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Inflammatory activation in children with primary hypertension

Mieczyslaw Litwin1, Jacek Michałkiewicz, Anna Niemirska

  • 1Department of Research, The Children's Memorial Health Institute, Warsaw, Poland. m.litwin@czd.pl

Pediatric Nephrology (Berlin, Germany)
|May 25, 2010
PubMed

Insights

In children with primary hypertension (PH), elevated inflammatory markers like CRP, MIP-1beta, and RANTES suggest a vascular inflammatory process contributing to target organ damage (TOD). This inflammation may precede broader systemic changes.

Area of Science:

  • Pediatric Cardiology
  • Inflammation Research
  • Vascular Biology

Background:

  • Low-grade inflammation is implicated in primary hypertension (PH) and target organ damage (TOD).
  • Understanding inflammatory profiles in children with PH is crucial for early intervention.
  • Metabolic syndrome (MS) is increasingly recognized in pediatric hypertension.

Purpose of the Study:

  • To evaluate the profile of inflammatory mediators in children with untreated PH.
  • To investigate the relationship between inflammatory markers, metabolic syndrome, and target organ damage in pediatric PH.

Main Methods:

  • Cross-sectional study comparing 44 children with PH to 30 healthy controls.
  • Measurement of inflammatory mediators: CRP, RANTES, MIP-1beta, MIP-1alpha, MCP-1, IL-6, angiogenin, adiponectin.
  • Assessment of metabolic syndrome criteria, body composition (MRI), carotid intima-media thickness (cIMT), and left ventricular mass index.

Main Results:

  • Patients with PH showed higher CRP, MIP-1beta, and RANTES than controls.
  • CRP levels correlated with MS criteria, BMI, visceral fat, and cIMT.
  • RANTES correlated with lipid profiles; angiogenin correlated with BMI and visceral fat.
  • Adiponectin was lower in patients with increased cIMT, suggesting vascular damage.

Conclusions:

  • Elevated RANTES and MIP-1beta in pediatric PH suggest a specific vascular inflammatory process.
  • CRP elevation and its correlations point to systemic inflammation linked to metabolic alterations and early vascular changes.
  • The findings indicate that vascular inflammation may precede systemic inflammatory markers in pediatric PH.

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