Introduction: Hypertension and kidney function are closely related. However, there are few studies on renal function during acute elevation of blood pressure (BP), denominated hypertensive crisis (HC). Objectives: To evaluate the relationship between renal function and inflammatory cytokines in HC, subdivided into hypertensive urgency (HUrg) and emergency (HEmerg). Methods: 74 normotensive subjects (NT), 74 controlled hypertensive (ContrHT), 50 patients with HUrg and 78 with HEmerg were studied. The glomerular filtration rate (eGFR) was estimated, and cytokine levels were measured. Statistical analysis was performed using the Kruskal-Wallis or Mann-Whitney test and Spearman's correlation, with significant differences p-value <0.05. Results: The eGFR was significantly lower in HEmerg group compared to the NT, ContrHT and HUrg groups. All cytokines were significantly elevated in patients with HC compared to the control groups (NT and ContrHT). In addition, the cytokines interleukin (IL)-1β, IL-6 and IL-10 were higher in the HEmerg group compared to the HUrg groups. There was a negative correlation between eGFR and the cytokines (IL-6, IL-8, IL-10 and TNF-α) in the HEmerg group. Conclusions: Elevated inflammatory cytokines are associated with reduced eGFR in individuals with HEmerg, indicating an involvement of the inflammatory process in the pathogenesis of acute elevations of BP.

Objective: To evaluate arterial stiffness (AS) and lipids transfer to high density lipoprotein cholesterol (HDL-c) in ischemic stroke due to hypertensive emergency (IS-HE). Methods: Thirty and one patients with IS-HE, 33 individuals with ischemic stroke without hypertensive emergency (IS), 31 controlled hypertensive (CHT) and 33 normotensive (NT) individuals were studied. AS was assessed by analyzing the pulse wave velocity (PWV), augmentation index and central blood pressure. The lipids transfer to HDL-c was evaluated after incubation of the plasma with an artificial radiolabeled nanoparticle, used as a donor of esterified and non-esterified cholesterol. Cholesterol transfer was measured in the HDL-c fraction, after chemical precipitation of lipoproteins containing apolipoprotein B. Results: Systolic (SBP) and diastolic (DBP) blood pressure were significantly higher in the IS-HE compared to IS, CHT and NT groups (190/110 mmHg vs 140/87, 128/69 and 129/80 mmHg, respectively; p<0.05). Similarly, central SBP and DBP were higher in patients with IS-HE compared to IS, CHT and NT (147/101 mmHg vs 128/90, 118/71 and 120/83 mmHg, respectively; p<0.05). PWV was significantly higher in the groups IS-HE and IS, compared to NT group (9.7 and 10.6 vs 7.8 m/s, respectively; p<0.05). The esterified cholesterol transfer was reduced in the IS-HE and IS groups in relation to the CHT and NT groups (4.19 and 3.76 vs 4.5 and 4.75, respectively; p<0.05). The non-esterified cholesterol transfer was also markedly decreased in IS-HE e IS groups compared to CHT and NT groups (4.57 and 4.06 vs 5.47 and 5.71, respectively; p<0.05). A negative correlation was observed between non-esterified cholesterol transfer and PWV in the IS-HE group. Conclusion: This study provides evidence that high blood pressure levels are associated to arterial stiffness and a marked decrease in the lipids transfer to HDL-c in patients with ischemic stroke due to hypertensive emergency, which indicates that changes in the HDL-c fraction can contribute to atherogenesis in these patients. These considerations contribute to the concept that determining HDL-c functionality with dynamic assays can be relevant for predicting the cardiovascular disease risk.

Objective: This study evaluates the association of expression of microRNAs (miRNAs) 221/222 and lipid transfer in ischemic stroke (IS) patients due to hypertensive emergency (HE). Methods: Thirty and one patients with IS due to hypertensive emergency (IS-HE), 33 individuals with IS without HE (IS), 31 controlled hypertensive (CHT) and 33 normotensive (NT) individuals were studied. The expression of miRNAs was performed by RT-q PCR (real-time quantitative polymerase chain reaction). The lipid transfer to high density lipoprotein cholesterol (HDLc) was evaluated after incubation of the plasma with an artificial nanoparticle used as a donor of esterified and non-esterified cholesterol, radiolabelled. Cholesterol transfer was measured in the HDLc fraction, after chemical precipitation of lipoproteins containing apolipoprotein B. Results: Systolic and diastolic blood pressure were significantly higher in the IS-HE compared to IS, CT and NT groups (162/99 mmHg vs 140/87, 128/69 and 129/82 mmHg, respectively; p<0.05). The miRNA-221 expression was higher in the IS-HE group compared to the IS, CHT and NT groups (4.23 vs 2.44, 1.35 and 1.05, respectively; p<0.003). MiRNA-222 showed overexpression in the IS-HE and IS groups compared to the CHT group (1.26 and 1.27 vs 0.24, respectively; p<0.0001). The esterified cholesterol transfer was reduced in the IS-HE and IS groups in relation to the CHT and NT groups (4.19 and 3.76 vs 4.5 and 4.75, respectively; p<0.05). Non-esterified cholesterol transfer was decreased in the IS-HE and IS groups compared to CHT and NT groups (4.57 and 4.06 vs 5.47 and 5.71, respectively; p<0.05). There was a negative correlation between miRNA-221 and esterified cholesterol transfer and also with free cholesterol. Conclusions: This study provides evidence of the miRNAs participation in IS-HE, suggesting that the increased expression of miRNAs-221/222 can be a biomarker in cases of IS, mainly associated to HE. In addition, lipid transfer to HDLc is decreased in patients with stroke and hypertensive emergency. This reduction was previously associated with coronary heart disease, but no with stroke. Therefore, HDLc functions can be reduced in ischemic stroke by hypertensive emergency, which can also contribute to atherogenic process.