Dr Vivek Baliga – The role of inflammation in pathogenesis of hypertension

Article by Dr Vivek Baliga

This is a nine-year repeated measures data analysis prospective cohort study that was presented at the American Heart Association scientific sessions 2016.

The underlying hypothesis for the study was that inflammation affects the development of hypertension through changes in the blood vessel or in renal pathophysiology.

The study was a Japanese study that included 3908 middle-aged employees of a construction company. The employees were aged between 41+/-9 years of age and did not have underlying hypertension at the start of the study.

Repeated assessments of blood pressure, ankle brachial pulse wave velocity, radial augmentation index and estimated GFR along with serum C reactive protein levels were studied between the years of thousand 7 to 2015.

Results

Out of the 3900+ patients, 520 of them i.e. 13% developed hypertension. At each annual measurement, it is found that the CRP levels were increased along with the ankle brachial pulse wave velocity is. Higher the ankle brachial velocity, greater was the degree of elevation in the blood pressure every year.

In conclusion, it is found that increased arterial stiffness was associated with elevation of blood pressure in a longitudinal fashion. This increase in the blood pressure eventually led to the development of hypertension. It therefore appears that inflammation plays a prime role in the development of hypertension. The underlying pathophysiology includes enhanced arterial stiffness that progresses in a rapid fashion.

It is important to recognise also that inflammation is the primary underlying reason for the development of atherosclerosis. Atherosclerosis is responsible for enhancing arterial stiffness and ultimately leads to hypertension and coronary artery disease.

If you are patient reading this article, you can understand what atherosclerosis is by reading this article by Dr Vivek Baliga on atherosclerosis.

For more articles on patient care by Dr Vivek Baliga, click here.

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