzy JJ, Weyand CM, Harrison DG, Guzik TJ. Inhibition and genetic ablation of the B7/CD28 T-cell costimulation axis prevents experimental hypertension. Circulation. 2010;122(24):2529-37. doi: 10.1161/circulationaha.109.930446, PMID 21126972.

Itani HA, Xiao L, Saleh MA, Wu J, Pilkinton MA, Dale BL, Barbaro NR, Foss JD, Kirabo A, Montaniel KR, Norlander AE, Chen W, Sato R, Navar LG, Mallal SA, Madhur MS, Bernstein KE, Harrison DG. CD70 exacerbates blood pressure elevation and renal damage in response to repeated hypertensive stimuli. Circ Res. 2016;118(8):1233-43. doi: 10.1161/CIRCRESAHA.115.308111, PMID 26988069.

Herrada AA, Contreras FJ, Marini NP, Amador CA, Gonzalez PA, Cortes CM, Riedel CA, Carvajal CA, Figueroa F, Michea LF, Fardella CE, Kalergis AM. Aldosterone promotes autoimmune damage by enhancing Th17-mediated immunity. J Immunol. 2010;184(1):191-202. doi: 10.4049/jimmunol.0802886, PMID 19949098.

Lu X, Rudemiller NP, Wen Y, Ren J, Hammer GE, Griffiths R, Privratsky JR, Yang B, Sparks MA, Crowley SD. A20 in myeloid cells protects against hypertension by inhibiting dendritic cell-mediated T-cell activation. Circ Res. 2019;125(12):1055-66. doi: 10.1161/circresaha.119.315343, PMID 31630621.

Tsay GJ, Zouali M. The interplay between innate-like B cells and other cell types in autoimmunity. Front Immunol. 2018;9:1064. doi: 10.3389/fimmu.2018.01064, PMID 29868023.

Kabelitz D. Expression and function of toll-like receptors in T lymphocytes. Curr Opin Immunol. 2007;19(1):39-45. doi: 10.1016/j.coi.2006.11.007, PMID 17129718.

Svendsen UG. Evidence for an initial, thymus independent and a chronic, thymus dependent phase of DOCA and salt hypertension in mice. Acta Pathol Microbiol Scand A. 1976;84(6):523-8. doi: 10.1111/j.1699-0463.1976.tb00150.x, PMID 998251.

Horan MJ, Lovenberg W. Genetic rat models for hypertension: guidelines for breeding, care and use. J Hypertens Suppl. 1986;4(3):S7-9. PMID 3465916.

Svendsen UG. Spontaneous hypertension and hypertensive vascular disease in the NZB strain of mice. Acta Pathol Microbiol Scand A. 1977;85(4):548-54. doi: 10.1111/j.1699-0463.1977.tb03887.x, PMID 899791.

Svendsen UG. The importance of thymus in the pathogenesis of the chronic phase of hypertension in mice following partial infarction of the kidney. Acta Pathol Microbiol Scand A. 1977;85(4):539-47. doi: 10.1111/j.1699-0463.1977.tb03886.x, PMID 331861.

Bataillard A, Vincent M, Sassard J, Touraine JL. Antihypertensive effect of an immunosuppressive agent, cyclophosphamide, in genetically hypertensive rats of the Lyon strain. Int J Immunopharmacol. 1989;11(4):377-84. doi: 10.1016/0192-0561(89)90084-2, PMID 2777432.

Norman RA, Jr, Galloway PG, Dzielak DJ, Huang M. Mechanisms of partial renal infarct hypertension. J Hypertens. 1988;6(5):397-403. doi: 10.1097/00004872-198805000-00010, PMID 3385205.

Okuda T, Grollman A. Passive transfer of autoimmune induced hypertension in the rat by lymph node cells. Tex Rep Biol Med. 1967;25(2):257-64. PMID 6040652.

Suryaprabha P, Padma T, Rao UB. Increased serum IgG levels in essential hypertension. Immunol Lett. 1984;8(3):143-5. doi: 10.1016/0165-2478(84)90067-1, PMID 6500633.

Hilme E, Herlitz H, Soderstrom T, Hansson L. Increased secretion of immunoglobulins in malignant hypertension. J Hypertens. 1989;7(2):91-5. doi: 10.1097/00004872-198902000-00003, PMID 2647845.

Chan CT, Sobey CG, Lieu M, Ferens D, Kett MM, Diep H, Kim HA, Krishnan SM, Lewis CV, Salimova E, Tipping P, Vinh A, Samuel CS, Peter K, Guzik TJ, Kyaw TS, Toh BH, Bobik A, Drummond GR. Obligatory role for B cells in the development of angiotensin II-dependent hypertension. Hypertension. 2015;66(5):1023-33. doi: 10.1161/HYPERTENSIONAHA.115.05779, PMID 26351030.

Taylor EB, Barati MT, Powell DW, Turbeville HR, Ryan MJ. Plasma cell depletion attenuates hypertension in an experimental model of autoimmune disease. Hypertension 2018;71(4):719-28.



How to Cite

MEHRA, R., AANCHAL, S. KALSI, and S. P. GAUTAM. “HYPERTENSION IN RELATION TO IMMUNE SYSTEM AND WAY OF LIFE ALONG WITH TREATMENT”. International Journal of Current Pharmaceutical Research, vol. 13, no. 6, Nov. 2021, pp. 1-10, doi:10.22159/ijcpr.2021v13i6.1907.



Review Article(s)