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The High Blood Pressure-Malaria Protection Hypothesis
Julio Gallego-Delgado1, Thomas Walther2, Ana Rodriguez1
1From the Department of Microbiology, New York University School of Medicine (J.G.-D., A.R.); and Department of Pharmacology and Therapeutics, School of Medicine and School of Pharmacy, University College Cork (UCC), Ireland (T.W.).
Elevated angiotensin II (Ang II) levels may protect against severe malaria, offering a new explanation for hypertension in malaria-endemic regions. This finding suggests novel therapeutic strategies for cerebral malaria.
Area of Science:
- Cardiovascular Physiology
- Infectious Diseases
- Genetics
Background:
- Hypertension is prevalent in malaria-endemic areas, with a proposed link to malaria.
- The role of angiotensin II (Ang II) in this association has not been previously explored.
Purpose of the Study:
- To investigate an alternative cause of hypertension in populations historically exposed to malaria.
- To explore the protective role of Ang II against malaria.
Main Methods:
- Literature review of genetic and functional studies linking Ang II and malaria.
- Analysis of experimental evidence, including genetic, functional, and interventional studies.
Main Results:
- High Ang II levels appear to protect against cerebral malaria.
- Evidence suggests Ang II strengthens the integrity of the endothelial brain barrier.
Conclusions:
- A causal link between high Ang II and malaria protection may explain hypertension in African and South Asian populations.
- This association could lead to new treatments for cerebral malaria.
Related Concept Videos
Hypertension and Regulation of Blood Pressure
Hypertension II: Pathophysiology
Hypertension III: Clinical Manifestations and Diagnostic Studies
Factors affecting Blood pressure
Physiological Factors:
Symbiosis
Hypertension I: Introduction

