Hypertension and diabetes are often associated, greatly increasing the risk of stroke and severe kidney damage. Researchers from Surrey (UK) and Lille (France), working in the "Multi-omics and pathophysiology of metabolic diseases" unit (Inserm/CNRS/Université de Lille/ CHU de Lille/Institut Pasteur Lille), have identified five biological pathways that explain why type 2 diabetes and hypertension coexist so frequently. By combining certain genetic signatures, they identify individuals whose risk of developing these two diseases is more than twice that of others, paving the way for earlier, more personalized prevention
Type 2 diabetes and hypertension are among the most widespread chronic diseases in the world, with hundreds of millions of people living with both conditions simultaneously. Until now, this overlap has often been attributed to overweight and a sedentary lifestyle, with excessive consumption of salt and sugars. A genetic study published on February 9 in Nature Communications shows a complex predisposing terrain: several distinct biological mechanisms can lead to the association of diabetes and hypertension, and their identification improves the ability to identify those most at risk at an early stage.
In a large-scale analysis carried out by the team led by Prof. Froguel and Prof. Inga Prokopenko of the PreciDIAB National Center for Diabetes Precision Medicine, the scientists analyzed 1,304 independent genetic profiles associating type 2 diabetes with hypertension.of type 2 diabetes and hypertension, then grouped them according to their mechanistic effects on a wide range of metabolic and cardiovascular parameters. The researchers thus identified five major genetic risk profiles corresponding to different biological mechanisms. Some are linked to metabolic syndrome, insufficient insulin production, excess body fat or blood vessel dysfunction. The study also shows that these profiles involve tissues and biological pathways beyond metabolism alone, notably those linked to thyroid function and early development, underlining the diversity of biological origins of risk
Professor Philippe Froguel, senior author at the University of Lille and Imperial College London, comments: "These results reinforce the need to consider that cardiometabolic comorbidity does not have a single cause. Genetics can help us better understand this complexity, and guide more personalized prevention and management based on the biological mechanisms involved. "
The team points out that genetics is only part of the equation: environment, behavior and medical history remain essential factors, in addition to genetic determinants. Nevertheless, this study proposes an evolutionary framework for understanding and potentially predicting cardiometabolic comorbidity in a way more closely aligned with biological mechanisms
Partitioned polygenic scores show mechanistic heterogeneity in type 2 diabetes and hypertension comorbidity
Pascat, V., Zudina, L., Maurin, L. et al
Nature Communications
https://doi.org/10.1038/s41467-025-67449-2
