title: Matrix metalloproteinase-9 (MMP-9), MMP-2, and serum elastase activity are associated with systolic hypertension and arterial stiffness.
abstract: BACKGROUND
  Arterial stiffness is an independent determinant of cardiovascular risk, and arterial stiffening is the predominant abnormality in systolic hypertension. Elastin is the main elastic component of the arterial wall and can be degraded by a number of enzymes, including matrix metalloproteinase-9 (MMP-9) and MMP-2. We hypothesized that elastase activity would be related to arterial stiffness and tested this using isolated systolic hypertension (ISH) as a model of stiffening and separately in a large cohort of healthy individuals.
  
  
  RESULTS
  A total of 116 subjects with ISH and 114 matched controls, as well as 447 individuals free from cardiovascular disease were studied. Aortic and brachial pulse wave velocity (PWV) and augmentation index were determined. Blood pressure, lipids, C-reactive protein, MMP-9, MMP-2, serum elastase activity (SEA), and tissue-specific inhibitor 2 of metalloproteinases were measured. Aortic and brachial PWV, MMP-9, MMP-2, and SEA levels were increased in ISH subjects compared with controls (P=0.001). MMP-9 levels correlated linearly and significantly with aortic (r=0.45; P=0.001) and brachial PWV (r=0.22; P=0.002), even after adjustments for confounding variables. In the younger, healthy subjects, MMP-9 and SEA were also independently associated with aortic PWV.
  
  
  CONCLUSIONS
  Aortic stiffness is related to MMP-9 levels and SEA, not only in ISH, but also in younger, apparently healthy individuals. This suggests that elastases including MMP-9 may be involved in the process of arterial stiffening and development of ISH. The relationship between arterial stiffness and elastase activity was examined in isolated systolic hypertension (ISH), and separately in a large cohort of healthy individuals. Aortic stiffness is related to MMP-9, not only in ISH, but also in healthy individuals, suggesting elastases may be involved in the process of arterial stiffening and the development of ISH.
authors.affiliation: Clinical Pharmacology Unit, University of Cambridge Addenbrooke's Hospital Cambridge, United Kingdom. my105@medschl.cam.ac.uk <my105@medschl.cam.ac.uk>
authors.lastname: Yasmin
authors.forename: Carmel M
authors.initials: CM
authors.lastname: McEniery
authors.forename: Sharon
authors.initials: S
authors.lastname: Wallace
authors.forename: Zahid
authors.initials: Z
authors.lastname: Dakham
authors.forename: Pawan
authors.initials: P
authors.lastname: Pulsalkar
authors.forename: Pusalkar
authors.initials: P
authors.lastname: Pusalkar
authors.forename: Kaisa
authors.initials: K
authors.lastname: Maki-Petaja
authors.forename: Mike J
authors.initials: MJ
authors.lastname: Ashby
authors.forename: John R
authors.initials: JR
authors.lastname: Cockcroft
authors.forename: Ian B
authors.initials: IB
authors.lastname: Wilkinson
mesh_terms: D000368:Aged; D001011:Aorta; D001158:Arteries / Q000033:anatomy & histology* / Q000473:pathology; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D001916:Brachial Artery; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D003187:Compliance; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000201:enzymology* / Q000473:pathology; D008055:Lipids / Q000097:blood; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000097:blood*; D020780:Matrix Metalloproteinase 9 / Q000097:blood / Q000502:physiology*; D008875:Middle Aged; D010196:Pancreatic Elastase / Q000097:blood / Q000502:physiology*; D011674:Pulse; D017534:Radial Artery; D012016:Reference Values; D012907:Smoking / Q000097:blood; D013599:Systole; D019716:Tissue Inhibitor of Metalloproteinase-2 / Q000097:blood
chemical_list: D001786:Blood Glucose; D008055:Lipids; D019716:Tissue Inhibitor of Metalloproteinase-2; D002097:C-Reactive Protein; D010196:Pancreatic Elastase; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9