Inflammation: A Link Between Hypertension and Atherosclerosis

Abstract

High blood pressure levels are associated with increases in circulating levels of inflammation markers which can reflect vascular inflammatory processes, suggesting that hypertension is a low-grade inflammatory process. The vascular inflammation associated with hypertension could be the link between high blood pressure levels and the atherosclerotic process, which is the principal origin of cardiovascular disease, the leading cause of worldwide mortality. High blood pressure levels are accompanied by increases in oxidative stress due to both higher reactive oxygen specie (ROS) production and reduced ROS scavenging by antioxidant defence. This situation favours endothelial function alterations which allow the expression of adhesion molecules and initiation of fatty streak, the earliest structural change in the atherosclerotic process. At the same time, this inflammation, allows endothelial dysfunction since some inflammatory mediators can negatively affect endothelial cell function. Inflammation, therefore, plays a critical role in development and in complications of the atherothrombotic process. Changes in mechanical stress and activation of humoral factors such as the reninangiotensin- aldosterone system can be underlying not only increases in oxidative stress (and consequently endothelial dysfunction) but also the development of the inflammatory process associated with hypertension.