Hypertension is associated with significant morbidity and mortality despite effective antihypertensive therapies. Soluble klotho is a circulating protein that in preclinical studies is protective against the development of hypertension. There are limited studies of klotho and blood pressure in humans.

Within the Health, Aging, and Body Composition Study, a cohort of well-functioning older adults, soluble klotho was measured in serum. We evaluated the cross-sectional and longitudinal association between klotho and blood pressure, prevalent hypertension, incident hypertension, and BP trajectories. Analyses were adjusted for demographics, cardiovascular disease and kidney disease risk factors, and measures of mineral metabolism including calcium, phosphate, parathyroid hormone, 25(OH) vitamin D, and fibroblast growth factor 23.

The median klotho concentration was 630 pg/ml (478–816, 25th to 75th percentile). Within the cohort, 2093 (76%) of 2774 participants had prevalent hypertension and 476 (70%) of the remaining 681 developed incident hypertension. There was no association between klotho and prevalent hypertension or baseline systolic BP, but higher klotho was associated with higher baseline diastolic BP (fully adjusted β=0.92 mmHg, 95% confidence interval, 0.24 to 1.60 mmHg, higher per two-fold higher klotho). Higher baseline serum klotho levels were significantly associated with a lower rate of incident hypertension (fully adjusted hazard ratio, 0.80; 95% confidence interval, 0.69 to 0.93 for every two-fold higher klotho). Higher klotho was also associated with lower subsequent systolic BP and diastolic BP (–0.16, 95% confidence interval, –0.31 to –0.01, mmHg lower systolic BP per year and –0.10, 95% confidence interval, –0.18 to –0.02, mmHg lower diastolic BP per year, for each two-fold higher klotho).

Higher klotho is associated with higher baseline diastolic but not systolic BP, a lower risk of incident hypertension, and lower BP trajectories during follow-up.

尽管有效的抗高血压治疗，高血压仍与显着的发病率和死亡率相关。可溶性 klotho 是一种循环蛋白，在临床前研究中它可以防止高血压的发展。对 klotho 和人类血压的研究有限。

在健康、衰老和身体成分研究中，一组功能良好的老年人在血清中测量了可溶性 klotho。我们评估了 klotho 与血压、高血压患病率、高血压事件和血压轨迹之间的横截面和纵向关联。对人口统计学、心血管疾病和肾脏疾病危险因素以及矿物质代谢指标（包括钙、磷酸盐、甲状旁腺激素、25(OH) 维生素 D 和成纤维细胞生长因子 23）的分析进行了调整。

中位 klotho 浓度为 630 pg/ml（478–816，第 25 至 75 个百分位数）。在队列中，2774 名参与者中有 2093 名 (76%) 患有高血压，其余 681 名参与者中有 476 名 (70%) 发生高血压事件。klotho 与普遍性高血压或基线收缩压之间没有关联，但较高的 klotho 与较高的基线舒张压（完全调整的β=0.92 mmHg，95% 置信区间，0.24 至 1.60 mmHg，klotho 每升高两倍就更高）。较高的基线血清 klotho 水平与较低的高血压发病率显着相关（完全调整后的风险比为 0.80；95% 置信区间为 klotho 每升高两倍则为 0.69 至 0.93）。较高的 klotho 还与较低的后续收缩压和舒张压相关（–0.16，95% 置信区间，–0.31 至 –0.01，mmHg 每年较低的收缩压和 –0.10，95% 置信区间，–0.18 至 –0.02，mmHg每年降低舒张压，klotho 每升高两倍）。

较高的 klotho 与较高的基线舒张压而非收缩压、较低的高血压事件风险以及较低的随访期间血压轨迹相关。