Key result
Hypertensive emergency and urgency are linked to higher plasma MMP-9 levels versus normotensive controls.
Why the study?
MMP-9 participates in extracellular matrix degradation and is involved in vascular remodeling, but its plasma levels in acute vascular alterations due to hypertensive crisis were unknown.
Are plasma levels of matrix metalloproteinase-9 (MMP-9) elevated in individuals with hypertensive crisis compared to normotensive and controlled hypertensive subjects?
Cross-Sectional (n=198)
No
Are plasma levels of matrix metalloproteinase-9 (MMP-9) elevated in individuals with hypertensive crisis compared to normotensive and controlled hypertensive subjects?
Absolute Event Rate: 2.31% vs 1.94%
p-value: p=<0.01
Plasma MMP-9 levels are significantly elevated during hypertensive crises and correlate independently with uric acid levels, suggesting a role in acute vascular remodeling and inflammation.
Elevated MMP-9 in hypertensive crises is hypothesis-generating; leaves open prognostic value and therapeutic targeting.
BACKGROUND: Matrix metalloproteinase-9 (MMP-9) participates in the degradation of components of the extracellular matrix and it is involved in vascular remodeling and vasomotor changes. The aim of this study was to investigate the plasma levels of MMP-9 in acute vascular alterations due to hypertensive crisis. METHODS: This cross-sectional study was performed in 40 normotensive (NT) and 58 controlled hypertensive subjects (CHyp) followed up in outpatient clinic. Moreover, 57 patients with hypertensive emergency (HypEmerg) and 43 in hypertensive urgency (HypUrg), seen in emergency department, were also included. Hypertensive crisis was divided into HypEmerg, which was characterized by levels of systolic blood pressure (BP) ≥ 180 mmHg and/or diastolic BP ≥ 120 mmHg complicated with target-organ damage (TOD), and HypUrg, defined by BP elevation without TOD. Univariate and multivariate regression analysis was performed to identify the influence of independent variables on MMP-9 levels. A p-value < 0.05 was considered statistically significant. RESULTS: The mean age was 43.5 years in the NT group (11 men); 57.7 years in the CHyp group (29 men); 59.4 years in the HypUrg group (21 men) and 62.4 years in the HypEmerg group (31 men). The age was statistically different in the NT group compared to other 3 groups. The mean BP was 116.5 ± 13.9/72.4 ± 10.6 mmHg for NT, 123.2 ± 12.6/79 ± 9.2 for CHyp, 194.1 ± 24.3/121.4 ± 17.3 for HypUrg and 191.6 ± 34.3/121.7 ± 18.8 mmHg for HypEmerg, respectively (p-value< 0.0001 between groups). MMP-9 levels were statistically different between the HypEmerg (2.31 ± 0.2 ng/mL) and HypUrg groups (2.17 ± 0.3 ng/mL) compared to the NT (1.94 ± 0.3 ng/mL) (p-value < 0.01 and p-value < 0.05, respectively) and CHyp groups (1.92 ± 0.2 ng/mL) (p-value < 0.01). Uric acid was the only independent variable for predicting MMP-9 levels (p-value = 0.001). CONCLUSION: MMP-9 concentrations are significantly higher in the hypertensive crisis groups (urgency and emergency) compared to the control groups. Therefore, MMP-9 may be a biomarker or mediator of pathophysiologic pathways in cases of acute elevations of blood pressure.
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Valente et al. (2020) conducted a cross-sectional in Hypertensive crisis (n=198). Hypertensive crisis (Emergency and Urgency) vs. Normotensive and controlled hypertensive subjects was evaluated on Plasma logMMP-9 levels (ng/mL) (p=<0.01). Plasma levels of matrix metalloproteinase-9 were significantly higher in patients with hypertensive emergency (2.31 ng/mL) and urgency (2.17 ng/mL) compared to normotensive controls (1.94 ng/mL).
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