Abstract P306: Inflammatory Biomarkers Participate in Physiopathology of Hypertensive Crisis

Abstract

Background: Recent evidence suggests the existence of an underlying inflammation process to vascular disease associated with chronic high blood pressure (BP), playing an important role in the pathophysiology of hypertension (HT). However, few studies show the participation of the inflammatory process in the pathophysiology of acute BP elevation. Objectives: To identify clinical and metabolic profile of presentation of hypertensive crisis (HC) divided into hypertensive urgency (HUrg) and emergency (HEmerg); 2 - To assess the involvement of inflammatory cytokines: IL-1β, IL-6, IL-8, IL-18, TNF-α and anti-inflammatory IL-10 in subjects with HC. Methods: We studied 274 individuals: 74 normotensive (NT), 74 controlled hypertensive (CHT), 50 HUrg and 78 HEmerg. Serum levels of cytokines were made by MULTIPLEX and ELISA techniques. Analysis of variance was used to compare the groups, with significant p-value <0.05. Results: The diastolic BP and heart rate were greater in the HC group (120mmHg and 85bpm, respectively) compared to the CHT group (75mmHg and 68 bpm, respectively; p<0.05). Individuals with HEmerg were older. Glycaemia was significantly higher in the HEmerg group (113mg/dL) in comparison to NT and CHT (91mg/dL and 98mg/dL, respectively; p<0.05). HDL-c was significantly lower in HEmerg group compared to the NT group (p=0.0088). Potassium levels were lower in HEmerg group compared to the other groups NT, CHT and HUrg (p=0.0118, p=0.036 and p=0.036; respectively). All measured cytokines were significantly greater in subjects who had HC compared to NT and CHT groups. Logistic regression showed that IL-1β, IL-6, IL-8 and IL-18 were predictors for HC development with odds ratios of: 4.29 (2.01 - 9.19), 11.02 (3.98 - 30.45), 22.56 (7.99 - 63.64) and 3.85 (1.85 - 8.02), respectively. Conclusions: The levels of inflammatory cytokines (IL-1β, IL-6, IL-8 and IL-18) and anti-inflammatory (IL-10) are higher in HUrg and HEmerg groups compared to NT and CHT groups. This suggests the involvement of inflammatory cytokines in the pathogenesis of acute hypertensive event.