Abstract 1626: Selective Mineralocorticoid Receptor Blocker Eplerenone Reduces Inflammatory Biomarkers in Hypertensive Patients
High blood pressure (BP) may stimulate an inflammatory reaction, which in turn might induce the changes in the arterial wall that are characteristic of hypertension. We have recently reported that BP control with the selective mineralocorticoid receptor (MR) blocker eplerenone is associated with reduced stiffness of resistance arteries of hypertensive patients. Here we questioned whether in hypertensive patients BP reduction after one year (1yr) of therapy with either eplerenone or the beta-blocker atenolol is associated with a decreased inflammatory response. Sixteen hypertensive patients (age 30 to 70 yrs) were randomized to double-blind treatment for 1yr with eplerenone (50–100 mg) or atenolol (50–100 mg) once daily. Seven normal subjects were studied as a control group. Serum levels of cytokines (IL-1β, IL-6, IL-8, IL-10, IL-1Ra), chemokines (MCP-1), and fibroblast growth factor (FGF) were measured by Bio-plex assay, and osteopontin by ELISA, as indices of systemic and vascular inflammation, before and 1yr after treatment. After 1yr of treatment, systolic and diastolic BP were well controlled in both the atenolol and eplerenone groups (144.3±3.7/95.4±1.8mmHg reduced to 121.4±3.1/79.2±2.6 mmHg, p<0.05; 141.8±3.6/90.0±1.1mmHg reduced to 129.1±2.0/ 84.5±1.4mmHg, p<0.05, respectively). Serum levels of all inflammatory markers before treatment were comparable in the two groups. The pro-inflammatory cytokine IL-8, the anti-inflammatory cytokine IL-10, MCP-1, FGF, and osteopontin were reduced significantly by eplerenone (1–2 fold vs pre-treatment, p<0.05) and tended to be reduced, albeit not significantly, by atenolol. The anti-inflammatory IL-1Ra was reduced significantly by atenolol (1–2 fold vs pre-treatment, p<0.05) and slightly reduced by eplerenone. IL-1β and IL-6 levels were partially reduced albeit not significantly by both treatments. In conclusion, our findings suggest that 1yr of antihypertensive treatment particularly with eplerenone improves global inflammatory status in hypertensive patients. Such effect is consistent with eplerenone-induced reduction of vascular stiffness in hypertensive patients that may contribute to cardiovascular protection obtained through treatment with MR blockers.