title: Tailored antihypertensive drug therapy prescribed to older women attenuates circulating levels of interleukin-6 and tumor necrosis factor-α.
abstract: OBJECTIVE
  To test the hypothesis that antihypertensive drug therapy produces anti-inflammatory effects in clinical practice, this study investigated circulating levels of selected proinflammatory mediators (interleukin-6 [IL-6], tumor necrosis factor-alpha [TNF-α], and interferon-γ [INF-γ]) in response to multivariate drug directions for blood pressure (BP) control.
  
  
  METHODS
  Prospective study involving 110 hypertensive, community-dwelling older women with different metabolic disorders. A short-term BP-lowering drug therapy was conducted according to current Brazilian guidelines on hypertension, and basal cytokine levels were measured before and after intervention.
  
  
  RESULTS
  Interventions were found to represent current hypertension-management practices in Brazil and corresponded to a significant reduction in systolic and diastolic BP levels in a whole-group analysis, as well as when users and nonusers of the most common therapeutic classes were considered separately. Considering all patients, mean IL-6 and TNF-α levels showed a significant decrease in circulating concentrations (P<0.01) at the endpoint compared with baseline, whereas the mean INF-γ level was not significantly different from baseline values. In separate analyses, only users of antagonists of the renin-angiotensin system and users of diuretics exhibited the same significant treatment-induced reduction in serum IL-6 and TNF-α observed in the whole group.
  
  
  CONCLUSIONS
  Our data demonstrates that a clinically guided antihypertensive treatment is effective in reversing the low-grade proinflammatory state of serum cytokines found in postmenopausal women and support extracardiac benefits from diuretics and renin-angiotensin system antagonists.
authors.affiliation: Graduate Program in Health Sciences, University of Brasília, Brasília, Brazil.
authors.forename: Juliana O
authors.initials: JO
authors.lastname: Toledo
authors.affiliation: Graduate Program in Medical Sciences, University of Brasília, Brasília, Brazil ; Graduate Program in Gerontology, Catholic University of Brasília, Brasília, Brazil.
authors.forename: Clayton F
authors.initials: CF
authors.lastname: Moraes
authors.affiliation: Graduate Program in Medical Sciences, University of Brasília, Brasília, Brazil.
authors.forename: Vinícius C
authors.initials: VC
authors.lastname: Souza
authors.affiliation: Graduate Program in Medical Sciences, University of Brasília, Brasília, Brazil.
authors.forename: Audrey C
authors.initials: AC
authors.lastname: Tonet-Furioso
authors.affiliation: Research Center in Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Brazil.
authors.forename: Luís C C
authors.initials: LC
authors.lastname: Afonso
authors.affiliation: Graduate Program in Gerontology, Catholic University of Brasília, Brasília, Brazil.
authors.forename: Cláudio
authors.initials: C
authors.lastname: Córdova
authors.affiliation: Graduate Program in Health Sciences, University of Brasília, Brasília, Brazil ; Graduate Program in Medical Sciences, University of Brasília, Brasília, Brazil.
authors.forename: Otávio T
authors.initials: OT
authors.lastname: Nóbrega
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000494:pharmacology; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000494:pharmacology; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D001938:Brazil; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000494:pharmacology; D004232:Diuretics / Q000008:administration & dosage / Q000494:pharmacology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology*; D018836:Inflammation Mediators / Q000097:blood*; D007371:Interferon-gamma / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008875:Middle Aged; D017698:Postmenopause; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics; D018836:Inflammation Mediators; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D007371:Interferon-gamma
keywords: cytokine; drug therapy; guidelines; hypertension; inflammation; renin–angiotensin system