title: Blood pressure in relation to neurogenic, inflammatory and endothelial dysfunction biomarkers in patients with treated essential arterial hypertension.
abstract: OBJECTIVE
  Clinical relevance of relations among blood pressure (BP), inflammation, endothelial dysfunction and sympathetic activation is unknown. Study aimed, whether in patients with diagnosed and treated essential arterial hypertension (HTN) biomarkers of inflammation (hs-C-reactive protein, hs-CRP), endothelial dysfunction (endothelin-1, ET-1), and sympathetic nervous system modulation (epinephrine, E and norepinephrine, NE) could be related to BP values.
  
  
  METHODS
  In 62 patients with diagnosed and treated HTN (mean time of disease 5±3.2 years), serum hs-CRP and ET-1 as well as plasma E and NE concentrations were measured. 24-hour ambulatory blood pressure measurement device (ABPM) was used to estimate efficacy of treatment.
  
  
  RESULTS
  A positive correlation between epinephrine and norepinephrine concentrations was found (r=0.246, p=0.05), however such a statistically significant correlation neither to hs-CRP, nor ET-1 were found. Patients with the highest hs-CRP and NE concentrations had the highest systolic (SBP) and diastolic (DBP) blood pressure values. Similar relation was found in subgroup of patients with suboptimal blood pressure values (SPB ł 130mmHg, DBP ł 80mmHg). In a group of optimal treated patients, elevated levels of ET-1 and NE related to increased blood pressure values. ROC analysis identified ET-1 as statistically significant to diagnose elevated blood pressure: 0.665 (95% Confidence interval 0.512 to 0.796).
  
  
  CONCLUSIONS
  In patients with diagnosed and treated arterial hypertension, there are relations among measurements of hs-CRP, ET-1, NE and blood pressure values in spite of treatment, which may improve understanding of mechanisms involving inflammation, endothelial dysfunction and sympathetic nerve activation and may identify patients with refractory hypertension.
authors.affiliation: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland. agnieszka.tycinska@gmail.com
authors.forename: A M
authors.initials: AM
authors.lastname: Tycinska
authors.forename: B
authors.initials: B
authors.lastname: Mroczko
authors.forename: W J
authors.initials: WJ
authors.lastname: Musial
authors.forename: R
authors.initials: R
authors.lastname: Sawicki
authors.forename: K
authors.initials: K
authors.lastname: Kaminski
authors.forename: H
authors.initials: H
authors.lastname: Borowska
authors.forename: B
authors.initials: B
authors.lastname: Sobkowicz
authors.forename: M
authors.initials: M
authors.lastname: Szmitkowski
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020078:Neurogenic Inflammation / Q000209:etiology*
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators