The hypertension advantage and natural selection: Since type 2 diabetes associates with co-morbidities and premature death, why have the genetic variants remained in the human genome?

Medical Hypotheses
Matthew T LewisStephen E DiCarlo

Abstract

Type 2 diabetes is a major public health crisis around the world. It is estimated that more than 300 million people worldwide have type 2 diabetes. Furthermore, the World Health Organization estimates that deaths from the complications of diabetes will increase by two thirds between 2008 and 2030. Since type 2 diabetes is a major public health crisis, why have the genetic variants for diabetes not been removed from the genome by natural selection? We hypothesize that insulin resistance, a predisposition to type 2 diabetes, and the associated elevation in sympathetic nervous system activity and arterial blood pressure provided an advantage to humans who lived as hunter-gatherers. Specifically, sympathetic hyperactivity stimulates the renin-angiotensin aldosterone system, promotes sodium reabsorption, and increases blood volume, heart rate, stroke volume and peripheral vascular resistance, thus inducing hypertension. The hypertension in turn provides a hemodynamic advantage for hunter-gatherers. Specifically, sympathetic hyperactivity and increased blood pressure increases blood flow delivery to working muscles by increasing cardiac output and shunting blood from non-active tissue. This natural selection for hypertension occurred...Continue Reading

Citations

Feb 19, 2020·Genome Biology and Evolution·Muthukrishnan EaaswarkhanthThangavel Alphonse Thanaraj
Oct 28, 2019·International Journal of Molecular Sciences·Matthew T LewisRobert W Wiseman

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