Increased arterial stiffness in resistant hypertension is associated with inflammatory biomarkers

Abstract

Background. Increased levels of inflammatory biomarkers such as interleukin-6 (IL-6), 10 (IL-10), 1β (IL-1β), tumor necrosis factor-α (TNF-α) high-sensitivity C-reactive protein (hs-CRP) are associated with arterial stiffness in hypertension. Indeed, resistant hypertension (RHTN) leads to unfavorable prognosis attributed to poor blood pressure (BP) control and target organ damage. This study evaluated the potential impact of inflammatory biomarkers on arterial stiffness in RHTN. Methods. In this cross-sectional study, 32 RHTN, 20 mild hypertensive (HTN) and 20 normotensive (NT) patients were subjected to office BP and arterial stiffness measurements assessed by pulse wave velocity (PWV). Inflammatory biomarkers were measured in plasma samples. Results. PWV was increased in RHTN compared with HTN and NT (p < 0.05). TNF-α levels were significantly higher in RHTN and HTN than NT patients. No differences in IL-6 levels were observed. RHTN patients had a higher frequency of subjects with increased levels of IL-10 and IL-1β compared with HTN and NT patients. Finally, IL-1β was independently associated with PWV (p < 0.001; R² = 0.5; β = 0.077). Conclusion. RHTN subjects have higher levels of inflammatory cytokines (TNF-α, IL-1β and IL-10) as well as increased arterial stiffness, and detectable IL-1β levels are associated arterial stiffness. These findings suggest that inflammation plays a possible role in the pathophysiology of RHTN.

Key Words::

• Arterial stiffness
• inflammatory cytokines
• pulse wave velocity
• resistant hypertension

Conflict of interest: The authors have no conflicts of interest to declare.

This study was supported by the State of São Paulo Research Foundation (FAPESP), SP, Brazil, National Council for Scientific and Technological Development (CNPq) and Coordination for Improvement of Higher Education Personnel (Capes), Brazil.

Notice of correction

The label on the y-axis of Figure 3 was updated post publication online.