EIF2AK3 and Hypertension: In a landmark study by Chen et al. (2019), they found that TMAO directly bound to and activated protein kinase R-like endoplasmic reticulum kinase (PERK); the endoplasmic reticulum (ER) stress kinase which has been associated with vascular injury via apoptotic inflammatory responses and ROS generation leading to increased risk for hypertension (Montezano and Touyz, 2012; Sinha and Dabla, 2015).