Relationship Between Inflammation And Endothelium Function Biomarkers And Ischemic Electrocardiogram Manifestation Among Hypertensives

Objective :Investigate the relationship between inflammation and Endothelium function biomarkers including vascular cell adhesion molecule-1(VCAM-1), intercellular adhesion molecule-1 (ICAM-1), endothelial selectin(E-selectin), C-reactive protein(CRP), rennin activity (RA), angiotensin II (Ang II) and ischemic electrocardiogram manifestation (IEM) among Hypertensives in Mongolian Population, and provide evidence for relationship between inflammation and endothelium function biomarkers and myocardial ischemic, and provide basis for prevention and control for cardiovascular disease in population.Methods Based on a cross sectional study on hypertension in Mongolian population, electrocardiogram examination was conducted, and VCAM-1, ICAM-1, E-selectin, CRP, Plasm rennin activity (PRA) and angiotensin II (Ang II) in serum were examined for 468 hypertensives. Epidata3 software was used to setup databank, and SPSS 13.0 Microsoft was used to analyze the data. The participants were divided into IEM (Ischemic electrocardiogram manifestation) and NIEM (None ischemic electrocardiogram manifestation ) groups, and distributions of clinical characteristics and risk factors were described in the two groups. Single and multiple logistic regression analysis were used to calculate odds ratios (ORs) and 95% confident intervals (95% CI) of IEM associated with the levels of various inflammation and endothelium dysfunction biomarkers, and tendency test was conducted.Results Systolic / diastolic BP in subjects with IEM were higher than that in those with NIEM (IEM vs. NIEM: 158/99mmHg vs.147/97mmHg), all P<0.01. Subjects with IEM had higher level of CRP(10.01 mg /L) than those with NIEM (7.15 mg/L), and the rate of high CRP (≥8.32 mg/L) was higher in subjects with IEM than that in those with NIEM(34.3% vs. 19.5%), P<0.05. There were no significant difference in VCAM-1, ICAM-1, E-selectin, Ang II levels and PRA between subjects with IEM and NIEM (VCAM-1: 349.3 vs. 366.8ng/ml; ICAM-1: 299.1 vs. 299.5 ng/ml; E-selectin: 24.02 vs. 22.95 ng/ml; PRA: 1.373 vs. 1.378 pg/ml;Ang II: 51.3 vs. 53.0 ng/ml.h), P>0.05.By multivariate logistic analysis,the ORs of IEM associated with CRP of 4.28～5.57 mg/L, 5.58～8.31 mg/L and≥8.32 mg/L were 1.388(0.740-2.407),1.365(0.720 -2.461) and 3.279(1.680-6.399), respectively, after adjustment for other factors compared with CRP<4.28 mg/L, the OR for CRP>8.32 mg/l . was significant, P<0.001. By trend test, there was a tendency that risk of IEM increased with CRP level, P<0.01.The ORs of IEM associated with 286.88～356.01, 356.02～422.80 and≥422.81ng/ml of VCAM-1 were 1.173(0.687-2.004),0.734(0.421-1.280) and 0.831(0.474-1.454), respectively, but not significant(all p>0.05), after adjustment for other factors, compared with VCAM-1<286.88 ng/ml. The ORs of IEM associated with 236.58～292.67, 292.68～361.17 and≥361.18 ng/ml of ICAM-1 were 1.132(0.658-1.949), 0.756(0.433-1.321) and 1.096(0.628-1.914), respectively, but not significant(all p>0.05), after adjustment for other factors, compared with <236.58 ng/ml. The ORs of IEM associated with 15.18～19.54,19.55～28.62 and≥28.63 ng/ml of E-selectin were 1.01 (0.57-1.80),0.94 (0.51-1.71)and 1.28(0.70-2.32), respectively, but not significant(all p>0.05), after adjustment for other factors, compared with <15.18 ng/ml.The ORs of IEM associated with 1.108～1.379, 1.380～1.834,≥1.835 ng/ml.h of PRA were 0.864(0.493-1.516), 0.882(0.501-1.554) and 1.056(0.603-1.849), respectively, but not significant(all p>0.05), after adjustment for other factors, compared with <1.108 ng/ml.h.The ORs of IEM associated with 38.2～52.4,52.5～72.9 and≥73.0 pg/ml of Ang II were 1.670 (0.950-2.937),0.950 (0.526-1.715) and1.306 (0.733-2.328), respectively, but not significant(all p>0.05), after adjustment for other factors, compared with <38.2 pg/ml.Conclusion: In Mongolian population, systolic and diastolic BP, especially systolic BP was associated with IEM among hypertensives, which meant that severity of hypertension was related to IEM. among the 6 inflammation and endothelium dysfunction biomarkers including VCAM-1, ICAM-1, E-selectin, CRP, PRA and Ang II, only CRP in serum was associated with IEM among hypertensives.