Prevalence of resistant hypertension and its relation with plasma lipoprotein-associated phospholipase A2

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL International Journal of Noncommunicable Diseases Pub Date : 2023-01-01 DOI:10.4103/jncd.jncd_80_22
Sriharsha Boppana, Nikhil Ravula, L. S. Simhachalam Kutikuppala, Nagarjuna Sivaraj, C. Raja Hamsa, Sidharth Mahajan, P. Chaitanya
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Abstract

Background: A major modifiable risk factor for cardiovascular disease is hypertension. Resistant hypertension is observed to be associated with an increased likelihood of deleterious effects such as cardiovascular events, cerebrovascular accident, and renal dysfunction. The raised levels of inflammatory cytokines in the plasma like the C-reactive protein (CRP) have previously been observed to be significantly raised in hypertensive patients, but the overlying mechanisms corresponding to these processes remain unknown. Materials and Methods: In essence, this was an observational study with data collected from a population at a specific moment in the time to assess the relationships between the variables analyzed. A total of 200 individuals with arterial hypertension took part in the study. Fasting venous blood was obtained to evaluate plasma lipoprotein-related phospholipase A2 (Lp-PLA2) activity, and baseline data were collected. To diagnose RH, a 24-h ambulatory blood pressure management was done. Results: RH was observed among 100 patients and found to be predominant among males and older individuals, who were smokers and having hypertension for a longer period of time with higher Lp-PLA2 activity. More RH patients used calcium channel blockers and diuretics, while a fewer used angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and statins (P 0.05 for all comparisons). Conclusion: The plasma Lp-PLA2 activity beyond a certain threshold suggests a raised risk of RH, and the statins can help in reducing the RH incidence among persons with high Lp-PLA2 levels.
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顽固性高血压患病率及其与血浆脂蛋白相关磷脂酶A2的关系
背景:心血管疾病的一个主要可改变的危险因素是高血压。据观察,顽固性高血压与心血管事件、脑血管意外和肾功能障碍等有害影响的可能性增加有关。血浆中炎性细胞因子水平升高,如C反应蛋白(CRP),先前已观察到在高血压患者中显著升高,但与这些过程相对应的叠加机制尚不清楚。材料和方法:本质上,这是一项观察性研究,使用在特定时刻从人群中收集的数据来评估所分析变量之间的关系。共有200名动脉高压患者参与了这项研究。采集禁食静脉血以评估血浆脂蛋白相关磷脂酶A2(Lp-PLA2)活性,并收集基线数据。为了诊断RH,进行了24小时动态血压管理。结果:在100名患者中观察到RH,发现RH在男性和老年人中占主导地位,他们是吸烟者,高血压持续时间较长,Lp-PLA2活性较高。使用钙通道阻滞剂和利尿剂的RH患者较多,而使用血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂和他汀类药物的患者较少(所有比较均为0.05)。结论:血浆Lp-PLA2活性超过一定阈值表明RH风险增加,他汀类药物有助于降低Lp-PLA2-高水平人群的RH发生率。
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