RELATIONSHIP BETWEEN DAILY BLOOD PRESSURE PROFILE AND A MARKER OF CHRONIC SYSTEMIC INFLAMMATION IN PATIENTS WITH STAGE 2 ESSENTIAL HYPERTENSION WITH MICROALBUMINURIA
Kharkiv Medical Academy of Postgraduate Education, Ukraine
Сhronic systemic inflammation (CSI) with immune damage of the vessels plays an important role in development and progression of essential hypertension. Immunocompetent cells have the ability to direct the damage and activation of endothelial cells by contact interaction and secretion of cytokines in the intercellular medium, which play a special role in the induction of vascular injury. The kidneys are involved in regulation of blood pressure and the long time they remained an asymptomatic lesion in the form of microalbuminuria (MAU). The method of ambulatory blood pressure monitoring provides important information about the mechanisms of cardiovascular regulation of blood pressure, allowing determination of the circadian rhythm and dynamics over time. The purpose of this study was to investigate the association between CSI markers TFN−?, C−reactive protein, IL−6, IL−10 with the types of circadian blood pressure profile in patients with stage II essential hypertension depending on the levels of MAU. The type of circadian blood pressure was dominated in patients with insufficient degree of nocturnal blood pressure reduction and a significant increase in the number of patients with «dipper» and «night−peaker» profile with an increase of MAU in the considered population. A significant increase in the all CSI markers was observed compared with the reference group, with the difference in the content of TNF−?, IL−6 and the ratio of IL−6/IL−10 by increasing the degree of MAU. The presence of circadian blood pressure type «dipper» had a negative correlation with the content of IL−6, TFN−? and C−reactive protein, such as blood pressure type «non−dipper» positively correlated with the content of IL−6, TFN−? and C−reactive protein. The blood pressure type «night−peaker» had a moderate positive relationship with the content of IL−6, TFN−? and C−reactive protein. It is concluded that elevated levels of CSI markers are an important determinant of formation and progression of arterial hypertension in patients with hypertensive nephropathy. Chronic systemic inflammation markers IL−6, TFN−? and C−reactive protein may serve as indicators of target organ damage in patients with essential hypertension.
Key words: hypertension, chronic systemic inflammation, cytokines, circadian blood pressure monitoring.