To study the role of markers of vascular inflammation as a predictor of cardiovascular and degenerative bone complications in postmenopausal female patients with arterial hypertension (AH) and osteoporosis
Design and method:
113 patients (mean age 58.23 ± 6.45 years) were divided into three groups. Group 1 included 39 healthy female, Group 2 included 30 postmenopausal female patients with AH, Group 3 consisted of 44 postmenopausal females with AH and osteoporosis. The parameters of 24-hour blood pressure monitoring; pulse wave velocity (PWV) as a sign of subclinical atherosclerosis measured on sphygmography Vasera VS-1000 Series (Fukuda Denishi, Japan), osteodensitometry performed on the spiral computed tomography Siemens Somatom Emotion (calcium content CA-HA, standard deviation of the peak T –Score); lipid profile parameters, inflammatory markers (hs-CRP, TNF-alpha, homocysteine, interleukine (IL) 1 β, 6, 8, uric acid); endothelial dysfunction markers (endothelin-1, nitrites) and sex hormones like estradiol, progesterone and testosterone were measured.
The levels of estradiol and progesterone were significantly higher in Gr.1 (p = 0.0001). The levels of mean 24-h and daytime systolic BP (SBP), time and square indices, in night time SBP and SBP variability; PWVL/R; total cholesterol, triglycerides, LDL cholesterol, APO-B, hs-CRP, TNF-alpha, IL 6,endothelin-1and uric acid have been above the reference value in Gr. 2 and 3. Besides, in there groups positive correlations between mean 24-h SBP, SBP variability in the daytime, total cholesterol, IL6, homocysteine, endothelin-1 with PWV were registered (p < 0.05). With an increase of the levels of endothelin-1 and homocysteine on 1 fmol/l the risk of high rate PWV > 10 m/s increased by 2.6 times and 35%, respectively. In Gr.3 positive correlation between T – Score with the level of IL1 β, TNF-alpha, PWV, age and negative correlation with progesterone were detected (p < 0.05)
The markers of the inflammatory response can be a general link of pathogenesis, combining subclinical manifestations of atherosclerosis (pulse wave velocity) and osteoporosis in postmenopausal female patients with arterial hypertension.