Tailored antihypertensive drug therapy prescribed to older women attenuates circulating levels of interleukin-6 and tumor necrosis factor-α

Juliana O Toledo,1 Clayton F Moraes,2,3 Vinícius C Souza,2 Audrey C Tonet-Furioso,2 Luís CC Afonso,4 Cláudio Córdova,3 Otávio T Nóbrega1,2 1Graduate Program in Health Sciences, 2Graduate Program in Medical Sciences, University of Brasília, Brasília, 3Graduate Program in Gerontology, Catholic University of Brasília, Brasília, 4Research Center in Biological Sciences, Federal University of Ouro Preto, Ouro Preto, Brazil Objective: To test the hypothesis that antihypertensive drug therapy produces anti-inflammatory effects in clinical practice, this study investigated circulating levels of selected proinflammatory mediators (interleukin-6 [IL-6], tumor necrosis factor-alpha [TNF-α], and interferon-γ [INF-γ]) in response to multivariate drug directions for blood pressure (BP) control.Methods: Prospective study involving 110 hypertensive, community-dwelling older women with different metabolic disorders. A short-term BP-lowering drug therapy was conducted according to current Brazilian guidelines on hypertension, and basal cytokine levels were measured before and after intervention.Results: Interventions were found to represent current hypertension-management practices in Brazil and corresponded to a significant reduction in systolic and diastolic BP levels in a whole-group analysis, as well as when users and nonusers of the most common therapeutic classes were considered separately. Considering all patients, mean IL-6 and TNF-α levels showed a significant decrease in circulating concentrations (P<0.01) at the endpoint compared with baseline, whereas the mean INF-γ level was not significantly different from baseline values. In separate analyses, only users of antagonists of the renin–angiotensin system and users of diuretics exhibited the same significant treatment-induced reduction in serum IL-6 and TNF-α observed in the whole group.Conclusion: Our data demonstrates that a clinically guided antihypertensive treatment is effective in reversing the low-grade proinflammatory state of serum cytokines found in postmenopausal women and support extracardiac benefits from diuretics and renin–angiotensin system antagonists. Keywords: renin–angiotensin system, cytokine, hypertension, drug therapy, guidelines, inflammation&nbsp

Apoliprotein E genotype is associated with apoliprotein B plasma levels but not with coronary calcium score in very elderly individuals in primary care setting

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Background: Epidemiological surveys indicate the influence of polymorphisms of apolipoprotein (apo) E on plasma lipids and triglyceride-rich lipoprotein levels, with impact on atherosclerotic phenotypes. Aim: We studied the association of classic genotypes of the apoE gene with clinical and biochemical risk factors for atherosclerosis in a segment of the very-old Brazilian individuals, with emphasis on the lipemic profile. Methods: We performed cross-sectional analyses of clinical and laboratory assessments, including cardiac computed tomography, across epsilon 2, epsilon 3 and epsilon 4 carriers of the apoE gene with a convenience sample of 208 participants eligible for prevention against cardiovascular events. Results: When non-epsilon 4 carriers were compared with epsilon 4 carrying subjects, lower levels of ApoB as well as ApoB/ApoA ratios were observed in the former group. Tests between apoE polymorphisms with other clinical/biochemical variables and those with arterial calcification showed no significant differences between groups. Conclusion: The study suggests a possible atherogenic role of the epsilon 4 allele attributable to increased ApoB levels and ApoB/ApoA ratios among very-old subjects in primary care setting. (C) 2014 Elsevier B.V. All rights reserved.5392275278Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)CNPq [471872/2011-3