Klotho protein: a new insight into the pathogenesis of essential hypertension

Essential hypertension is a most prevalent global health concern. Despite extensive research, the exact mechanisms contributing to essential hypertension remain unclear. Several factors contribute to the pathogenesis of essential hypertension. Klotho, a membrane-bound and soluble protein, has been found to modulate hypertension through physiological processes like vascular function and sodium balance. This study aimed to determine the association of klotho protein with essential hypertension.

The study included 164 hypertensive cases and 164 normotensive controls, after imposing certain inclusion and exclusion criteria with written consent from all subjects. Subject's details were obtained using structured proforma to account for potential confounding variables. To estimate klotho protein activity using sandwich enzyme-linked immunosorbent assay, 2 mL blood was collected in a plain vial. All data were tested at a 5% significance level.

The analysis revealed a significant decrease in klotho protein levels in cases compared to controls (1.52 ± 0.87 vs. 2.45 ± 0.90, P < 0.001), suggesting an inverse relationship of klotho protein with risk of essential hypertension. All indices in the structural equation model have suggested that the final model fitted the data reasonably (chi-square to df ratio, 1.153; goodness of fit index, 0.990; adjusted goodness of fit index, 0.945; normed fit index, 0.936; standardized root mean square residual, 0.953; root mean square error of approximation, 0.031). Also, klotho was negatively associated with blood pressure. The area under the receiver operating characteristic curve for klotho and blood pressure was 0.765 (95% confidence interval, 0.716-0.815; P < 0.001).

Klotho levels were significantly reduced in essential hypertension cases compared to controls, Also, klotho had a negative direct association with essential hypertension indicating a potential role for klotho as a prognostic and predictive marker for essential hypertension. This suggests that klotho may have a role in the pathogenesis of essential hypertension. Understanding klotho's role in essential hypertension may lead to the development of novel therapeutic strategies for this disease.