Page 8 - GALENIKA MEDICAL JOURNAL

reactive oxygen species. However, these complex interacti- AIM
ons cannot definitively explain whether inflammation is the
cause of hypertension or represents a secondary effect of Our research aimed to investigate the association be-
chronic blood pressure elevation. Nevertheless, oxidative tween cardiovascular risk factors, dyslipidemia, elevated
stress and increased production of reactive oxygen species levels of uric acid, and homocysteine with the incidence of
likely represent a common molecular basis linking immune arterial hypertension.
inflammation with hypertension .
3
Prolonged immune activation and inflammatory respon- Methodology
se support the development of hypertension. Immuno-me-
tabolism is an emerging field of research focused on asse- A prospective study included 154 patients, 98 (63.6%)
ssing the connection between cellular metabolism and the male and 56 (36.4%) female, who presented at the outpa-
functioning of immune cells. Cholesterol plays a key role, tient clinic of Euromedik Health Center in Belgrade for a re-
and two main sources available to the cell are receptor-me- gular check-up in January 2023.
diated endocytosis and cholesterol biosynthesis. Evidence From all patients, socio-demographic data were colle-
from prospective epidemiological studies, along with clini- cted, including age, gender, place of residence, marital
cal trials with various therapies to lower LDL cholesterol, status, education, and occupation. Additionally, anamne-
unequivocally show that high levels of cholesterol in pla- stic data were gathered (previous illnesses, family medical
sma are a risk factor for atherosclerosis, hypertension, and history, smoking, alcohol consumption, level of physical
many cardiovascular diseases. Continuous intake of oxidi- activity). Laboratory analyses included complete blood co-
zed low-density lipoproteins (oxLDL) by plaque macropha- unt and biochemistry, along with a clinical examination
ges supports inflammation. Moreover, cholesterol accu- supplemented by diagnostic procedures such as electrocar-
mulation in the plasma membrane favors the activation of diography (EKG), echocardiography, and abdominal ultraso-
receptors (Toll-like receptor 4) responsible for initiating in- und (EHO).
tracellular signaling pathways (nuclear factor kappa β) and
the production of inflammatory cytokines responsible for The diagnosis of arterial hypertension in the subjects
stimulating the innate immune response . was established based on the recommendations of the Eu-
4
ropean Society of Hypertension . The patients were divided
2
Risk factors such as obesity, dyslipidemia, diabetes melli- into three groups according to age: the first group aged up
tus, smoking, exposure to stress, physical inactivity, and to 39 years, the second group aged 40 to 49 years, and the
poor diet contribute to the activation of the immune system third group aged 50 to 59 years. Each group had an equal
and exacerbation of inflammation. Additional risk factors number of participants. All patients had been diagnosed
for early-onset hypertension that we can also influence inc- with hypertension, and in this study, we investigated the
lude elevated levels of homocysteine and uric acid . frequency and association of other cardiovascular risk fa-
5
ctors such as obesity, dyslipidemia, and elevated levels of
Homocysteine (Hcy) is a non-proteinogenic amino acid
formed during the metabolism of the essential amino acid uric acid and homocysteine with arterial hypertension.
methionine. Hcy is considered a risk factor for atherosclero- The data were presented using descriptive parameters:
sis and cardiovascular diseases, but the molecular basis of mean ± standard deviation, median (min-max), absolute and
these associations remains unclear. Endothelial dysfunction relative frequencies. The Kruskal-Wallis test was used to test
is a key initial event in the development of both atherosc- the significance of differences in mean values, with analysis
lerosis and arterial hypertension. Therefore, homocysteine of variance using Tukey's post hoc test. The chi-square test
is considered a sensitive clinical and biological health mar- was used to analyze differences in frequencies between
ker. Various observations may explain the vascular toxicity groups. The criterion for statistical significance was set at p
associated with elevated levels of homocysteine, which im- < 0.05. EZR 3.4.3 was used for data analysis.
pairs the production of nitric oxide (NO), the main regulator
of endothelial homeostasis . Homocysteine simultaneously
6
hinders the role of the gasotransmitter hydrogen sulfide, Results
leading to a loss of efficiency in the endothelial antioxidant
system and an increase in intracellular concentration of re- The study involved 154 participants aged 22 to 59 ye-
active oxygen species (ROS), causing oxidative stress. ROS ars. Male participants accounted for 63.6% (98 individuals),
disrupts lipid metabolism, contributing to the progression while female participants accounted for 36.4% (56 individu-
of vascular lesions. Thus, dyslipidemia and elevated homo- als). Patients were divided into 3 age groups. The first gro-
cysteine levels have a synergistic effect in the progression up, aged up to 39 years, consisted of 48 participants, the
of endothelial dysfunction, which is one of the initial steps second group (aged 40 to 49 years) consisted of 51 partici-
in the imbalance between vasoconstriction and vasorelaxa- pants, and the third group (aged 50 to 59 years) consisted of
tion, and subsequent arterial hypertension . 55 participants (Table 1).
7

6 DOI: 10.5937/Galmed2409007S