Role of TNF-α in hypertension and its modulation by antihypertensive agents

Abstract

Background: Hypertension is the leading cause of cardiovascular disease and contributes to10 million deaths per year. It exerts an enormous public health burden on cardiovascular health status and healthcare systems in India. There is up growing evidence that inflammation and abnormal immune responses are involved in the etio-pathogenesis of hypertension but role of any specific pro-inflammatory cytokine is controversial.

Objectives: 1) To compare the levels of TNF-a in treatment naïve hypertensive patients with those on regular anti-hypertensive medications for at least three months.  2) To assess whether change in TNF-a levels corresponds to change in BP

Methods: The study included 3 groups of 30 subjects each (Group 1- Known cases of essential hypertension on regular anti-hypertensive medications for at least 3 months, Group 2-treatment naïve hypertensive patients, Group 3 – normotensive controls) of either sex in the age group 30-70 years who attended the OPD, Department of Medicine at a tertiary care hospital of Northern India. Written informed consent was taken from all the study participants. Blood samples were collected from every patient and TNF-a levels were determined using Human TNF-a ELISA kit.

Results:  TNF- α  levels were statistically significant between the 3 groups (p <0.001).TNF-α value in the Group 1 had a mean of 18.94 ± 7.01 pg/mL, Group 2 had a mean of 29.83 ± 10.03 pg/mL and Group 3 had a mean of 9.29 ± 6.44 pg/mL.

Conclusion: 1) TNF- α was significantly higher in patients with hypertension as compared to normotensive subjects. 2) TNF- α in patient on antihypertensive medication was significantly less than patients who were treatment naïve.