ABSTRACT
Hypertension is a major health problem worldwide. Individuals with hypertension are
at an increased risk for stroke, heart disease, and kidney failure. Although the etiology
of essential hypertension has a genetic component, lifestyle factors such as diet
play an important role. Insulin resistance is a common feature of hypertension in
both humans and animal models affecting glucose and lipid metabolism producing excess
aldehydes including methylglyoxal. These aldehydes react with proteins to form conjugates
called advanced glycation end products (AGEs). This alters protein structure and function
and can affect vascular and immune cells leading to their activation and secretion
of inflammatory cytokines. AGEs also act via receptors for advanced glycation end
products on these cells altering the function of antioxidant and metabolic enzymes,
and ion channels. This results in an increase in cytosolic free calcium, decrease
in nitric oxide, endothelial dysfunction, oxidative stress, peripheral vascular resistance,
and infiltration of vascular and kidney tissue with inflammatory cells leading to
hypertension. Supplementation with dietary antioxidants including vitamins C, E, or
B6, thiols such as cysteine and lipoic acid, have been shown to lower blood pressure
and plasma inflammatory cytokines in animal models and humans with essential hypertension.
A well-balanced diet rich in antioxidants that includes vegetables, fruits, low fat
dairy products, low salt, and includes whole grains, poultry, fish and nuts, lowers
blood pressure and vascular inflammation. These antioxidants may achieve their antihypertensive
and anti-inflammatory/immunomodulatory effects by reducing AGEs and improving insulin
resistance and associated alterations. Dietary supplementation with antioxidants may
be a beneficial, inexpensive, front-line alterative treatment modality for hypertension.
KEYWORDS
Hypertension - immune system - insulin resistance - advanced glycation end products
- receptors for advanced glycation end products - renin-angiotensin system - oxidative
stress - renal damage - inflammatory cytokines - T cells - macrophages - dietary antioxidants
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Sudesh VasdevD.V.M. Ph.D. F.A.C.B.
Professor, Faculty of Medicine, Director, Renal Laboratory, Room H-4310, Health Sciences
Centre
Memorial University, St. John's, Newfoundland, Canada A1B 3V6
Email: svasdev@mun.ca
