[The activity of nonspecific inflammation in hypertensive patients]

Abstract

Aim: To study the indices of nonspecific inflammation (C-reactive protein--CRP, interleukine 6--IL-6) in patients with essential hypertension (EH) as compared to a circadian profile of blood pressure (BP); changes of CRP in the course of therapy with indapamide-retard and ACE inhibitor perindopril.

Material and methods: The trial enrolled 81 patients with hypertension of stage I-II, moderate and high risk, aged 45.1 +/- 1.3 years, free of chronic inflammatory disease exacerbation, 2 months and more after acute respiratory diseases and 2-week absence of antihypertensive therapy. CRP was estimated by turbidimetry, IL-6--by ELISA, circadian BP monitoring was made using TM 2421 device. Seventeen patients were randomized to receive ariphon retard (Servier), twenty patients--prestarium. The data were processed with STATISTICA 6 programs.

Results: CRP level in the patients was 7.0 +/- 1.6 mg/l; an elevated CRP concentration (> 3 mg/l) was registered in 55% patients. These patients demonstrated a positive correlation of CRP concentration with the data of 24-h systolic BP (r = 0.37, p < 0.05) and 24-h diastolic BP (r = 0.43, p = 0.003) monitoring, abnormal circadian rhythm of BP (nondippers). IL-6 in the examinees was 6.7 +/- 1.3 pg/ml. An elevated IL-6 concentration was detected in 30%. In such patients a positive correlation was found between IL-6 and 24-h systolic and diastolic BP (r = 0.88; p < 0.05 and r = 0.97; p < 0.01, respectively).

Conclusion: A positive correlation between CRP, IL-6 and BP may evidence for involvement of nonspecific inflammation in the course of EH. Patients with elevated CRP responded to ariphon retard with positive CRP dynamics. This can be explained by a relief of chronic hemodynamic stress. A positive CRP dynamics in response to prestarium can be mediated by block of angiotensin II.