Science Study Maps How Blood Pressure Rises and Harms the Body

High blood pressure is often called a “silent” condition because people may feel perfectly healthy while damage gradually develops in the heart, kidneys, brain and blood vessels. Now, a new study published in Science offers one of the most detailed views yet of what is happening inside the body as hypertension develops.

Hypertension affects about one in three adults worldwide and is a major cause of heart disease, stroke and kidney failure. Although medications help many patients, hypertension has no cure, and millions continue to have high blood pressure despite taking multiple drugs. One reason may be that hypertension is not a single disease process; it affects many organs and cell types in different ways in different people.

In the new study, researchers created a detailed “cellular map” of hypertension by examining more than 650,000 individual cells from the brain, heart, kidneys, blood and several types of blood vessels. They found that some biological changes appeared repeatedly across the body and different types of hypertension, while others were unique to one organ or one hypertension type. Certain changes in blood-vessel cells tracked closely with blood pressure, while kidney-cell changes were linked to both high blood pressure and kidney injury.

The researchers also connected these cellular changes with findings from human genetic studies of high blood pressure, stroke, heart disease and kidney damage. They then used DNA editing to investigate one genetic region linked to blood pressure and discovered how it influences blood-pressure regulation and the activity of nearby genes.

The findings could help researchers move beyond treating hypertension mainly as a number on a blood pressure cuff. By revealing which cells and groups of genes are affected, and how those effects differ across organs and hypertension types, the study provides a roadmap for understanding how hypertension causes such widespread damage.

Ultimately, that knowledge could help scientists identify more precise ways to prevent organ damage, develop better treatments for people whose blood pressure remains difficult to control, and tailor the treatments for different patients.

The study illustrates the power of molecular systems medicine. In this new scientific discipline, scientists and physicians base their work on the understanding that humans are molecular systems with emergent properties, not just collections of individual molecules or organs.

The study was led by Dr. Qiongzi (Joan) Qiu, Assistant Research Professor in the Department of Physiology at the University of Arizona College of Medicine, and Dr. Mingyu Liang, Cosden Professor and Chair of the Department of Physiology. 

Associate Research Professor Dr. Yong Liu and former Postdoctoral Fellows Dr. Hong Xue and Dr. Rajan Pandey are co-first authors. Co-authors include Assistant Research Professor Dr. Jing Liu, former PhD student Lishu He, Research Professor Dr. Pengyuan Liu, Laboratory Manager Bhavika Therani, former Postdoctoral Fellow Dr. Vinod Kumar, former Research Associate Jing Huang, Postdoctoral Fellow Dr. Shima Sadri, former medical student Maya Guenther, and several collaborators from the Medical College of Wisconsin, Versiti Wisconsin, and the Jackson Laboratory.

The study was supported by the National Institutes of Health grants HL149620, DK129964, and HL121233.