Purpose: Hemodynamic stress in arterial hypertension leading to increased production of endothelin-1 (ET-1). Changes in the extracellular matrix are controlled largely by methalloproteinase-2 (MMP-2) and methalloproteinase-9 (MMP-9) which play an important role in vascular remodeling of hypertension. C-reactive protein (CRP) is an acute phase protein which is synthesized by hepatocytes under the effect of interleukin-6 (IL-6) in inflammation. The purpose of the study was to investigate the relationship of ET-1, MMP-2, MMP-9 and CRP with the degree of arterial hypertension and the systemic and vascular inflammatory response.
Methods: Three groups were formed: group I - 31 patients with mild hypertension (MH); group II - 29 patients with severe hypertension (SH); group III - 15 persons in a control group (CG). ET-1 was determined by ELISA kit of "Biomedika", MMP-2 and MMP-9 by ELISA kit of the "R&D Systems", and the CRP- through immunoturbidimetric method with monoclonal anti-CRP antibodies. The analysis used the statistical program STATGRAPHICS.
Results: It was found that there was a statistically significant difference between serum concentration of ET-1 (pg/ml) at MH when compared to CG (p = 0.0189) and SH compared to CG (p = 0.0181). There is a statistically significant difference between concentration of MMP-9 (ng/ml) of SH when compared to CG (p = 0.0010) and between MH when compared to SH (p = 0.0006). There is no statistically significant difference of MMP-2 (ng/ml) between the three groups (p> 0.05). There is also a statistically significant difference between the concentrations of CRP (mg/l) at MH when compared with CG (p = 0.0170) and SH when compared with CG (p = 0.0366).
Conclusions: Serum levels of ET-1 are increased in the groups with arterial hypertension, which demonstrates its role in the pathogenesis of the disease. The levels of MMP-9 are greatly reduced in patients with severe hypertension which can be used as an indicator of increased cardiovascular risk in these patients. Serum levels of MMP-2 do not show specific changes at the different degrees of hypertension. Based on our experimental data can be concluded that the levels of MMP-9 in arterial hypertension are defined by complex causes - the degree of hypertension, drug therapy and accompanying cardiovascular diseases and complications. The average levels of CRP at MH and SH are significantly increased which confirms the pathogenetic relationship of arterial hypertension with systemic and vascular inflammation.