C-reactive protein and intercellular adhesion molecule-1 are stronger predictors of oxidant stress than blood pressure in established hypertension

Background Oxidant stress is implicated in the pathogenesis of atherosclerosis in cardiovascular diseases. Our aim was to test oxidative stress, as 8-iso-prostaglandin F2 alpha (8-iso-PGF2 alpha), and its relationship with inflammation markers C-reactive protein (CRP) and tumour necrosis factor-alpha (TNF alpha), and endothelial activation assayed as soluble intercellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1 in essential hypertension. Methods In 216 essential hypertensive patients and 55 healthy control individuals, plasma levels of high-sensitivity CRP and TNF alpha, 8-iso-PGF2 alpha, ICAM-1 and VCAM-1 were measured in basal conditions. Moreover, basal and 24-h ambulatory blood pressure monitoring measurements were obtained. Results Essential hypertensive patients showed higher levels of 8-iso-PGF2 alpha (P < 0.0001), high-sensitivity CRP, TNF alpha, ICAM-1 and VCAM-1 (P < 0.001, respectively) than control individuals. In control individuals, 8-iso-PGF2 alpha correlated only with high-sensitivity CRP (P < 0.001). In essential hypertensive patients, 8-iso-PGF2 alpha correlated with high-sensitivity CRP (P < 0.000001), TNF alpha (P < 0.0001), ICAM-1 (P < 0.000001), VCAM-1 (P < 0.0001) and blood pressure. The multiple regression analysis considering 8-iso-PGF2 alpha as the dependent variable showed that in essential hypertensive patients the independent predictors of 8-iso-PGF2 alpha were ICAM-1, high-sensitivity CRP (P < 0.00001, respectively), and TNF alpha (P=0.028). Conclusion Our findings demonstrate that oxidant stress is increased in essential hypertension, and relates to inflammation and endothelial activation. Factors other than blood pressure are stronger predictors of oxidant stress. J Hypertens 25:423-428 (c) 2007 Lippincott Williams & Wilkins.