Inflammatory activation and left ventricular mass in essential hypertension.
BACKGROUND
Inflammation is an independent risk factor for high blood pressure, and as a consequence inflammatory cytokines could be related with left ventricular hypertrophy (LVH). We sought to assess the association and predictive role of different cytokine levels with LVH in a group of patients with essential hypertension (HT).


METHODS
We studied 251 asymptomatic hypertensive patients (142 with LVH and 109 without LVH), referred from 11 hospitals. A routine physical examination, laboratory analyses, and echo-Doppler study were performed. Plasma soluble tumor necrosis factor (TNF) receptors (sTNF-R1 and sTNF-R2), interleukin-6 (IL-6), and interleukin-1 receptor antagonist (IL-1ra) were centrally determined.


RESULTS
Hypertensive patients with LVH had higher inflammatory cytokine levels than the group without hypertrophy (P < 0.001). Multivariate linear regression reported that sTNF-R1 (P < 0.01) was an independent predictor of left ventricular mass index (LVMI). All cytokines had significant area under the curves for detection of LVH, but sTNF-R1 has the highest area, 0.71 +/- 0.03 (P < 0.001). Finally, prevalence of LVH was increased in the group of patients with higher cytokine levels, and logistic regression analysis showed that sTNF-R1 (odds ratio = 2.59, 95% CI of 1.14-5.87) was an independent predictor of LVH.


CONCLUSIONS
Cytokine levels were significantly correlated with LVMI in hypertensive patients. The sTNF-R1 was an independent predictor of LVMI. Plasma sTNF-R1 concentrations could be a predictive factor of LVH in patients with essential HT.
Roselló-Lletí
Esther
E
Cardiocirculatory Unit, Research Center, Hospital Universitario La Fe, Valencia, Spain.
Rivera
Miguel
M
Martínez-Dolz
Luís
L
González Juanatey
Jose R
JR
Cortés
Raquel
R
Jordán
Alejandro
A
Morillas
Pedro
P
Lauwers
Catheline
C
Calabuig
Jose R
JR
Antorrena
Isabel
I
de Rivas
Beatriz
B
Portolés
Manuel
M
Bertomeu
Vicente
V
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D000068800:Etanercept; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000473:pathology*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000473:pathology*; D007074:Immunoglobulin G / Q000097:blood; D007249:Inflammation / Q000150:complications / Q000503:physiopathology*; D053590:Interleukin 1 Receptor Antagonist Protein / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor / Q000097:blood
D007074:Immunoglobulin G; D053590:Interleukin 1 Receptor Antagonist Protein; D015850:Interleukin-6; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept