title: C-reactive protein and intercellular adhesion molecule-1 are stronger predictors of oxidant stress than blood pressure in established hypertension.
abstract: 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.
authors.affiliation: 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
authors.forename: Santina
authors.initials: S
authors.lastname: Cottone
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mulè
authors.forename: Emilio
authors.initials: E
authors.lastname: Nardi
authors.forename: Anna
authors.initials: A
authors.lastname: Vadalà
authors.forename: Maria C
authors.initials: MC
authors.lastname: Lorito
authors.forename: Marco
authors.initials: M
authors.lastname: Guarneri
authors.forename: Rosalia
authors.initials: R
authors.lastname: Arsena
authors.forename: Alessandro
authors.initials: A
authors.lastname: Palermo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cerasola
mesh_terms: 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
chemical_list: 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