Expression Of Inflammatory Factors In Hypertension And Influence Of Olmesartan On Inflammatory Factors

Background: Aterial hypertension is a polygenic disease involving a major contribution of various inflammation factors. A great deal of evidence suggests that different underlying pathophysiological mechanisms may be involved. Particular attention was given to inflammation factors that are responsible for the pathogenesis of hypertension. Recently, The link between hypertension and inflammatory factors has been strengthened by findings of several studies. The mechanisms are not known for certain but probably initially involve the action of hs-CRP, ICAM-1 and sCD₄₀L. hs-CRP was the symboling factor of inflammation factors. The adhesion of leukocyte on endothelial cell was mediated by ICAM-1,which was the important factor reflecting impairment of vascular and inflammation in endothelial cells. SCD₄₀L , being founded in recent years as a new factors, participate in critical signal pathways of inflammatory process. Thus, we chose hs-CRP, ICAM-1 and sCD₄₀L.as measuring index. Furthermore, Angiotensin II ,the primary effector hormone of the renin - angiotensin system (RAS), play an essential role in the regulation of the cardiovascular system by inducing not only vasocontraction but also inflammatory action. Several results of studies demonstrated an possible anti- inflammation effect of angiotensin II receptor blockers (ARB). Olmesartan was the newest member of ARB and the effect of anti-hypertension was illustrated by animals and clinical experiments. In addition to its anti-hypertensive effect, olmesartansanti-inflammatory action is uncertain. This experiment was to discuss the possible relation between hypertension olmesartan and inflammatory responses.Objective: The aim of the study was (1) to compare the concentration of inflammatory factors including hs-CRP, ICAM-1 and SCD₄₀L between mild-to-moderate hypertensive patients and normal subjects, and to observe the changes of inflammatory factors in hypertensive patients ,so we can assess the relationship between hypertension and inflammation. (2) To elucidate whether there's relation or not between the level of inflammatory factors and blood pressure in patients with hypertension. (3) To study the influence of Olmesartan on hs-CRP, ICAM-1 and SCD40L in hypertension ,estimate whether Olmesartan has Anti-inflammatory action.Methods: Patients( 41 male ,12 femals) with mild-to-moderate hypertension, according to the WHO/ISA criteria, were eligible for inclusion. 20 normal subjects ( 18 male ,6 femals) served as control. Patients with conorary heart disease, diabetes, tumor, pregnancy or already receiving ACEI or Statins were excluded. Blood sample were obtained by standard venipuncture after 12-h fast from total population, Serum were obtained by centrifugation at 3000rpm for 10 min at 4°C and was assayed for hs-CRP, ICAM-1 and SCD40L using by Enzyme-Linked Immunosorbent Assay (ELISA). All patients were started on drug therapy for 8 weeks. The initial olmesartan dose was 20 mg once a day. The dosage was increased to 40 mg after 4 weeks if diastolic blood pressure (DBP)> 90 mmHg. Blood pressure was measured using a standard mercury sphygmomanometer (Korotkoff I and V) with a cuff of appropriate size on the right arm, as well as weight and height measurement were obtained. Serum glocuse and lipid were assayed in our laboratory .Above all measurements were evaluated again by the same methods after 8 weeks.Results: After 8 weeks of treatment, olmesartan reduced blood pressure compared with baseline. There was a significant increase (2.37 + 1.81mg/L vs 0.45 + 0.37mg/L,204.86 ± 489.33ng/ml vs 123.24 ±32.57ng/ml, 5191.72+1144.33pg/ml vs2358.65 + 951.37pg/ml, P<0.01 for all comparisions, respectively) in serum hs-CRP, ICAM-1 and SCD40L. in hypertensive patients compared with controls. In hypertensive patients, there were significantly positive linear correlation between.systolic blood pressure (SDP), diastolic blood pressure (DBP) and hs-CRP ( r=0.63, PO.01;r=0.567, P<0.05, respectively). ICAM-1 correlated with SDP, DBP (r=0.52, PO.01;r=0.567, PO.05, respectively) also.Conclusion: (1) The level of serum hs-CRP, ICAM-1 and SCD40L were significantly increased in patients with mild-to-moderate hypertension., which suggested inflammation played a important role in the development of hypertension. (2) SDP and DBP were all correlated with hs-CRP and ICAM-1 in patients with mild-to-moderate hypertension., which represented the level of hs-CRP and ICAM-1 were associated with blood pressure. (3) There were significant decrease of the concentration of hs-CRP, ICAM-1 and SCD40L after using olmesartan, which suggested olmesartan had anti-inflammatory effect as well as anti- hypertension.