Relation of C-reactive protein to oxidative stress and to endothelial activation in essential hypertension.

Abstract

Background: C-reactive protein (CRP) predicts cardiovascular outcome. Oxidative stress is considered to be involved in endothelial alteration. We hypothesized that in essential hypertension (EH), oxidative stress, as measured by 8-iso-prostaglandin-F2 alfa (8-iso-PGF2alfa), should be associated with increased CRP and endothelial activation, as evaluated by soluble intercellular adhesion molecule–1 (ICAM-1) and vascular adhesion molecule–1 (VCAM-1) plasma levels. Methods: In 83 subjects with mild EH and in 50 healthy control subjects we measured, in basal conditions, plasma levels of hs-CRP, 8-iso-PGF2 alfa, ICAM-1 and VCAM-1, and tumor necrosis factor–alfa (TNF-alfa). Results: Subjects with EH had higher levels of 8-iso- PGF2 alfa(P < .0001), CRP (P < .001), ICAM-1 and VCAM-1 (P <.001), and TNF- (P < .001) than did control subjects. We divided successively EH according to CRP values (1, 1–3, 3 mg/L), and we observed increasing and significantly different levels of the endothelial parameters and of TNF- along with increasing CRP. Linear analysis of correlation pointed out significant correlation of CRP with 8-iso-PGF2 alfa (r = 0.730, P < .001), ICAM-1 and VCAM-1 (r =0.642 and 0.468, P < .001 respectively), and TNF- alfa (r =0.609, P< .001). Multiple regression analysis using CRP as a dependent variable confirmed the relationship of CRP with systolic blood pressure ( beta = 0.216, P = .039) and with 8-iso-PGF2alfa (beta 0.602, P = .0001). Conclusions: Our data demonstrate that in EH, inflammatory molecules such as CRP and TNF-alfa are increased and related to both oxidative stress and endothelial activation.