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European Heart Journal Advance Access originally published online on April 19, 2007
European Heart Journal 2007 28(9):1162-1169; doi:10.1093/eurheartj/ehm089
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Low-grade inflammation and hypoadiponectinaemia have an additive detrimental effect on aortic stiffness in essential hypertensive patients

Costas Tsioufis1,*, Kyriakos Dimitriadis1, Maria Selima1, Costas Thomopoulos1, Costas Mihas1, Ioannis Skiadas1, Dimitrios Tousoulis2, Christodoulos Stefanadis2 and Ioannis Kallikazaros1

1 Department of Cardiology, Hippokration Hospital, Athens, Greece
2 First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece

Received 12 October 2006; revised 9 March 2007; accepted 15 March 2007; online publish-ahead-of-print 19 April 2007.

* Corresponding author: 43, Agias Marinas Street, 15127 Melissia, Athens, Greece. Tel: +30 210 7704802; fax: +30 210 7704802. E-mail address: ktsioufis{at}hippocratio.gr

Aims: In this study, we investigated the combined effect of increased high-sensitivity C-reactive protein (hs-C-reactive protein) and hypoadiponectinaemia on aortic stiffness in essential hypertensive subjects.

Methods and results: A total of 267 untreated patients with stage I–II essential hypertension underwent ambulatory BP and carotid–femoral pulse wave velocity (c–f PWV) evaluation. The distributions of hs-C-reactive protein and adiponectin were split by the median (1.3 mg/L and 7.8 µg/mL, respectively) and accordingly subjects were stratified into those with high and low values. Patients with high (n = 134) compared with those with low hs-C-reactive protein (n = 133) values exhibited greater c–f PWV levels (by 0.8 m/s, P < 0.0001), whereas patients with low (n = 133) compared with those with high (n = 134) adiponectin levels had higher c–f PWV (by 0.9 m/s, P < 0.0001). Stepwise regression analysis revealed that age, 24 h systolic BP, hs-C-reactive protein and adiponectin were independent predictors of arterial stiffness. In patients with low hs-C-reactive protein, hypoadiponectinaemia (n = 46) compared with high adiponectin (n = 87) was accompanied by increased c–f PWV (by 0.8 m/s, P < 0.0001). Similarly in patients with high hs-C-reactive protein, hypoadiponectinaemia (n = 84) compared with high adiponectin (n = 50) was related to heightened c–f PWV (by 0.7 m/s, P = 0.008).

Conclusion: In essential hypertension, pronounced low-grade inflammation in conjunction with hypoadiponectinaemia exerts an additive detrimental effect on aortic stiffness, accelerating the vascular ageing process.

Key Words: High-sensitivity C-reactive protein • Adiponectin • Aortic stiffness • Hypertension


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