Lifestyle Marker Found in Black Adults May Signal Stroke Risk

An organic compound called gluconic acid could serve as a way to identify high blood pressure and stroke risk in Black adults, early research suggests.

By Don Rauf

Black adults may face a greater risk of high blood pressure and stroke if they are found to have a high level of an organic compound called gluconic acid in their body, according to preliminary research presented at the American Stroke Association’s International Stroke Conference 2023 in Dallas (held February 8–10). The study has not been published in a peer-reviewed journal.

“Whether gluconic acid causes high blood pressure or vice versa is yet to be determined in a future study,” says the lead study author, Naruchorn Kijpaisalratana, MD, PhD a research fellow in neurology at Massachusetts General Hospital in Boston. “We think that gluconic acid is a dietary related marker of inflammation, and those with higher stroke risk would have higher gluconic acid level.”

Marker Linked to Cardio Problems in Black but Not White Adults

For the study, Dr. Kijpaisalratana and colleagues examined blood samples collected from 1,075 ischemic stroke survivors during an average follow-up period of seven years. (In an ischemic stroke, a blood clot blocks or narrows an artery leading to the brain.)

Of those, 439 were Black adults and 636 were white adults. Their average age was 70, and participants were about 50 percent male and 50 percent female. The scientists compared these blood results with samples drawn from a group of nearly 1,000 Black and white adults who were similar in age but had not had a stroke. Samples were collected from participants over a four-year period from 2003 to 2007.

Elevated amounts of gluconic acid were found in the samples taken from Black adults who had high blood pressure, but not white participants with high blood pressure. Black adults with the highest gluconic acid levels were 86 percent more likely to have high blood pressure than those with low gluconic acid levels. Black adults with the highest gluconic acid levels also had a 53 percent increased risk of ischemic stroke, but no such association was seen in white participants.

A Biomarker Tied to Lifestyle Practices

The results suggested that higher gluconic acid levels among the Black participants may be related to lifestyle habits — such as consuming foods high in fats, fried foods, processed meats, and sugary drinks (which are often part of a “Southern diet”), as well as a lack of physical activity. Kijpaisalratana added that education levels may also be associated with lifestyle and health behaviors.

“We hypothesize that the changes in behavior including eating a healthy diet and more physical activity would lower gluconic acid levels,” she explains. “But this would require another experimental study to confirm our hypothesis.”

Why Scientists Focused on Gluconic Acid

Gluconic acid is a type of metabolite. Metabolites are substances made or used when the body breaks down food, drugs, chemicals, or its own tissue (for example, fat or muscle tissue). Past research has demonstrated that metabolites are linked to oxidative stress – a condition that may occur when there are too many unstable molecules called free radicals in the body and not enough antioxidants to get rid of them. A growing body of evidence suggests that oxidative stress may play a role in the development of hypertension.  

The researchers focused on gluconic acid after screening 162 metabolites that are relevant to human metabolism; they found that gluconic acid was the only metabolite that demonstrated racial differences.

“What surprised us was that we identified a metabolite that has racial differences in association with the diseases, and this metabolite was linked to social determinants of health including diet, education, and exercise,” said Kijpaisalratana.

Gluconic acid may be considered a dietary-related marker because of its availability in foods (such as fruits, wine, and honey), and it is potentially produced by the gut microbiome, according to study authors. They emphasized that gluconic acid at this point is just a marker of inflammation, and has not been proven to be a cause.

“Our findings did not demonstrate that gluconic acid by itself is harmful,” says Kijpaisalratana. “We demonstrated that gluconic acid could be a marker that links to several health behaviors. Therefore, we suggest that people should maintain their healthy lifestyle through eating healthy and exercising regularly.”

A Potential Tool to Identify Heart Disease Risks

Bruce Oybiagele, MD an associate dean and professor of neurology at the University of California in San Francisco and an American Heart Association expert volunteer, notes that gluconic acid could be a helpful tool for healthcare providers in spotting Black adults who are in danger of having a stroke.

“Given the long-standing higher risk of stroke in Black compared to white adults in the United States, which is so far still not fully explained by a higher frequency of traditional stroke risk factors, the potential discovery of a new prognostic marker or therapeutic target is extremely important,” says Dr. Ovbiagele, who was not involved in the study.

He added that gluconic acid might “serve as an objective measure to inform healthcare professionals about how well their patients are doing in reducing hypertension and stroke risk and may also be helpful to motivate Black patients to modify their lifestyles as appropriate to prevent stroke”