The Comparative Effects of Valsartan and Amlodipine on Vascular Microinflammation in Newly Diagnosed Hypertensive Patients

Abstract

Pentraxin 3 (PTX3) is a new candidate immunoinflammatory marker that has been reported to be associated with cardiometabolic risk factors. We aimed to investigate the effects of valsartan and amlodipine on the PTX3 and C-reactive protein (CRP) levels in patients with essential hypertension. Patients with a newly diagnosed essential hypertension were admitted to our internal medicine outpatient clinic. Patients were randomized to one of the following intervention protocols: calcium channel blocker (amlodipine, 5-10 mg/day) as group A (n = 22; mean age ± standard deviation [SD]: 52 ± 11 year) and angiotensine II receptor blocker (valsartan, 80-320 mg/day) as group B (n = 28; mean age ± SD: 50 ± 14 year). Endothelial dysfunction and systemic inflammation were evaluated with PTX3 and CRP. There was a significant decrease in the level of PTX3 after treatment in two groups (P < .05). Although there was a significant decrease in the level of CRP after treatment in amlodipine group, there was no significant decrease in the levels of PTX3 and CRP after treatment in two groups. There were no significant differences in the systolic and diastolic blood pressure reduction between the two treatment groups. In the treatment of hypertension, prior knowledge of the level of plasma PTX3 could be important in antihypertensive drug choice. C-reactive protein and PTX3 are the markers that have role in vascular inflammation and are found associated with the prognosis of cardiovascular outcomes in many trials. In our study, PTX and CRP levels were decreased when compared to baseline levels.

Other Inflammatory Markers Should Not be Forgetten When Assessing the Neutrophil-to-Lymphocyte Ratio

“…The PTX3, a novel inflammatory marker, plays a major role in vascular microinflammation and endothelial dysfunction, which are listed among the causes of cardiovascular morbidity and mortality and are found associated with the prognosis of cardiovascular outcomes. 6 Furthermore, PTX3 was more closely associated with the complexity and the severity of CAD than high-sensitivity CRP and was found to be an independent predictor for high SS. 7 For this reason, if further studies evaluate the PTX3 level in patients with CAD, it may contribute to the literature.…”

Endocan and Atherosclerosis

“…, Turgay Celik, MD 3 , Cengiz Ozturk, MD 3 , and Atila Iyisoy, MD 3 We read with interest the letter by Aparci et al 1 Endothelial dysfunction and inflammation are related to hypertension (HT). 3,4 Carotid intima-media thickness (cIMT) is associated with inflammation, 5 and high-sensitivity C-reactive protein (hsCRP) is frequently used as an inflammatory marker.…”

Endothelial Function and Behçet Disease

“…5 The hsCRP reflects systemic inflammation and is related to ED. 16,[18][19][20][21][22][23][24] These findings as well as coagulation and fibrinolytic abnormalities may contribute to ED in BD. 25 Other factors have been implicated in the ED process in BD such as increased low-density lipoprotein (LDL) oxidation and production of antibodies against oxidized LDL (oxLDL).…”

“…Ideally, such markers should not be influenced by these factors and should be widely used, reproducible, and noninvasive. The ED is also assessed by flow-mediated dilatation (FMD), arterial stiffness (AS), 14 carotid intima-media thickness 15 as well as high-sensitivity C-reactive protein (hsCRP), 16 total homocysteine (tHcy), asymmetric dimethylarginine (ADMA), soluble thrombomodulin, E-selectin, vascular endothelial growth factor (VEGF), and endocan levels. 17 The FMD is mainly influenced by nitric oxide (NO) from endothelial cells.…”