Abstract 1584: Subclinical Inflammation and Hypoadiponectinemia have an Additive Detrimental Effect on Aortic Stiffness in Essential Hypertensive Patients: A “Double-Edged Sword” of Vascular Damage
Introduction: Low-grade inflammation and arterial stiffening are associated with atherosclerosis progression, while adiponectin acts as an endogenous antiatherogenic factor.
Hypothesis: The combination of increased high-sensitivity C-reactive protein (hs-CRP) levels with hypoadiponectinemia may exert an unfavorable effect on aortic stiffness in essential hypertensives.
Methods: In 267 untreated patients with stage I-II essential hypertension (177 men, aged 50 years, office blood pressure (BP) =147/95 mmHg) aortic stiffness was evaluated on the basis of carotid to femoral pulse wave velocity (PWV), by means of a computerized method (Complior SP). Moreover, venous blood samples were drawn for estimation of lipid profile, hs-CRP and adiponectin levels. The distributions of hs-CRP and adiponectin were split by the median (1.3 mg/L and 7.8 μg/ml, respectively) and accordingly subjects were stratified into those with high and low values.
Results: Patients with high (n=134) hs-CRP compared to those with low hs-CRP (n=133) values exhibited greater PWV (8.2±1.3 vs 7.4±1.1 m/sec, p<0.0001), whereas patients with low (n=134) adiponectin compared to those with high (n=133) adiponectin levels had higher PWV (8.3±1.3 vs 7.4±0.9 m/sec, p<0.0001). Multiple stepwise regression analysis revealed that age (b=0.04, p<0.0001), 24-h systolic BP (b=0.168, p<0.009), hs-CRP (b=0.203, p<0.002) and adiponectin (b=0.172, p<0.008) were independent predictors of PWV. In patients with low hs-CRP, hypoadiponectinemia (n=46) compared to high adiponectin (n=87) was accompanied by increased PWV (7.8±1.2 vs 7.1±0.9 m/sec, p<0.0001). Similarly in patients with high hs-CRP, hypoadiponectinemia (n=84) compared to high adiponectin (n=50) was related to heightened PWV (8.5±1.3 vs 7.8±1.2 m/sec, p<0.004). Analysis of covariance revealed that PWV values remained different between groups after adjustment for confounders (p<0.05 for all).
Conclusions: In hypertensives, hypoadiponectinemia in conjunction with pronounced low-grade inflammation exerts an additive unfavorable effect on aortic stiffness. This finding suggests that co-estimation of hs-CRP and adiponectin may contribute to a better identification of patients with accelerated vascular ageing.