Effect of Mono- And Combination Antihypertensive Therapy on the Systemic Inflammation Activity in Hypertensive Patients

L.A. Mischenko, H.M. Bozhenko, O.O. Matova, V.V. Radchenko, M.P. Mospan

Abstract


The aim of the study is to assess the impact of mono- and combination antihypertensive therapy on parameters of systemic inflammation (C-reactive protein, CRP, interleukin 6, IL-6 and tumor necrosis factor α, TNF-α) relative to the dynamic of ambulatory blood pressure.
The study involved 99 patients with essential hypertension (EH) stage I–II, grade I–II who were randomized into 3 treatment groups: 29 patients received monotherapy with telmisartan 40–80 mg/day, 27 persons received S-amlodipine 5 mg/day and 43 patients got a fixed combination of valsartan with amlodipine 160/5 mg/day). Levels of CRP, IL-6 and TNF-α were determined before (after the 7-day non-drug period) and after 6 months of treatment.
It was found that treatment with telmisartan reduces serum CRP level by 13.9 % and IL-6 by 36.4 %, but does not affect the blood concentration of TNF-α. Monotherapy with calcium antagonist S-amlodipine results in reduction of blood levels of inflammatory cytokines IL-6 by 39 % and TNF-α by 11.9 %. The use of a fixed combination of valsartan with amlodipine produces a more significant antihypertensive effect, but it is not accompanied by more expressive reduction of CRP and IL-6 levels than under monothe­rapy, which accounted for 12.5 and 31.5 %.
Blood pressure reduction is associated with the decrease of acti­vity of low-grade inflammation. Reduction of serum concentration of TNF-α correlates with a decrease of systolic and diastolic BP at day- and night-time, and reduction of CRP associates with changes in 24-hour and average daily systolic BP, 24-hour SBP index and its night-time variability.
Our data confirm that monotherapy with angiotensin II receptor blockers (telmisartan) and calcium antagonists (S-amlodipine) reduces activity of low grade inflammation and when used its combinations (valsartan with amlodipine). This effect directly correlates with a decrease in ambulatory blood pressure indexes.


Keywords


hypertension; blood pressure; systemic inflammation; C-reactive protein; interleukin 6; tumor necrosis factor α; antihypertensive therapy

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DOI: https://doi.org/10.22141/2224-1485.1.45.2016.74141

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