Inflammation in patients with essential hypertension

Introduction: Atherosclerosis and its complications (acute myocardial infarction, stroke, peripheral arterial disease) is a complex pathological process in which inflammation, expressed by the blood levels of C reactive protein (CRP), fibrinogen, or interleukin 6 (IL6), is demonstrated to be a valid risk factor. Epidemiological studies are showing a possible correlation between the systemic and vascular inflammation and the presence of essential arterial hypertension, especially when it is associated with metabolic risk factors (obesity, dyslipidemia, and diabetes mellitus). The aim of this study was to evaluate CRP and fibrinogen as biological inflammatory markers in patients with essential hypertension without or with different cardiovascular risk factors. Methods: We retrospectively analyzed 160 patients hospitalized in Cardiovascular Rehabilitation Clinic, diagnosed with hypertension, comparatively with 40 subjects without hypertension as controls. After assessment of nutritional status (body mass index, abdominal circumference) and measurements of fasting plasma glucose, glycated hemoglobin and glucose tolerance test, patients were introduced in four groups (hypertension – group A, hypertension and obesity – group B, hypertension and non-obese diabetes mellitus – group C, hypertension and obese diabetes mellitus – group D). All patients have been assed clinically, biochemically and have undergone electrocardiography and echocardiography, to analyze the subclinical cardiac involvement. Results: Fibrinogen levels were significantly increased in all hypertension groups as compared to controls (319.5 ± 79.9, p = 0.046 in group A, 363.3 ± 144.4, p = 0.004 in group B, 326 ± 84.7, p = 0.021 in group C and 354.02 ± 85.02, p = 0.001 in group D vs 288.6 ± 53.09 in controls). Among metabolic risk factors, obesity was the strongest predictor of increasing in CRP levels: patients in group B and D had the highest values of CRP (1.56 ± 3.08, p = 0.014 and 0.92 ± 1.11, p = 0.001, respectively, vs 0.3 ± 0.36 in controls). In hypertensive obese patients CRP levels were correlated with total-cholesterol, HDL-cholesterol and diastolic blood pressure. Conclusions: The data collected from the five study groups have shown an obvious link between the inflammatory process and hypertension, fibrinogen and CRP being the most reliable markers for clinical screening. Even if obesity and diabetes were the strongest predictors of inflammation, hypertension alone was demonstrated as a state associated with biological inflammation.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)