Parasite-Host Biology, ICMR-National Institute of Malaria Research, New Delhi, India.
Department of Biotechnology, Bhimtal, Kumaun University, Nainital, Uttarakhand, India.
J Hum Hypertens. 2022 Apr;36(4):344-351. doi: 10.1038/s41371-021-00599-0. Epub 2021 Sep 3.
Despite clinical and pathological distinctions between malaria and hypertension, accumulated epidemiological and evolutionary evidence indicate the need of deeper understanding how severe malaria contributes to elevated hypertension risk. Malaria is said to exert strong selection pressure on the host genome, thus selecting certain genetic polymorphisms. Few candidate polymorphisms have also been reported in the RAS (ACE I/D and ACE2 rs2106809) that are shown to increase angiotensin II (ang II) levels in a combinatorial manner. The raised ang II has some antiplasmodial actions in addition to protecting against severe/cerebral malaria. It is hypothesized that RAS polymorphisms may have been naturally selected over time in the malaria-endemic areas in such a way that hypertension, or the risk thereof, is higher in such areas as compared to non-malaria endemic areas. The purpose of this review is to gain deeper insights into various sparse evidence linking malaria and hypertension and suggesting a way forward.
尽管疟疾和高血压在临床和病理上有所区别，但积累的流行病学和进化证据表明，需要更深入地了解严重疟疾如何导致高血压风险增加。据说疟疾对宿主基因组施加了强大的选择压力，从而选择了某些遗传多态性。在 RAS（ACE I/D 和 ACE2 rs2106809）中也报道了一些候选多态性，这些多态性被证明以组合方式增加血管紧张素 II（ang II）水平。升高的 ang II 除了防止严重/脑型疟疾外，还具有一些抗疟作用。据推测，随着时间的推移，RAS 多态性可能在疟疾流行地区被自然选择，从而导致这些地区的高血压或高血压风险高于非疟疾流行地区。本综述的目的是更深入地了解各种将疟疾和高血压联系起来的稀疏证据，并提出前进的方向。
