C-reactive protein and intercellular adhesion molecule-1 are stronger predictors of oxidant stress than blood pressure in established hypertension.
BACKGROUND
Oxidant stress is implicated in the pathogenesis of atherosclerosis in cardiovascular diseases. Our aim was to test oxidative stress, as 8-iso-prostaglandin F2alpha (8-iso-PGF2alpha), and its relationship with inflammation markers C-reactive protein (CRP) and tumour necrosis factor-alpha (TNFalpha), and endothelial activation assayed as soluble intercellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1 in essential hypertension.


METHODS
In 216 essential hypertensive patients and 55 healthy control individuals, plasma levels of high-sensitivity CRP and TNFalpha, 8-iso-PGF2alpha, ICAM-1 and VCAM-1 were measured in basal conditions. Moreover, basal and 24-h ambulatory blood pressure monitoring measurements were obtained.


RESULTS
Essential hypertensive patients showed higher levels of 8-iso-PGF2alpha (P < 0.0001), high-sensitivity CRP, TNFalpha, ICAM-1 and VCAM-1 (P < 0.001, respectively) than control individuals. In control individuals, 8-iso-PGF2alpha correlated only with high-sensitivity CRP (P < 0.001). In essential hypertensive patients, 8-iso-PGF2alpha correlated with high-sensitivity CRP (P < 0.000001), TNFalpha (P < 0.0001), ICAM-1 (P < 0.000001), VCAM-1 (P < 0.0001) and blood pressure. The multiple regression analysis considering 8-iso-PGF2alpha as the dependent variable showed that in essential hypertensive patients the independent predictors of 8-iso-PGF2alpha were ICAM-1, high-sensitivity CRP (P < 0.00001, respectively), and TNFalpha (P = 0.028).


CONCLUSIONS
Our findings demonstrate that oxidant stress is increased in essential hypertension, and relates to inflammation and endothelial activation. Factors other than blood pressure are stronger predictors of oxidant stress.
Cottone
Santina
S
Cattedra di Medicina Interna, Divisione di Medicina Interna, Nefrologia ed Ipertensione Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Università di Palermo, Italy. sancott@tin.it
Mulè
Giuseppe
G
Nardi
Emilio
E
Vadalà
Anna
A
Lorito
Maria C
MC
Guarneri
Marco
M
Arsena
Rosalia
R
Palermo
Alessandro
A
Cerasola
Giovanni
G
D000328:Adult; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D015237:Dinoprost / Q000031:analogs & derivatives / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000175:diagnosis; D007249:Inflammation; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D011237:Predictive Value of Tests; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D015415:Biomarkers; D014409:Tumor Necrosis Factor-alpha; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; C075750:8-epi-prostaglandin F2alpha; D002097:C-Reactive Protein; D015237:Dinoprost