The Malaria-High Blood Pressure Hypothesis
Rationale: Several studies have demonstrated links between infectious diseases and cardiovascular conditions. Malaria and hypertension are widespread in many low and middle-income countries but the possible link between them has not been considered.
Objective: In this article we outline the basis for a possible link between malaria and hypertension, and discuss how the hypothesis could be confirmed or refuted.
Methods and Results: We reviewed published literature on factors associated with hypertension and checked whether any of these were also associated with malaria. We then considered various study designs that could be used to test the hypothesis. Malaria causes low birth weight, malnutrition and inflammation, all of which are associated with hypertension in high-income countries. The hypothetical link between malaria and hypertension can be tested through the use of ecological, cohort or Mendelian randomization studies, each of which poses specific challenges.
Conclusions: Confirmation of the existence of a causative link with malaria would be a paradigm shift in efforts to prevent and control hypertension and would stimulate wider research on the links between infectious and non-communicable disease.
- Received March 22, 2016.
- Revision received April 21, 2016.
- Accepted May 2, 2016.
Circulation Research is published on behalf of the American Heart Association, Inc., by Wolters Kluwer. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0/), which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited.