INVESTIGATING A CORRELATION BETWEEN THE LEVELS OF PERIPHERAL BLOOD CYTOKINES AND THE RISK FOR CARDIOVASCULAR COMPLICATIONS IN PATIENTS WITH STAGE II ESSENTIAL HYPERTENSION

Essential hypertension (EH) is one of the most common modifiable risk factors for cardiovascular diseases and death. The aim of this study was to investigate a correlation between the levels of some cytokines (interleukins, adhesion molecules, tumor necrosis and growth factors, etc.) in the peripheral blood of patients with stage II EH and the rate of complications (myocardial infarction, acute cerebrovascular events, and transient ischemic attacks) occurring in a 5-year follow-up period. Twenty-eight cytokines were measured using ELISA, including IL1 beta, ILi alpha, IL1 ra, IL18, IL18BP, IL37, IL6, sIL6r, LIF, sLIFr, IGF-1, IGFBP-1, TNF alpha, sTNF-RI, sVCAM-1, IL17, IL2, IL4, IL10, TGF-beta 1, IL8, CX3CL1, CXCL10, INF gamma, M-CSF, IL34, VEGF-A, and erythropoietin, and a few vasoactive peptides, including NO, iNOS, eNOS, ADMA, SDMA, Nt-proCNP, and Nt-proBNP, in the peripheral blood samples of 200 patients with stage II EH who had been suffering from this condition for 10 to 14 years and were receiving comparable therapies to bring their blood pressure down. The patients were followed up for 5 years to keep track of complications. The retrospective analysis revealed that the group of patients who developed complications during the 5-year follow-up period exhibited a decline in the levels of IL1 ra (p < 0.001) and IL10 (p < 0.001) and a rise in IL1 beta (p < 0.001), TNF alpha (p < 0.001) and M-CSF (p < 0.001) in comparison with the group of those who did not develop any complications. The multivariate Cox regession analysis was applied to the following parameters: IL1 beta > 18.8 pg/ml; IL1ra < 511 pg/ml; IL6 > 23.8 pg/ml; IL10 < 26.3 pg/ml; 389 pg/ml < M-CSF < 453 pg/ml; ADMA > 0.86 mu mol/L; total cholesterol > 4.9 mmol/L; LDL> 3.0 mmoVL; HDL in men < 1.0 mmol/L; HDL in women < 1.2 mmoI/L. The analysis revealed that M-CSF in the range from 389 to 453 pg/ml (p < 0.001) and LDL above 3.0 mmoVL (p < 0.01) correlated with an increase in the risk for end-organ damage in stage II EH. Changes in the cytokine levels can be regarded as a predictor of myocardial and cerebral damage in patients with stage II EH. Measurement of peripheral blood M-CSF can be included into the classic risk assessment schemes for the cardiovascular complications in the studied cohort of patients.