Inflammatory activation and left ventricular mass in essential hypertension

Am J Hypertens. 2009 Apr;22(4):444-50. doi: 10.1038/ajh.2008.369. Epub 2009 Jan 22.

Abstract

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.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Etanercept
  • Female
  • Humans
  • Hypertension / complications
  • Hypertension / pathology*
  • Hypertrophy, Left Ventricular / complications
  • Hypertrophy, Left Ventricular / pathology*
  • Immunoglobulin G / blood
  • Inflammation / complications
  • Inflammation / physiopathology*
  • Interleukin 1 Receptor Antagonist Protein / blood
  • Interleukin-6 / blood
  • Male
  • Middle Aged
  • Receptors, Tumor Necrosis Factor / blood

Substances

  • Immunoglobulin G
  • Interleukin 1 Receptor Antagonist Protein
  • Interleukin-6
  • Receptors, Tumor Necrosis Factor
  • Etanercept