title: Plasma tissue inhibitor of metalloproteinase-1 levels are elevated in essential hypertension and related to left ventricular hypertrophy.
abstract: BACKGROUND
  Essential hypertensive patients have an increased heart and arterial collagen concentration. Increased collagen synthesis can be assessed using procollagen III N peptide (PIIINP) and reduced collagen degradation measured using tissue inhibitor of metalloproteinase-1 (TIMP-1).
  
  
  METHODS
  Plasma TIMP-1 and PIIINP levels were measured in 31 patients with essential hypertension and in 17 normotensive control subjects. The hypertensive patients were either treatment naive (n = 18) or had been without treatment for 1 month (n = 13). Both groups of patients were screened to exclude other fibrotic diseases.
  
  
  RESULTS
  In the hypertensive patients, TIMP-1 levels were significantly (P < .0002) elevated (median 380 ng/ mL, range 160 to 1,560 ng/mL) compared with those of the normotensive control subjects (median 178 ng/mL, range 99 to 330 ng/mL). In hypertensive subjects who had never received antihypertensive therapy there were significant correlations between TIMP-1 and left ventricular posterior wall thickness in diastole (LVPWd) (r = 0.58) (P < .02) and left ventricular mass index (r = 0.58) (P < .02). There was no difference in PIIINP levels (mean +/- 2 SD) between the hypertensive (0.56 U/mL +/- 0.3) and normotensive groups (0.52 U/mL +/- 0.2).
  
  
  CONCLUSIONS
  The increased tissue collagen III levels found in the heart and vessels of hypertensive patients is due to a reduction in collagen degradation because of high TIMP-1 levels, rather than an increase in synthesis of collagen type III. The tissue source of this TIMP-1 is unclear.
authors.affiliation: Immunoassay Laboratory, St Bartholomew's Hospital, and the Royal London NHS Trust, United Kingdom. p.m.timms@matrix15.freeserve.co.uk
authors.forename: Peter Mclean
authors.initials: PM
authors.lastname: Timms
authors.forename: Ann
authors.initials: A
authors.lastname: Wright
authors.forename: Paul
authors.initials: P
authors.lastname: Maxwell
authors.forename: Stewart
authors.initials: S
authors.lastname: Campbell
authors.forename: Anne Beatrice
authors.initials: AB
authors.lastname: Dawnay
authors.forename: Vinajur
authors.initials: V
authors.lastname: Srikanthan
mesh_terms: D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood*; D017379:Hypertrophy, Left Ventricular / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D011347:Procollagen / Q000097:blood; D019715:Tissue Inhibitor of Metalloproteinase-1 / Q000097:blood*
chemical_list: D010446:Peptide Fragments; D011347:Procollagen; D019715:Tissue Inhibitor of Metalloproteinase-1; C041876:procollagen Type III-N-terminal peptide