The relationship between inflammation and arterial stiffness in patients with essential hypertension.
BACKGROUND
Data about the correlation between augmentation index (AIx), timing of the reflected waveform (T(r)) and inflammatory markers in patients with essential hypertension are not yet well established. The aim of this study was to compare plasma high-sensitivity C-reactive protein (hsCRP), white blood cell count and fibrinogen in hypertensive patients and in normotensive controls and to assess the relationship between inflammatory markers and arterial stiffness.


METHODS
Forty-two healthy middle-aged patients with untreated stage I-II essential hypertension and 42 sex- and age-matched controls were recruited in the study. Pulse wave analysis was used to assess AIx and T(r).


RESULTS
Plasma hsCRP, white blood cell count, AIx and T(r) were significantly higher in the patients with essential hypertension. In multiple regression analysis, AIx correlated positively with age, female gender, mean arterial pressure and log(hsCRP), and negatively with heart rate and height (R(2)=0.75, p<0.001). T(r) correlated negatively with log(hsCRP) (r=-0.34, p=0.002) for the whole study group. However, after adjusting for mean arterial pressure, age, height, heart rate and sex to the regression model, no correlation was revealed between log(hsCRP) and T(r) (p=0.35) as the dependent variable (R(2)=0.48, p<0.001).


CONCLUSIONS
Untreated hypertensive patients with low or moderate total cardiovascular risk had significantly increased blood hsCRP and white blood cell count and arterial stiffness, expressed as AIx and T(r). AIx correlated independently with hsCRP in multiple regression analysis. Measurement of arterial stiffness and inflammation can be suggested as an additional tool to assess cardiovascular risk in hypertensive patients with low or moderate total cardiovascular risk as estimated by traditional risk factors.
Kampus
Priit
P
Department of Cardiology, University of Tartu, 8 Puusepa Street, Tartu 51014, Estonia. pritt.kampus@kliinikum.ee
Muda
Piibe
P
Kals
Jaak
J
Ristimäe
Tiina
T
Fischer
Krista
K
Teesalu
Rein
R
Zilmer
Mihkel
M
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001011:Aorta / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000503:physiopathology*; D018836:Inflammation Mediators / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000503:physiopathology; D012044:Regression Analysis; D013318:Stroke Volume; D014280:Triglycerides / Q000097:blood
D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D018836:Inflammation Mediators; D014280:Triglycerides; D005340:Fibrinogen; D002097:C-Reactive Protein