The Effect of Hypertension on Inflammatory Reaction in Diseases of Coronary Artery Patients

Atherosclerosis is one of the most encountered causes of death presently in the world and also in Turkey. Atherosclerotic plaque and chronic inflammation are similar in many ways. Hypertension (HT) is the major element of risk. Researches show the relation between HT and chronic inflammation. That is one of the most important elements of risk in cardiovascular diseases and it increases the morbidity and morality significantly. Present symptoms revive these questions: ?Is HT an inflammatory disease? Or does inflammatory process take role in the progression of HT or not??. Understanding the vascular inflammation of HT in the atherosclerotic process may help to determine new cure strategies to decrease the morbidity and mortality and decrease the damage of targeted organs. We suggest a hypothesis that HT may have contribution to the inflammatory process in stable CAD.In our study, patients were distributed in to tree groups each forming of thirty people. Group I includes carries the patients who has only CAD and group II carries the patients who has not only CAD but also HT. HT defined to have the higher blood pressure than 140 mmHg systolic blood pressure or 90 mmHg diastolic blood pressure. Control group (group III) was formed from healthy volunteers in the same age group. The patients who were stimulated while they are eating, exercising practicing, exposed to cold or emotional stress, they get well then they relax or take nitrate pills -which is a typical stable angina pectoris- for minimum 6 weeks were included in to the research. All participants? detailed histories were recorded, physical consultations were performed, 12 derived electrocardiography and transthrocic echocardiography are done. Some of the patients when necessary underwent exercise stress test under the Bruce protocol. All patients in group I and group II had coroner angiographies. CAD is described as 70% or higher tightness in any coroner vessel. The blood has taken from all patients after minimum 12 hours of hunger and after 5 minutes resting. The levels of hs-CRP, IL-1ß, IL-6, IL-10 and TNF-? were measured with inflammatory markers.In our studies, when the control group was compared to both other CAD group and CAD+HT group; hs-CRP, IL-1ß, IL-6 and TNF-?, blood levels which are the symptoms of the inflammation, were higher. These differences were statistically quite significant. However, when the groups CAD and CAD+HT compared among them, inflammatory markers in CAD+HT group were higher but it was not statistically significant.All the hypertensive patients who form Group II our group take antihypertensive treatment, therefore blood pressure values were relatively under control. Value of blood pressure in our study was lower than the previous studies, which show low degreed inflammation in hypertensive patients. Besides, all of our patients take antihypertensive treatment, and 87% of them take angiotensin converting enzyme inhibitor (ACE-I) or angiotensin receptor blocker (ARB). The system of renin angiotensin aldesteron?s end product is angiotensin II (ATII). ATII especially has proinflamatory effects though AT type-1 receptors, and ACE-I and ARBs can decrease these negative effects of ATIIIn conclusion, even if it is stable, the inflammatory response was determined higher in CAD group according to the control group even the patients were stable. However, additive effect of HT on inflammatory processes can not be demonstrated. Use of ACEI or ARB as an antihypertensive treatment in stable CAD, may decrease the inflammatory response.