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Markers of inflammation, endothelial activation, and arterial stiffness in hypertensive heart disease and the effects of treatment : results from the SILVHIA study

Jekell, Andreas; Malmqvist, Karin; Wallén, N Håkan; Mörtsell, David LU and Kahan, Thomas (2013) In Journal of Cardiovascular Pharmacology 62(6). p.66-559
Abstract

We assessed the contribution of blood pressure (BP), inflammation, and endothelial activation to the development of structural vascular and cardiac changes in hypertension. Furthermore, the effects of antihypertensive therapy were studied. We studied 114 patients with hypertension and left ventricular hypertrophy and 38 matched hypertensive subjects without cardiac hypertrophy and 38 normotensive subjects. The group with hypertension and cardiac hypertrophy were randomized to treatment with an angiotensin receptor blocker (irbesartan) or a beta-adrenergic receptor blocker (atenolol) for 48 weeks. Markers of inflammation (high-sensitive C-reactive protein, interleukin-6, leukocyte counts), vascular function (ambulatory aortic stiffness... (More)

We assessed the contribution of blood pressure (BP), inflammation, and endothelial activation to the development of structural vascular and cardiac changes in hypertension. Furthermore, the effects of antihypertensive therapy were studied. We studied 114 patients with hypertension and left ventricular hypertrophy and 38 matched hypertensive subjects without cardiac hypertrophy and 38 normotensive subjects. The group with hypertension and cardiac hypertrophy were randomized to treatment with an angiotensin receptor blocker (irbesartan) or a beta-adrenergic receptor blocker (atenolol) for 48 weeks. Markers of inflammation (high-sensitive C-reactive protein, interleukin-6, leukocyte counts), vascular function (ambulatory aortic stiffness index, arterial compliance, and pulse pressure), and endothelial activation (E-selectin, intracellular adhesion molecule-1, vascular adhesion molecule-1) were assessed. Markers of inflammation and arterial stiffness were lowest in the normotensive group and highest in patients with hypertensive heart disease; endothelial markers were similar between groups. Inflammation was independently related to BP. Markers of arterial stiffness were independently related to BP and to a lesser extent to left ventricular mass. Antihypertensive treatment improved arterial compliance; inflammatory and endothelial markers remained unchanged. In conclusion, markers of inflammation and arterial stiffness are independently related to BP. Antihypertensive therapy seems to improve arterial stiffness, but effects on markers of inflammation and endothelial activation are small.

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published
subject
keywords
Adrenergic beta-Antagonists/therapeutic use, Adult, Aged, Angiotensin Receptor Antagonists/therapeutic use, Antihypertensive Agents/therapeutic use, Arteries/drug effects, Atenolol/therapeutic use, Biomarkers/blood, Biphenyl Compounds/therapeutic use, Double-Blind Method, Endothelium, Vascular/drug effects, Female, Humans, Hypertension/drug therapy, Hypertrophy, Left Ventricular/etiology, Inflammation Mediators/blood, Irbesartan, Male, Middle Aged, Tetrazoles/therapeutic use, Vascular Resistance/drug effects, Vascular Stiffness/drug effects
in
Journal of Cardiovascular Pharmacology
volume
62
issue
6
pages
66 - 559
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:84890555711
ISSN
1533-4023
DOI
10.1097/FJC.0000000000000017
language
English
LU publication?
no
id
e0194159-8772-4e27-adbc-16c7a678d1da
date added to LUP
2019-06-03 19:38:33
date last changed
2019-07-02 04:47:18
@article{e0194159-8772-4e27-adbc-16c7a678d1da,
  abstract     = {<p>We assessed the contribution of blood pressure (BP), inflammation, and endothelial activation to the development of structural vascular and cardiac changes in hypertension. Furthermore, the effects of antihypertensive therapy were studied. We studied 114 patients with hypertension and left ventricular hypertrophy and 38 matched hypertensive subjects without cardiac hypertrophy and 38 normotensive subjects. The group with hypertension and cardiac hypertrophy were randomized to treatment with an angiotensin receptor blocker (irbesartan) or a beta-adrenergic receptor blocker (atenolol) for 48 weeks. Markers of inflammation (high-sensitive C-reactive protein, interleukin-6, leukocyte counts), vascular function (ambulatory aortic stiffness index, arterial compliance, and pulse pressure), and endothelial activation (E-selectin, intracellular adhesion molecule-1, vascular adhesion molecule-1) were assessed. Markers of inflammation and arterial stiffness were lowest in the normotensive group and highest in patients with hypertensive heart disease; endothelial markers were similar between groups. Inflammation was independently related to BP. Markers of arterial stiffness were independently related to BP and to a lesser extent to left ventricular mass. Antihypertensive treatment improved arterial compliance; inflammatory and endothelial markers remained unchanged. In conclusion, markers of inflammation and arterial stiffness are independently related to BP. Antihypertensive therapy seems to improve arterial stiffness, but effects on markers of inflammation and endothelial activation are small.</p>},
  author       = {Jekell, Andreas and Malmqvist, Karin and Wallén, N Håkan and Mörtsell, David and Kahan, Thomas},
  issn         = {1533-4023},
  keyword      = {Adrenergic beta-Antagonists/therapeutic use,Adult,Aged,Angiotensin Receptor Antagonists/therapeutic use,Antihypertensive Agents/therapeutic use,Arteries/drug effects,Atenolol/therapeutic use,Biomarkers/blood,Biphenyl Compounds/therapeutic use,Double-Blind Method,Endothelium, Vascular/drug effects,Female,Humans,Hypertension/drug therapy,Hypertrophy, Left Ventricular/etiology,Inflammation Mediators/blood,Irbesartan,Male,Middle Aged,Tetrazoles/therapeutic use,Vascular Resistance/drug effects,Vascular Stiffness/drug effects},
  language     = {eng},
  number       = {6},
  pages        = {66--559},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Journal of Cardiovascular Pharmacology},
  title        = {Markers of inflammation, endothelial activation, and arterial stiffness in hypertensive heart disease and the effects of treatment : results from the SILVHIA study},
  url          = {http://dx.doi.org/10.1097/FJC.0000000000000017},
  volume       = {62},
  year         = {2013},
}