Background
There is evidence that subclinical systemic inflammation is present in
resistant hypertension (RHTN).
Objective
The aim of the study was to develop an integrated measure of circulating
cytokines/adipokines involved in the pathophysiology of RHTN.
Methods
RHTN (n = 112) and mild to moderate hypertensive (HTN) subjects (n=112) were
studied in a cross-sectional design. Plasma cytokines/adipokines (TNF-alpha,
interleukins [IL]-6, -8, -10, leptin and adiponectin) values were divided
into tertiles, to which a score ranging from 1 (lowest tertile) to 3
(highest tertile) was assigned. The inflammatory score (IS) of each subject
was the sum of each pro-inflammatory cytokine scores from which
anti-inflammatory cytokines (adiponectin and IL-10) scores were subtracted.
The level of significance accepted was alpha = 0.05.
Results
IS was higher in RHTN subjects compared with HTN subjects [4 (2-6) vs. 3
(2-5); p = 0.02, respectively]. IS positively correlated with body fat
parameters, such as body mass index (r = 0.40; p < 0.001), waist
circumference (r = 0.30; p < 0.001) and fat mass assessed by
bioelectrical impedance analysis (r = 0.31; p < 0.001) in all
hypertensive subjects. Logistic regression analyses revealed that IS was an
independent predictor of RHTN (OR = 1.20; p = 0.02), independent of age,
gender and race, although it did not remain significant after adjustment for
body fat parameters.
Conclusion
A state of subclinical inflammation defined by an IS including TNF-alpha,
IL-6, IL-8, IL-10, leptin and adiponectin is associated with obese RHTN. In
addition, this score correlates with obesity parameters, independently of
hypertensive status. The IS may be used for the evaluation of conditions
involving low-grade inflammation, such as obesity-related RHTN. Indeed, it
also highlights the strong relationship between obesity and inflammatory
process.
Aim. The present study compared the acute effects of aerobic (AER), resistance (RES), and combined (COM) exercises on blood pressure (BP) levels in people with resistant hypertension (RH) and nonresistant hypertension (NON-RH). Methods. Twenty patients (10 RH and 10 NON-RH) were recruited and randomly performed three exercise sessions and a control session. Ambulatory BP was monitored over 24 hours after each experimental session. Results. Significant reductions on ambulatory BP were found in people with RH after AER, RES, and COM sessions. Notably, ambulatory BP was reduced during awake-time and night-time periods after COM. On the other hand, the effects of AER were more prominent during awake periods, while RES caused greater reductions during the night-time period. In NON-RH, only RES acutely reduced systolic BP, while diastolic BP was reduced after all exercise sessions. However, the longest postexercise ambulatory hypotension was observed after AER (~11 h) in comparison to RES (~8 h) and COM (~4 h) exercises. Conclusion. Findings of the present study indicate that AER, RES, and COM exercises elicit systolic and diastolic postexercise ambulatory hypotension in RH patients. Notably, longer hypotension periods were observed after COM exercise. In addition, NON-RH and RH people showed different changes on BP after exercise sessions, suggesting that postexercise hypotension is influenced by the pathophysiological bases of hypertension.
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