Infection and high blood pressure
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Infection and High Blood Pressure: A Comprehensive Overview
Cytomegalovirus (CMV) Infection and Hypertension
Cytomegalovirus (CMV) infection is prevalent globally and has been linked to cardiovascular diseases, including hypertension. Research indicates that CMV infection can independently cause a significant increase in arterial blood pressure (ABp) in both mouse models and human cells. This increase is associated with elevated levels of pro-inflammatory cytokines such as IL-6, TNF-α, and MCP-1, as well as increased expression of renin and angiotensin-II (Ang II) . These findings suggest that CMV infection is a risk factor for hypertension and aortic atherosclerosis, potentially through persistent infection of endothelial cells.
HIV Infection and Blood Pressure
Increased Risk of Hypertension and Cardiovascular Events
HIV-infected individuals are at a higher risk of developing hypertension and cardiovascular events compared to uninfected individuals. Studies have shown that both prehypertensive and hypertensive HIV-infected individuals have an increased risk of acute myocardial infarction (AMI) . Additionally, HIV-infected children and young adults exhibit a higher prevalence of high blood pressure (HBP), with significant risk factors including comorbidities, male gender, and tobacco use .
Blood Pressure Control in HIV-Infected Patients
In Sub-Saharan Africa, the prevalence of hypertension in HIV-infected patients varies, with some studies indicating lower blood pressure in treated HIV-infected individuals compared to untreated or uninfected controls . However, HIV-infected patients often exhibit higher 24-hour systolic and pulse pressures, as well as increased arterial stiffness, which are significant cardiovascular risk factors . Effective management of hypertension in HIV-infected individuals is crucial to reduce the risk of cardiovascular events .
Gut Microbiota and Hypertension
Role of Microbiota in Blood Pressure Regulation
Emerging evidence suggests that gut microbiota play a significant role in the regulation of blood pressure. Altered gut microbiota can lead to increased levels of lipopolysaccharides (LPS) in the bloodstream, causing metabolic endotoxemia, endothelial dysfunction, and vascular inflammation . Studies have shown that high blood pressure patients have distinct gut microbiomes and increased markers of gut barrier dysfunction, such as zonulin, which strongly correlates with systolic blood pressure . Probiotic interventions have shown promise in improving vascular health and reducing hypertension by modulating gut microbiota and reducing inflammation .
Other Infections and Hypertension
Bacterial and Viral Infections
Various bacterial and viral infections have been associated with hypertension. For instance, higher colonization levels of certain oral bacteria are linked to increased blood pressure . Additionally, infections such as Zika virus, Epstein-Barr virus, and malaria have been associated with elevated blood pressure and increased cardiovascular risk . The relationship between COVID-19 and hypertension involves endothelial dysfunction and dysregulation of the renin-angiotensin system, with poor blood pressure control being linked to adverse outcomes in hypertensive COVID-19 patients .
Conclusion
Infections, whether viral or bacterial, play a significant role in the development and exacerbation of hypertension. CMV and HIV infections are particularly notable for their impact on blood pressure and cardiovascular risk. Additionally, the gut microbiota's influence on blood pressure regulation highlights the potential for novel therapeutic interventions. Understanding these relationships is crucial for developing effective strategies to manage and mitigate the cardiovascular risks associated with infections.
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Most relevant research papers on this topic
Cytomegalovirus Infection Causes an Increase of Arterial Blood Pressure
Cytomegalovirus infection increases arterial blood pressure and is a co-factor in aortic atherosclerosis, with persistent infection of endothelial cells potentially underlining the mechanism.
Prehypertension, hypertension, and the risk of acute myocardial infarction in HIV-infected and -uninfected veterans.
HIV, prehypertensive blood pressure, and hypertension are associated with an increased risk of acute myocardial infarction in both HIV-infected and -uninfected veterans.
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