Abstract 4887: Inflammatory Activation and Left Ventricular Mass in Essential Hypertension
Previous studies on the relationship between left ventricular hypertrophy (LVH) and inflammatory markers in essential hypertension are limited. We sought to assess the association and predictive role of different cytokine levels with LVH in a group of patients with essential hypertension.
Hypothesis: We assessed the hypothesis that inflammation is an independent risk factor for high blood pressure, as consequence inflammatory cytokines could be related with LVH. We studied 251 asymptomatic hypertensive patients (107 with LVH and 144 without LVH), referred from eleven hospitals, and 45 control subjects. A routine physical examination, laboratory analysis and echo-Doppler study were performed. Plasma soluble TNF receptors (sTNF-R1 and sTNF-R2), interleukin-6 (IL-6) and interleukin-1 receptor antagonist (IL-1ra) were centrally determined. Results were expressed in pg/ml. Hypertensive patients had higher inflammatory cytokines levels than control group (p<0.0001), and LVH patients showed the highest markers levels. Multivariate linear regression reported that sTNF-R1 (p<0.0001) and IL-6 (p<0.05) were independent factors of left ventricular mass index. All cytokines had significant area under the curve for detection of LVH, but the best diagnostic factor was sTNF-R1 with an area of 0.70±0.04 (p<0.0001). Finally, prevalence of LVH was increased in group of patients with higher cytokine levels, and logistic regression analysis showed that sTNF-R1 (odds ratio=2.764), IL-6 (odds ratio=2.350) and IL-1ra (odds ratio=3.310) were independent predictors of LVH. In conclusion, cytokine levels were significantly correlated with left ventricular mass index in hypertensive patients. Plasma cytokine concentrations were diagnostic (especially sTNF-R1) and predictor factors of LVH in patients with essential hypertension. These findings support the hypothesis that immune system is closely related with the presence of left ventricular hypertrophy in essential hypertension.