Abstract
Background: Hypertension presents different severity phenotypes, from prehypertension to resistant hypertension. The early assessment of macrovascular damage through the measurement of pulse wave velocity (PWV) and the inflammatory profile through the measurement of reactive C protein (hs-RCP) is capable of early assessment of the impact of blood pressure on cardiovascular risk. Objective: The aim of this study is to analyze macrovascular damage and the immunoinflammatory profile of patients with different hypertension phenotypes. Methods: This is a cross-sectional study that is being developed in 2 research centers in Rio de Janeiro, a primary care unit and a tertiary university hospital center. Sociodemographic and anthropometric data, office blood pressure and HBPM were registered. Arterial stiffness was assessed by measuring PWV. The inflammatory profile was assessed by measuring hs-RCP, the metabolic profile was assessed by measuring serum lipids and glycated hemoglobin. Results: A total of 150 participants were included (54% women, age 47.3 ± 11.7 years, 58% black/brown), 35 of whom were pre-hypertensive, 72 hypertensive and 43 resistant hypertensives. We found 54% of participants to be obese and 66% have abdominal obesity. More than half of the individuals are sedentary (53.3%), and 39% of participants having metabolic syndrome. Comparatively evaluating pre-hypertensive, hypertensive and resistant hypertensive patients, we observed a progressive increase in age, in the prevalence of black/brown (42.9% vs 56.9% vs 72.1%, p<0.05), centripetal fat distribution (351 ± 145 vs 403 ± 151 vs 444 ± 267, p<0.04), glycated hemoglobin (5.3 ± 1.7 vs 5.7 ± 1.3 vs 6.4 ±1.6, p<0.05), and in the prevalence of metabolic syndrome (31.4% vs 34.7% vs 53.5%, p<0.05). There is a progressive increase in hs-RCP (1.0[0.5-3.2] vs 4.0[2.6-8.8] vs 5.4[0.5-10.6]) and pulse wave velocity measurement (8.1 ± 0.1 vs 8.8 ± 1.8 vs 10.4 ± 2.2, p<0.01), identifying individuals with greater arterial stiffness and systemic inflammation. Conclusion: Cardiovascular risk increased proportionally with hypertension severity, especially in relation to metabolic profile, arterial stiffness, and inflammatory status.
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