title: Abnormal soluble CD40 ligand and C-reactive protein concentrations in hypertension: relationship to indices of angiogenesis.
abstract: BACKGROUND
  Abnormal inflammation, platelets and angiogenesis are involved in the pathophysiology of cardiovascular disease (CVD).
  
  
  OBJECTIVE
  To test the hypothesis that concentrations of high sensitive C-reactive protein (CRP, an index of inflammation) and soluble CD40 ligand (sCD40L, an index of platelet activation) would be abnormal in hypertension, and in turn, be related to plasma indices of angiogenesis, the angiopoietins-1 and -2, and vascular endothelial growth factor (VEGF), in addition to the presence or absence of CVD.
  
  
  METHODS
  Using a cross-sectional approach, we measured plasma concentrations of CRP, sCD40L, VEGF, and angiopoietins-1 and -2 in 147 patients with hypertension (85 with a history of CVD event/s, 62 CVD event-free) and 68 age- and sex-matched healthy controls.
  
  
  RESULTS
  Concentrations of sCD40L (P = 0.039), CRP (P < 0.001), angiopoietin-1 (P < 0.001), angiopoietin-2 (P = 0.003) and VEGF (P < 0.001) were all greater amongst hypertensive patients than in controls. There were no significant differences in sCD40L and VEGF concentrations between hypertensive individuals with and without CVD events, but CRP and angiopoietin-1 concentrations were significantly greater amongst those with CVD events. On multiple regression analysis, sCD40L was associated with angiopoietin-2 (P = 0.01) and VEGF (P = 0.007) in hypertensive individuals, but no such associations were found within the healthy control group.
  
  
  CONCLUSIONS
  In patients with hypertension, sCD40L was associated with increased circulating markers of abnormal angiogenesis (angiopoietin-2, VEGF). The interaction between sCD40L and angiogenesis may contribute to the pathophysiology of CVD in hypertension.
authors.affiliation: Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, UK.
authors.forename: Jeetesh V
authors.initials: JV
authors.lastname: Patel
authors.forename: Hoong Sern
authors.initials: HS
authors.lastname: Lim
authors.forename: Sunil
authors.initials: S
authors.lastname: Nadar
authors.forename: Muzahir
authors.initials: M
authors.lastname: Tayebjee
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Hughes
authors.forename: Gregory Yh
authors.initials: GY
authors.lastname: Lip
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D042683:Angiopoietin-1 / Q000097:blood / Q000502:physiology; D042702:Angiopoietin-2 / Q000097:blood / Q000502:physiology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis* / Q000502:physiology; D023201:CD40 Ligand / Q000097:blood* / Q000502:physiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000503:physiopathology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000503:physiopathology; D007249:Inflammation / Q000097:blood / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000097:blood* / Q000503:physiopathology; D015539:Platelet Activation / Q000502:physiology; D012044:Regression Analysis; D042461:Vascular Endothelial Growth Factor A / Q000097:blood / Q000502:physiology
chemical_list: D042683:Angiopoietin-1; D042702:Angiopoietin-2; D015415:Biomarkers; D042461:Vascular Endothelial Growth Factor A; D023201:CD40 Ligand; D002097:C-Reactive Protein