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These conditions activate the immune system either directly or through their impact on the gut microbiome, which ultimately produces chronic inflammation and hypertension. T cells are central to the immune responses contributing to hypertension. They are activated in part by binding specific antigens that are presented in major histocompatibility complex molecules on professional antigen-presenting cells, and they generate repertoires of rearranged T-cell receptors. Activated T cells infiltrate tissues and produce cytokines including interleukin 17A, which promote renal and vascular dysfunction and end-organ damage leading to hypertension. In this comprehensive review, we highlight environmental, genetic, and microbial associated mechanisms contributing to both innate and adaptive immune cell activation leading to hypertension. Targeting the underlying chronic immune cell activation in hypertension has the potential to mitigate the excess cardiovascular risk associated with this common and deadly disease.<\/jats:p>","DOI":"10.1161\/circresaha.121.318052","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T18:13:18Z","timestamp":1617300798000},"page":"908-933","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":215,"title":["Hypertension"],"prefix":"10.1161","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0407-634X","authenticated-orcid":true,"given":"Meena S.","family":"Madhur","sequence":"first","affiliation":[{"name":"Division of Clinical Pharmacology (M.S.M., F.E., M.R.A., A.P., J.I., J.P.V.B., D.M.P., C.D.S., C.L.L., A.K.), Department of Medicine, Vanderbilt University Medical Center, Nashville, TN."},{"name":"Division of Cardiovascular Medicine (M.S.M., M.R.A., D.M.P.), Department of Medicine, 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