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Identifying a metabolomics profile associated with masked hypertension in two independent cohorts: Data from the African-PREDICT and SABPA studies

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Individuals with masked hypertension (MHT) have a greater risk of adverse cardiovascular outcomes than normotensive (NT) individuals. Exploring metabolomic differences between NT and MHT individuals may help provide a better understanding of the etiology of MHT. We analyzed data from 910 young participants (83% NT and 17% MHT) (mean age 24 ± 3 years) from the African-PREDICT and 210 older participants (63% NT and 37% MHT) from the SABPA (mean age 42 ± 9.6 years) studies. Clinic and ambulatory blood pressures (BPs) were used to define BP phenotypes. Urinary amino acids and acylcarnitines were measured using liquid chromatography time-of-flight mass spectrometry in SABPA and liquid chromatography tandem mass spectrometry in the African-PREDICT studies. In the SABPA study, amino acids (leucine/isoleucine, valine, methionine, phenylalanine), free carnitine (C0-carnitine), and acylcarnitines C3 (propionyl)-, C4 (butyryl)-carnitine and total acylcarnitine) were higher in MHT than NT adults. In the African-PREDICT study, C0- and C5-carnitines were higher in MHT individuals. With unadjusted analyses in NT adults from the SABPA study, ambulatory SBP correlated positively with only C3-carnitine. In MHT individuals, positive correlations of ambulatory SBP with leucine/isoleucine, valine, methionine, phenylalanine, C0-carnitine and C3-carnitine were evident (all p < 0.05). In the African-PREDICT study, ambulatory SBP correlated positively with C0-carnitine (r = 0.101; p = 0.006) and C5-carnitine (r = 0.195; p < 0.001) in NT adults and C5-carnitine in MHT individuals (r = 0.169; p = 0.034). We demonstrated differences between the metabolomic profiles of NT and MHT adults, which may reflect different stages in the alteration of branched-chain amino acid metabolism early on and later in life.

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Acknowledgements

The authors are grateful to all individuals who voluntarily participated in the SABPA and African-PREDICT studies. The dedication of the support and research staff as well as students at the Hypertension Research and Training Clinic at the North-West University are also duly acknowledged. The SABPA study would not have been possible without collaboration with the Department of Education, North-West Province, South Africa. Images were obtained from Servier Medical Art (smart.servier.com).

Funding

With regard to the African-PREDICT study, the research funded in this manuscript is part of an ongoing larger research project financially supported by the South African Medical Research Council (SAMRC) with funds from National Treasury under its Economic Competitiveness and Support Package; the South African Research Chairs Initiative (SARChI) of the Department of Science and Technology and National Research Foundation (NRF) of South Africa (GUN 86895); SAMRC with funds received from the South African National Department of Health, GlaxoSmithKline R&D (Africa Non-Communicable Disease Open Lab grant), the UK Medical Research Council and with funds from the UK Government’s Newton Fund; and corporate social investment grants from Pfizer (South Africa), Boehringer-Ingelheim (South Africa), Novartis (South Africa), the Medi Clinic Hospital Group (South Africa) and in-kind contributions of Roche Diagnostics (South Africa). Any opinion, findings, and conclusions or recommendations expressed in this material are those of the authors, and therefore, the NRF does not accept any liability in this regard. The SABPA study was supported by the National Research Foundation, South Africa; the North-West University, Potchefstroom, South Africa; and the Metabolic Syndrome Institute, France.

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Authors and Affiliations

  1. Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, 2520, North-West Province, South Africa

    Michél Strauss-Kruger, Ruan Kruger, Esmé Jansen Van Vuren, Adriaan Jacobs & Carina Mels

  2. MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, 2520, North-West Province, South Africa

    Michél Strauss-Kruger, Ruan Kruger, Esmé Jansen Van Vuren, Adriaan Jacobs & Carina Mels

  3. Human Metabolomics, North-West University, Potchefstroom, 2520, North-West Province, South Africa

    Roan Louw

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Correspondence to Carina Mels.

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Strauss-Kruger, M., Kruger, R., Jansen Van Vuren, E. et al. Identifying a metabolomics profile associated with masked hypertension in two independent cohorts: Data from the African-PREDICT and SABPA studies. Hypertens Res 45, 1781–1793 (2022). https://doi.org/10.1038/s41440-022-01010-2

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