HYPERTENSION AND CHRONIC HEART FAILURE WITH PRESERVED LEFT VENTRICULAR EJECTION FRACTION: FOCUS ON GENDER-SPECIFIC FEATURES OF THE PROINFLAMMATORY STATUS

Abstract

Background. Hypertension (HTN) represents the most significant factor associated with the development of chronic heart failure (CHF) with preserved left ventricular ejection fraction (LVEF). Low-intensity systemic inflammation is considered an important element for the pathogenesis of both HTN and CHF. Objective. To set gender-dependent features of pro-inflammatory status in middle-aged patients with HTN complicated by non-severe CHF with preserved LVEF. Design and methods . The study involved 165 middle-aged subjects. The main study group comprised 104 patients (including 55 males) with HTN complicated by CHF with preserved LVEF. CHF diagnosis was confirmed by the elevated blood plasma N‑terminal brain natriuretic peptide precursor and 6‑minute walk test. Also, the main group was stratified depending on the presence of the 1st or the 2nd grade of left ventricular diastolic dysfunction (LVDD). The comparison group consisted of 30 patients with stage II HTN (including 15 males), and a control group — of 31 normotensive individuals (including 15 males). In all subjects we measured serum levels of C‑reactive protein (CRP), tumor necrosis factor alpha (TNF-α), interleukin‑6 (IL‑6). The data were processed by the program Statistica for Windows (version 10.0). Results. In each group the blood markers of proinflammatory status were normal. Males of the main group showed higher levels of CRP, TNF-alpha, IL‑6 than females. Hypertensive males and females with CHF with preserved LVEF demonstrated significantly higher indices of all parameters than in the comparison group. We also analyzed data depending significantly greater than in subjects with the 1st LVDD grade (both among males and females). Conclusions . In comparison with females, males with HTN complicated by CHF with preserved LVEF have significantly higher CRP, TNF-α, IL‑6 serum levels. Development of CHF with preserved LVEF in HTN patients is associated with increased intensity of the pro-inflammatory pattern among both males and females. Regardless of gender and clinical status of CHF, hypertensive patients with the 2nd grade of LVDD are characterized by higher serum levels of CRP, TNF-α, IL‑6 compared to those with the 1st grade of LVDD.