The pathophysiology of hypertension remains incompletely understood. The associations of circulating metabolites with longitudinal blood pressure (BP) changes were investigated in the Prospective Investigation of the Vasculature in Uppsala Seniors cohort. The findings were validated in the Uppsala Longitudinal Study of Adult Men cohort.
Circulating metabolite levels were evaluated with gas- and liquid-chromatography coupled to mass spectrometry amongst patients without BP-lowering medication. Associations of BP levels with baseline levels of metabolites changes and the clinical BP stage were studied between a follow-up and baseline examination five years later. In the cohort, 757 observations of paired BP measurements were obtained by investigating 504 individuals. The metabolites associated with diastolic BP change were cholesteryl ester ceramide, oleic acid, total glycerolipids, and triacylglycerol. Metabolites with similar structures to the 5 top findings in the discovery cohort were investigated in the validation cohort. Monoacylglycerol (18:0) and diacylglycerol (36:2), two glycerolipids, were associated with diastolic BP change in the validation cohort.
In conclusion, four metabolites (oleic acid, glycerolipids, triacylglycerol, and ceramide) were discovered to be directly associated with subsequent longitudinal DBP change in a population-based cohort, and one (cholesteryl ester) inversely associated with DBP change. These metabolites could point towards pathophysiological pathways of hypertension; elucidating those pathways may lead to an understanding of potentially treatable hypertension causes.
Ref: https://www.ahajournals.org/doi/10.1161/ATVBAHA.120.314356