A Third, Previously Overlooked Driver of High Blood Pressure Discovered

A new study suggests high blood pressure may have a third driver that has gone largely overlooked: the body's processes for resolving inflammation once it has been triggered.

Published in the journal Communications Biology, the research also tested whether reactivating that process could reverse some of the organ damage linked to established hypertension.

For decades, blood pressure treatment has centered mainly on two mechanisms: overactivity of the body's stress response, and the renin-angiotensin-aldosterone system, a hormone system involved in regulating blood volume.

This study, by Jaideep Singh, Kristy L. Jackson, Anida G. Devasia and colleagues, adds inflammation resolution as a third factor worth investigating alongside them.

What the researchers did

The team used BPH/2J mice, a strain with naturally high blood pressure, alongside BPN/3J mice, a related strain with normal blood pressure.

Over 28 days, the hypertensive mice received an experimental compound called Cmpd17b, which activates formylpeptide receptors (FPRs), receptors involved in regulating inflammatory responses and their resolution.

Cmpd17b lowered average blood pressure in the hypertensive mice by about 6 millimeters of mercury.

It did not significantly lower blood pressure in the normal blood pressure mice, suggesting its effect may be more pronounced when blood pressure is already elevated, though this would need further testing to confirm.

Repair, with limits

Beyond the modest blood pressure drop, the treated mice showed improved aortic distensibility, a measure of how flexible the main artery stays under pressure, and reduced collagen deposition, a form of scarring, across the kidney, aorta and heart, with the strongest effect in the kidney.

The improvements were not universal. Cardiac function was not significantly altered by the treatment, so its effects were selective rather than a broad reversal of everything hypertension damages.

Why it works differently

Cmpd17b is designed to activate signaling pathways involved in resolving inflammation, rather than broadly suppressing the immune system the way some anti-inflammatory drugs do.

What comes next, and what does not yet

ScienceAlert, reporting on the study, said the researchers are not proposing Cmpd17b as a replacement for existing blood pressure medications, but as a possible option for patients who cannot tolerate current drugs, or as an add-on treatment aimed at inflammation and scarring.

Before any of that could be tested in people, researchers would need to establish the drug's safety, dosing and pharmacokinetics, followed by controlled human trials. The study received partial funding from the National Heart Foundation of Australia.

Why it matters for Africa

High blood pressure carries an especially heavy burden in the World Health Organization (WHO) African Region.

According to WHO's 2023 Global Report on Hypertension, the number of hypertensive adults aged 30 to 79 in the region rose from 45 million in 1990 to 106 million in 2019, a prevalence of 36 percent.

Of those, only 43 percent were diagnosed, 27 percent were receiving treatment, and just 12 percent had their hypertension effectively controlled, the lowest control rate of any WHO region.

A more recent WHO African Region statement confirms the same picture: fewer than a third of people with hypertension in the region are on treatment, and only about 12 percent have it under control.

The gaps in diagnosis, treatment and access to affordable medicines are a major part of that picture. Any future therapy would still need to reach patients through health systems facing those same gaps.

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