Inflammatory markers in essential hypertension and some clinical forms of the coronary heart disease: clinical and predictive value

To study clinical and predictive value of inflammatory markers in patients with essential hypertension and coronary heart disease (CHD) in correlation with serum lipids, haemostatic parameters, and myocardial anatomy. Design and methods. We examined 256 people, including 70 healthy volunteers, 79 hypertensive patients, 82 - with stable angina pectoris II-III functional class, 25 - with myocardial infarction (MI). Serum levels of interleukins (IL) -1, -6, -17, tumor necrosis factor alpha (TNF-α) and C-reactive protein (CRP) were measured by the immunoenzyme method. Blood pressure and Holter monitoring, echocardiography, tredmil-test, serum lipids, biochemical and clinical blood analyses were also performed. Results. The groups differed by the change of the inflammatory cytokines. CRP, TNF-α, Il-1 and -6 were higher in all groups with cardiovascular diseases compared to the controls (p < 0,05). Patients with MI had the highest hs-CRP level- 4,8 ± 3,16 mg/l. No correlation was found between Il-6 and hs-CRP. Higher cytokine levels were found in patients with CHD compared to hypertensives, but the difference was not significant. Hypertensive patients had increased levels of serum cholesterol and low density lipoproteins, compared to the controls (5,8 ± 2,26, 3,7 ± 1,17 versus 4,7 ± 0,18, 2,9 ± 0,45 mmol/l, р = 0,004, р = 0,02, respectively). The performed regression analysis revealed the age, serum cholesterol, TNF-α and Il-6 to be the independent predictors of arterial hypertension. Age, serum cholesterol and hs-CRP are considered to be the independent predictors of CHD. No significant correlations between the peripheral blood cells, inflammatory cytokines and heart structural parameters were found. Conclusion. Chronic asymptomatic inflammation can be mentioned as one of the additive risk factors for essential hypertension and CHD.

arterial hypertension, angina pectoris, myocardial infarction, cytokines

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