Chlamydia pneumoniae seropositivity and systemic and renovascular atherosclerotic disease.
BACKGROUND
Patients with hypertension may be vulnerable to vascular Chlamydia pneumoniae and/or cytomegalovirus (CMV) infection because of increased expression of adhesion molecules.


OBJECTIVE
To determine whether C pneumoniae or CMV is associated with the presence of atherosclerotic lesions in hypertensive patients.


METHODS
Ninety-six angiographic studies on 100 consecutive patients with of clinical signs or symptoms suggestive of renovascular hypertension were reviewed for the presence or absence of atherosclerotic lesions at the level of the renal arteries as well and abdominal aorta. Also, the presence of a hemodynamically notable renal artery stenosis and antibodies to C pneumoniae (IgG and IgA) and CMV (IgG and IgM) was determined, and all classic risk factors were recorded.


RESULTS
Atherosclerotic lesions were documented in 67 patients (70%), and in 49 patients (51%) such lesions were present at the level of the renal artery. In the univariate analysis, significant associations between IgG (odds ratio, 3.8; 95% confidence interval, 1.2-11.7; P =.02) as well as IgA (odds ratio, 2.6; 95% confidence interval, 1.1-6.7; P =.03) antibodies to C pneumoniae and the presence of atherosclerosis were found for both the aorta and the renal arteries. Seroprevalence (IgG) to C pneumoniae in the 23 patients with a hemodynamically notable renal artery stenosis was 100% and differed (P =.01) from those without a notable renal artery stenosis (78%). In the multivariate analysis, IgG seropositivity to C pneumoniae was significantly associated with atherosclerosis (odds ratio, 6.0; 95% confidence interval, 1.33-27.5; P =.02), and age. There was no association between CMV seropositivity and atherosclerosis.


CONCLUSIONS
The presence of antibodies to C pneumoniae was significantly associated with atherosclerosis and renovascular disease in hypertensive patients in whom a renal artery stenosis was strongly suspected.
van der Ven
Andre J A M
AJ
Department of Medical Microbiology, Academic Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, the Netherlands. avve@lmib.azm.nl
Hommels
Marianne J
MJ
Kroon
Abraham A
AA
Kessels
Anton
A
Flobbe
Karin
K
van Engelshoven
Jos
J
Bruggeman
Catrien A
CA
de Leeuw
Peter W
PW
D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D000907:Antibodies, Bacterial / Q000032:analysis*; D000914:Antibodies, Viral / Q000032:analysis*; D001161:Arteriosclerosis / Q000276:immunology* / Q000382:microbiology / Q000821:virology; D016993:Chlamydophila pneumoniae / Q000276:immunology*; D003587:Cytomegalovirus / Q000276:immunology*; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000276:immunology* / Q000382:microbiology / Q000821:virology; D007070:Immunoglobulin A / Q000032:analysis*; D007074:Immunoglobulin G / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012078:Renal Artery Obstruction / Q000000981:diagnostic imaging
D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D007070:Immunoglobulin A; D007074:Immunoglobulin G