Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2012;65:819-25 - Vol. 65 Num.09 DOI: 10.1016/j.rec.2012.03.019

Inflammation and Apoptosis in Hypertension. Relevance of the Extent of Target Organ Damage

Pedro Morillas a,, Helder de Andrade a, Jesus Castillo a, Juan Quiles a, Vicente Bertomeu-González a, Alberto Cordero a, Estefanía Tarazón b, Esther Roselló b, Manuel Portolés b, Miguel Rivera b, Vicente Bertomeu-Martínez a

a Unidad de Hipertensión Arterial, Servicio de Cardiología, Hospital Universitario de San Juan, Sant Joan d́Alacant, Alicante, Spain
b Centro de Investigación, Hospital Universitario La Fe, Valencia, Spain

Keywords

Systemic arterial hypertension. Inflammation. Apoptosis.

Abstract

Introduction and objectives

To investigate the relationship between inflammatory and apoptotic parameters and the severity and extent of target organ damage in patients with essential hypertension.

Methods

We studied 159 consecutive patients with treated essential hypertension. An exhaustive evaluation of damage to heart, kidney, and blood vessels was performed and plasma levels of inflammatory (interleukin 6 and soluble receptor of tumor necrosis factor-alpha type 2) and apoptotic markers (soluble receptor of tumor necrosis factor-alpha type 1 and soluble Fas receptor) were determined. Patients were categorized into four groups: a) no organ damage (33 patients); b) 1 organ damaged (52 patients); c) 2 organs damaged (44 patients), and d) 3 organs damaged (30 patients).

Results

Serum levels of interleukin 6, soluble receptor of tumor necrosis factor-alpha type 1 and soluble receptor of tumor necrosis factor-alpha type 2 were higher in patients with target organ damage than in hypertensive patients without organ damage. Increasing levels of these molecules were progressively associated with an increase in the number of organs damaged, and the highest levels were observed in the group with damage to 3 organs (heart, kidney, and blood vessels). There were no differences in soluble Fas receptor levels between groups. Logistic regression analysis showed that age, smoking, diabetes mellitus, abdominal circumference, interleukin 6, and soluble receptor of tumor necrosis factor-alpha type 1 were independently related to the number of target organs damaged.

Conclusions

Extensive hypertensive disease with involvement of more target organs was associated with greater inflammatory and apoptotic activation in these hypertensive patients.

1885-5857/© 2012 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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