Endothelial dysfunction and sympathetic nervous system activation in young patients with essential arterial hypertension and without hypercholesterolaemia

OBJECTIVE: The aim of the study was to evaluate whether measurements of hs-C-reactive protein (hs-CRP), endothelin-1 (ET-1), epinephrine (E) and norepinephrine (NE) would provide useful information for the assessment of endothelial dysfunction and sympathetic nervous system activation in a selected group of young, properly treated patients with essential arterial hypertension (HTN) and without hypercholesterolaemia. METHODS AND RESULTS: Serum hs-CRP and ET-1 as well as plasma epinephrine and norepinephrine concentrations were measured in 134 subjects (62 patients with diagnosed HTN and 72 healthy subjects from a reference group). In patients the concentrations of hs-CRP, ET-1 and NE were significantly higher, than in healthy subjects. The highest diagnostic sensitivity (87%; 95% CI 76.1-94.2) was found for serum hs-CRP; the highest diagnostic specificity (96%; 95% CI 88.3-99.1) and positive predictive value (89%) were found for ET-1 measurements. The analysis of logistic regression showed that the highest risk of HTN was found for the patients with high levels of ET-1, hs-CRP and NE, but not epinephrine. CONCLUSIONS: These results indicate that measurements of hs-CRP, ET-1 and NE may be useful in the identification of endothelial dysfunction and sympathetic activation in young patients with properly controlled essential arterial hypertension and without hyperlipidaemia.