New Research: A Physiological Link Between Hypertension and Diabetes
Two of the most prevalent disorders are hypertension and diabetes. Hypertension affects 30% of the population in the world or approximately 1 billion persons.1 About 460 million persons are living with diabetes around the world.2 These 2 disorders, if physiologically linked, could provide an opportunity for a major research breakthrough to develop novel therapeutic targets, either with currently available therapies or with new agents.
High levels of sympathetic nerve activity are present in hypertension and type 2 diabetes.3 The high sympathetic tone, over time, leads to altered regulation of carotid baroreceptors.4 Alterations in the carotid bodies are important to blood pressure control.5 However, the role of carotid bodies in glucose control has yet to be well defined.6
Researchers in the United Kingdom investigated molecular targets implicated in energy metabolism mediated by carotid bodies, which were associated with regulation of sympathetic outflow of experimental hypertension.6 They discovered that activation of glucagon-like peptide 1 receptors (GLP1R), which are expressed in hypoxia-sensing glomus cells of the carotid bodies, suppresses sympathetic and arterial pressure responses. Reduction of the GLP1R in the carotid body is associated with increased sympathetic drive in a model of cardiometabolic disease.
The importance of this finding may explain, in part, the antihypertensive effects of GLP1R agonist therapy, which may serve in the near future as a therapeutic target for controlling abnormal sympathetic activity in hypertension and diabetes. A potential singular treatment for both disorders would be most welcome to treat worldwide cardiometabolic disease.
References:
- Alexander MR. What is the global prevalence of hypertension (high blood pressure)? Medscape. Accessed February 2, 2022. https://www.medscape.com/answers/241381-7614/what-is-the-global-prevalence-of-hypertension-high-blood-pressure
- Elflein J. Diabetes—Statistics and Facts. Statista. Published February 18, 2021. Accessed February 2, 2022. https://www.statista.com/topics/1723/diabetes/
- Carmethon MR, Jacobs DR Jr, Sidney S, Liu K. Influence of autonomic nervous system dysfunction on the development of type 2 diabetes: the CARDIA study. Diabetes Care. 2003;26(11):3035-3041. doi:10.2337/diacare.26.11.3035
- McBryde FD, Abdala AP, Hendy EB, et al. The carotid body as a putative therapeutic target for the treatment of neurogenic hypertension. Nat Commun. 2013;4:2395. doi:10.1038/ncomms3395
- Niewinski P, Janczak D, Rucinski A, et al. Carotid body resection for sympathetic modulation in systolic heart failure: Results from the first-in-man study. Eur J Heart Fail. 2017;19(3):391-400. doi:10.1002/ejhf.641
- Pauza AG, Thakkar P, Tasic T, et al. GLP1R attenuates sympathetic response to high glucose via carotid body inhibition. Circ Res. Published online February 1, 2022. doi:10.1161/CIRCRESAHA.121.319874
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