Increased plasma neopterin levels are associated with reduced endothelial function and arterial elasticity in hypertension

Abstract

Inflammation has been shown to play a pivotal role in the pathogenesis and development of hypertensive vascular injury. Neopterin is a novel marker of immune activation produced mainly by activated macrophages. Few data are available to show the association between neopterin and vascular function in hypertension. The present study was designed to investigate the relationship between neopterin levels related to arterial stiffness and endothelial function in patients with hypertension, and their changes after blood pressure-lowering treatment. Twenty-four hypertensive patients and 30 age- and gender-matched healthy volunteers were recruited. Plasma neopterin levels were higher in hypertensive patients compared with their counterparts (log-neopterin: 0.77±0.18 versus 0.61±0.16, P=0.003). Increased neopterin levels were correlated with increased brachial-ankle pulse wave velocity (baPWV; control: r=0.659, P<0.001; hypertension: r=0.487, P=0.021), and inversely associated with impaired brachial flow-mediated dilation (FMD; control: r=-0.735, P<0.001; hypertension: r=-0.557, P=0.005). Fifteen hypertensives received 3 months of standard antihypertensive treatment. Three months later, their plasma neopterin levels decreased (log-neopterin: 0.63±0.17 versus 0.50±0.19, P=0.001), whereas arterial elasticity (baPWV: 1764±101 versus 1685±96 cm s(-1), P=0.272) and endothelial function (FMD: 5.92±1.43% versus 7.73±1.31%, P<0.05) were improved. The decline in neopterin levels was linearly correlated with baPWV decrease (r=0.800, P<0.001), FMD improvement (r=0.670, P=0.006) and blood pressure reduction (r=0.548, P=0.042). Our present study demonstrated for the first time that neopterin is closely correlated with vascular dysfunctions, and measurement of plasma neopterin levels might be used as a surrogate biomarker for the clinical evaluation of vascular damage and risk stratification of future atherosclerotic cardiovascular disease in patients with hypertension.

Inflammation Is Strongly Associated With Cardiorespiratory Fitness, Sex, BMI, and the Metabolic Syndrome in a Self-reported Healthy Population: HUNT3 Fitness Study

“…Previous studies have also shown that CRP is not correlated to FMD 30 . One study reported an inverse correlation between neopterin and FMD in hypertensives and a control group 31 , whereas another study found no correlation of FMD with neopterin in patients with coronary artery disease 32 . However, both these studies were small, including 54 and 30 participants, respectively.…”

Relationship between neutrophil/lymphocyte ratio and epicardial fat tissue thickness in patients with newly diagnosed hypertension

“…For this purpose, arterial stiffness and an increased carotid intima–media thickness are used as markers of subclinical atherosclerosis in hypertensive patients. 9 , 10 Unfortunately, no study has focused on the importance of EFT and the NLR in hypertensive patients. Thus, in the present study, EFT and the NLR were compared between hypertensive patients and a control group.…”

Association of plasma neopterin with risk of an inpatient hospital diagnosis of atrial fibrillation: results from two prospective cohort studies

“…It has been suggested that neopterin participates in the modulation of ROS‐mediated processes and activates the ROS‐sensitive transcription factor NF‐κB . In addition, neopterin is suggested to be linked to other pathological processes such as nitric oxide‐dependent apoptosis , fibrosis within the atria , and endothelial dysfunction , which may alter AF substrates and trigger AF.…”