Hypertension: a lymphatic disease?

Hypertension affects nearly one in two American adults and is a major risk factor for cardiovascular events and organ damage. Many treatments exist to lower blood pressure in hypertensive patients; however, their degree of effectiveness varies. It is well known that the pathology of hypertension is interwoven with actions of the immune system. Different types of immune cells infiltrate and accumulate in organs under hypertensive conditions and contribute to cytokine release and persistent inflammation. Recently, it has been shown that blood pressure can be lowered by increasing renal-specific lymphangiogenesis, which facilitates the movement of immune cells out of the kidneys. Hypertension is known to be correlated with increased lymphangiogenesis in tissues including the kidneys, heart, gonads, and skin; however, little is known about this relationship. In this brief review article, we explore the connections between hypertension, a well-studied disease, and the lymphatic system, a historically understudied system. We speculate on points of relation and the potential impact of lymphatic-focused hypertension treatments.