Heart Dysfunction in Essential Hypertension Depends on Systemic Proinflammatory Influences: A Retrospective Clinical...

Area of Science:

• Cardiology
• Internal Medicine
• Inflammation Research

Background:

• Low-intensity systemic inflammation is a key factor in heart failure development.
• Essential hypertension (HTN) is a major risk factor for cardiovascular disease, often associated with cardiac dysfunction.
• Left ventricular diastolic dysfunction (LVDD) is a common complication of HTN, impacting heart function.

Purpose of the Study:

• To investigate serum inflammatory markers (C-reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6)) in middle-aged males and females with essential hypertension.
• To assess the relationship between these inflammatory markers and the severity of left ventricular diastolic dysfunction (LVDD).
• To explore the correlation between the proinflammatory status and exercise tolerance in hypertensive patients.

Main Methods:

• Study included 55 males and 49 females with essential hypertension (grade 1-2) and mild heart failure with preserved ejection fraction.
• Patients were categorized based on LVDD severity (first or second degree) and compared with hypertensive individuals without cardiac dysfunction and a normotensive control group.
• Inflammatory markers (CRP, TNF-α, IL-6) were quantified, and associations with LVDD and 6-minute walk test (exercise tolerance) were analyzed using statistical methods including Mann-Whitney test, ANOVA, and Spearman correlation.

Main Results:

• Hypertensive males exhibited significantly higher levels of CRP, TNF-α, and IL-6 compared to females, though all within reference ranges.
• Patients with second-degree LVDD showed markedly elevated levels of CRP, TNF-α, and IL-6 compared to those with first-degree LVDD, in both sexes.
• Significant negative correlations were observed between inflammatory marker levels (CRP, IL-6, TNF-α) and 6-minute walk test performance in both hypertensive males and females.

Conclusions:

• A strong association exists between the proinflammatory status and the presence and severity of left ventricular diastolic dysfunction in hypertensive patients.
• Inflammatory markers are closely linked to reduced exercise tolerance in individuals with essential hypertension.
• These findings highlight the role of systemic inflammation in the pathogenesis of hypertensive heart disease and its impact on functional capacity, independent of sex.