An increase in blood levels of vascular endothelial growth factor and highly sensitive C-reactive protein in patients with hypertension and obesity is associated with the left ventricular hypertrophy

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background In patients with essential hypertension (H) in combination with abdominal obesity (АО), there is a more frequent and earlier development of asymptomatic hypertension-mediated organ damage (HMOD). One of the prognostically unfarable HMODs is left ventricular hypertrophy (LVH). According to modern concepts, in the mechanisms of HMOD formation, a significant place is given to subclinical inflammation and disturbances in the processes of angio-arteriogenesis. Purpose To study blood levels of one of the powerful proangiogenic and proinflammatory factors vascular endothelial growth factor (VEGF) and a marker of inflammation highly sensitive C-reactive protein(hsCRP) in patients with H and AO and their relationship with asymptomatic HMOD. Methods. The study involved 64 patients with grade 2 H and grade I-II AO (38 men and 26 women aged 35 to 60 years) and 23 practically healthy individuals in the control group (14 men and 9 women aged 18 to 50 years).The survey included standard clinical, anthropometrical, biochemical and instrumental methods. The blood levels of VEGF and hsCRP were determined by the enzyme immunoassay. Diagnostics of H, risk factors and HMOD was performed in accordance with the recommendations of the ESC/ESH (2018). Results. There was a significant increase in the blood levels of VEGF (162,31 [102,67; 226,41] pg / ml) and hsCRP (3,11[1,17;5,82] mg/L) in patients with H and AO in general by group in comparison with practically healthy individuals (89,07 [61,43; 135,57] pg/ml (р=0,004) and 1,07 [0,46;2,99] mg/L (р=0,016), respectively). At the same time, the blood levels of VEGF (238,53 [138,31; 294,84] pg/ml) and hsCRP (3,94 [1,89;5,82] mg/L) were significantly higher in patients with LVH than in patients without LVH (149,96 [75,18; 174,96] pg/ml (р=0,035) and 2,30 [0,65; 5,31] mg/L (р=0,042), respectively). The following direct correlations were found: between the blood levels of VEGF and hsCRP (р =0,0018), between the blood levels of EGF, hsCRP and LV mass index (р =0,016, р =0,021, respectively), between the blood levels of VEGF and systolic blood pressure (р =0,035), as well as left atrial volume index (р =0,037). Conclusion. In patients with H in combination with AO, there are manifestations of the activation of the production of proangiogenic and proinflammatory factors -VEGF and hsCRP, which can play an important role in the development of both LVH and in the progression of H in general.