Abstract
Human cytomegalovirus (CMV) infection is associated with hypertension and has been linked with the pathogenesis of increased arterial blood pressure (BP). Currently, whether CMV infection is associated with the progression of hypertension and hypertensive target organ damage (TOD) remains to be identified. We aimed to examine the relationship between CMV infection and the progression of hypertension and hypertensive TOD, which could provide clues on the possible mediating mechanisms, in the Han Chinese population. A total of 372 patients with hypertension and 191 healthy controls (Han participants from Xinjiang, China) were included in the study. Enzyme-linked immunosorbent assay (ELISA) and qPCR were used to detect CMV infection. C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) titers were also analyzed using an ELISA kit. Moreover, cardiovascular disease markers were evaluated by echocardiography, carotid ultrasonography, and tomographic scans. Essential hypertension (EH) patients exhibited a marked increase in CMV IgG antibody, CRP, TNF-α, and IL-6 levels. Higher grade of hypertension and hypertensive TOD had higher CMV IgG antibody and CRP levels. The CMV IgG antibody titers were positively correlated with arterial BP, greater grade of hypertension and hypertensive TOD, and CRP and IL-6 levels. The higher quartile of CMV IgG titer and CRP level were associated with the incidence of hypertension and the progression of hypertension and hypertensive TOD. In the Han Chinese population, high CMV IgG titers are associated with the progression of hypertension and hypertensive TOD. CMV IgG titer >4.25 U could be an independent predictor of hypertension and progression of hypertension, while that >4.85 U could be an independent risk factor for hypertensive TOD. The underlying mechanism may be largely mediated by chronic inflammation.
Highlights
Hypertension is a global disease [1]
Participants were further categorized into two or four groups according to the blood pressure (BP) values
As the inflammatory cytokines levels were positively correlated with BP, we examined whether inflammatory cytokines levels were positively correlated with higher grades of BP and hypertension and hypertension with target organ damage (TOD) (Table 11)
Summary
More than 1 billion adults have hypertension worldwide, and 90–95% of which is essential hypertension (EH) [2]. Several risk factors and features are involved in the development of hypertension, including age, race, gender, family history of hypertension (FH), environmental interactions, dietary factors, and stress [1, 3,4,5,6]. Human cytomegalovirus (CMV) infection plays an essential role in hypertension. CMV seroprevalence is 40% during people’s first year of life [11] and ranges from 40 to 100% in adults [12]. Primary CMV infection has lifelong persistence, mostly an asymptomatic infection in a human host, and results in the development of a lifelong carrier status with periodic reactivation and shedding of the virus from mucosal sites [11, 16]. Previous studies demonstrated that CMV is associated with various diseases, including cardiovascular disease (CVD) [14, 15, 17,18,19], those affecting cognitive functioning [20, 21], tumor [22], and type 2 diabetes mellitus [3, 23], and even mortality [4, 24]
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