Adhesion molecules and cell-cytokine complex in vascular remodeling among patients with arterial hypertension and metabolic risk factors

The interaction between intercellular adhesion molecules, pro-inflammatory cytokines as apoptosis agents, and lymphocyte receptors was studied in patients with arterial hypertension (AH) and metabolic disturbances. The study involved 85 AH patients: Group I (AH and obesity, O), Group II (AH, O, and insulin resistance, IR), Group III (AH only). Integral leukocyte indices, intercellular and vascular wall adhesion molecules (ICAM-2, VCAM-1, p-selectin), lymphocyte receptors (CD16, CD25, CD95), pro-inflammatory cytokines (IL-в, IF-г, TNF-б), carbohydrate and lipid metabolism parameters were studied. Increased expression of soluble adhesion molecules sVCAM-1 and sp-selectin was observed in all AH patients, especially in Group II. Decreased levels of apoptosis initiators, CD16+(NK) and CD25+ lymphocytes with high expression of Fas-receptors (CD95) which activate neutrophil apoptosis, were observed, as well as a 2-5-fold increase in TNF concentration - a key factor in inflammation and apoptosis induction. Massive cell death and lipid accumulation is one of the main morphologic characteristics of atherosclerotic plaque, highly prevalent in patients with AH, O, and IR. Intercellular adhesion molecule expression could be regarded as endothelial cell apoptosis predictor

ARTERIAL HYPERTENSION AND LEFT VENTRICULAR REMODELLING IN ELDERLY PATIENTS

In total, 104 elderly patients with arterial hypertension (AH) and 20 healthy controls were examined. Thirty-four individuals had essential AH (EAH), and 70 – isolated systolic AH (ISAH). Statistically significant increase in blood pressure (BP) variability, reduction in night-time diastolic BP (DBP) combined with high systolic BP (SBP) level, and an increase in temporal index and night-time BP drop were maximal in ISAH patients. Disturbed systolic and diastolic left ventricular function was associated with transitory myocardial ischemia (79,7%) and silent night-time ischemia (SNI). SNI was characterised by higher SBP levels, and ISAH – by decreased night-time DBP. In elderly AH patients, cerebral perfusion was reduced, and in ISAH, adaptive and compensatory potential of cerebral vessels was also decreased