Markers Of Vascular Inflammation And Vitamin D In The Pathogenesis Of Vascular Wall Remodeling In Female Patients With Arterial Hypertension

Objective: To study the role of markers of vascular inflammation and level of vitamin D as predictors of vascular wall remodeling in female patients with arterial hypertension (AH). Design and method: 111 patients (mean age 58.45 ± 6.26 years) were examined and divided into three groups. Gr.1 included 42 healthy women, Gr.2 - 30 women with AH and low level of vitamin D, Gr.3 - 39 women with AH and normal level of vitamin D. Patients had a median history of AH 12.31 ± 8.91 years. All patients received optimal hypertensive therapy. The parameters of 24-hour blood pressure monitoring; sphygmography: pulse-wave velocity (PWV), ankle-brachia index (ABI); osteodensitometry performed on the spiral computed tomography (standard deviation of the peak T-Score); lipid profile parameters, inflammatory markers (hs-CRP, TNF-alpha, homocysteine, interleukine (IL) 1 β, 6, 8); endothelial dysfunction markers (endothelin-1, nitrites), 25-hydroxy-cholecalciferol (25(OH)D)-vitamin D and hormonal profile (estradiol, progesterone, cortisol and testosterone) were measured. Results: In Gr.1 the levels of lipids, inflammatory markers, vitamin D and sex hormones were within the reference values. The levels of total cholesterol, LDL cholesterol, triglycerides, APO-B, hs-CRP, homocysteine and endothelin-1 have been above the reference value in Gr. 2 and 3. In Gr.2 there were significantly lower levels of sex hormones, higher levels of PWV and mean 24-hour systolic and diastolic blood pressure (SBP, DBP), mean night DBP and night SBP and DBP variability. Besides, there were registered correlations between lipid and inflammatory markers; between PWV and age, history of AH, level of LDL cholesterol, IL 8, hs-CRP, body mass index (positive) and negative correlations with estradiol; between vitamin D and IL8, hs-CRP, speed of morning elevation of DBP, night DBP and SBP variability, PWV-L, testosterone (negative) and positive correlations with Apo-A, T-Score, ABI-L, cortisol (p < 0.05 for all correlations). Conclusions: Raised levels of inflammatory response markers and reduced levels of vitamin D may be part of the pathogenesis of vascular wall remodeling, more significant in postmenopausal women, determining the development of cardiovascular and metabolic complications.