Salt causes aging-associated hypertension via vascular Wnt5a under Klotho deficiency

J Clin Invest. 2020 Aug 3;130(8):4152-4166. doi: 10.1172/JCI134431.


Aging is associated with a high prevalence of hypertension due to elevated susceptibility of BP to dietary salt, but its mechanism is unknown. Serum levels of Klotho, an anti-aging factor, decline with age. We found that high salt (HS) increased BP in aged mice and young heterozygous Klotho-knockout mice and was associated with increased vascular expression of Wnt5a and p-MYPT1, which indicate RhoA activity. Not only the Wnt inhibitor LGK974 and the Wnt5a antagonist Box5 but Klotho supplementation inhibits HS-induced BP elevation, similarly to the Rho kinase inhibitor fasudil, associated with reduced p-MYPT1 expression in both groups of mice. In cultured vascular smooth muscle cells, Wnt5a and angiotensin II (Ang II) increased p-MYPT1 expression but knockdown of Wnt5a with siRNA abolished Ang II-induced upregulation of p-MYPT1, indicating that Wnt5a is indispensable for Ang II-induced Rho/ROCK activation. Notably, Klotho inhibited Wnt5a- and Ang II-induced upregulation of p-MYPT1. Consistently, Klotho supplementation ameliorated HS-induced augmentation of reduced renal blood flow (RBF) response to intra-arterial infusion of Ang II and the thromboxane A2 analog U46619, which activated RhoA in both groups of mice and were associated with the inhibition of BP elevation, suggesting that abnormal response of RBF to Ang II contributes to HS-induced BP elevation. Thus, Klotho deficiency underlies aging-associated salt-sensitive hypertension through vascular non-canonical Wnt5a/RhoA activation.

Keywords: Hypertension; Nephrology; Vascular Biology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aging* / drug effects
  • Aging* / genetics
  • Aging* / metabolism
  • Aging* / pathology
  • Angiotensin II / genetics
  • Angiotensin II / metabolism
  • Animals
  • Glucuronidase / deficiency*
  • Glucuronidase / metabolism
  • Hypertension* / chemically induced
  • Hypertension* / genetics
  • Hypertension* / metabolism
  • Hypertension* / pathology
  • Klotho Proteins
  • Male
  • Mice
  • Mice, Knockout
  • Muscle, Smooth, Vascular* / metabolism
  • Muscle, Smooth, Vascular* / pathology
  • Myocytes, Smooth Muscle* / metabolism
  • Myocytes, Smooth Muscle* / pathology
  • Myosin-Light-Chain Phosphatase / genetics
  • Myosin-Light-Chain Phosphatase / metabolism
  • Sodium Chloride, Dietary / adverse effects*
  • Sodium Chloride, Dietary / pharmacology
  • Wnt-5a Protein / genetics
  • Wnt-5a Protein / metabolism*


  • Sodium Chloride, Dietary
  • Wnt-5a Protein
  • Wnt5a protein, mouse
  • Angiotensin II
  • Myosin-Light-Chain Phosphatase
  • Ppp1r12a protein, mouse
  • Glucuronidase
  • Klotho Proteins