Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Inflammation does not influence arterial stiffness and pulse-wave velocity in patients with coronary artery disease

Journal of Human Hypertension volume 27, pages 629–634 (2013)Cite this article

Subjects

Abstract

Vascular function is an important pathophysiological factor in cardiovascular disease, and is influenced by many factors, one of the principles being hypertension. Developing evidence suggests that inflammation may be another risk factor. Vascular function and blood pressure haemodynamics can be assessed by arterial stiffness, pulse pressure and plasma markers. Testing the hypothesis of a relationship between inflammatory markers, hypertension and vascular function, we recruited 222 stable coronary artery disease outpatients, assessing inflammation with levels of high sensitivity CRP and interleukin-6 (IL-6), vascular function/arterial stiffness by pulse-wave velocity (PWV), augementation (SphygmoCor system Artcor, Sidney, Australia), aortic and brachial artery pulse pressure, Von Willebrand factor (vWf) and soluble E-selectin (both enzyme-linked immunosorbent assay). In multivariate regression analysis, PWVs, augmentation indices and pulse pressures were linked with age, blood pressure and (some) with heart rate (all P<0.01), while vWf was associated with age (P=0.01). We conclude that, in patients with stable coronary artery disease, arterial stiffness and pulse pressure are related strongly and independently with age, blood pressure and heart rate, and that any effect of inflammation is minimal.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Nadar S, Blann AD, Lip GYH . Endothelial dysfunction: methods of assessment and application to hypertension. Curr Pharm Des 2004; 10: 3591–3606.

    Article  CAS  Google Scholar 

  2. Reriani MK, Lerman LO, Lerman A . Endothelial function as a functional expression of cardiovascular risk factors. Biomark Med 2010; 4: 351–360.

    Article  Google Scholar 

  3. Lim HS, Lip GY . Arterial stiffness: beyond pulse wave velocity and its measurement. J Hum Hypertens 2008; 22: 656–658.

    Article  CAS  Google Scholar 

  4. Vlachopoulos C, Aznaouridis K, Stefanadis C . Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 2010; 55: 1318–1327.

    Article  Google Scholar 

  5. Paulinska P, Spiel A, Jilma B . Role of von Willebrand factor in vascular disease. Hamostaseologie 2009; 29: 32–38.

    Article  CAS  Google Scholar 

  6. Roldán V, Marín F, Lip GY, Blann AD . Soluble E-selectin in cardiovascular disease and its risk factors. A review of the literature. Thromb Haemostas 2003; 90: 1007–1020.

    Article  Google Scholar 

  7. Blann AD . Plasma von Willebrand factor, thrombosis, and the endothelium: the first 30 years. Thromb Haemost 2006; 95: 49–55.

    Article  CAS  Google Scholar 

  8. Mizuno Y, Jacob RF, Mason RP . Inflammation and the development of atherosclerosis. J Atheroscler Thromb 2011; 18: 351–358.

    Article  CAS  Google Scholar 

  9. Brevetti G, Giugliano G, Brevetti L, Hiatt WR . Inflammation in peripheral artery disease. Circulation 2010; 122: 1862–1875.

    Article  Google Scholar 

  10. Paffen E, DeMaat MP . C-reactive protein in atherosclerosis: a causal factor? Cardiovasc Res 2006; 71: 30–39.

    Article  CAS  Google Scholar 

  11. Jialal I, Devaraj S, Venugopal SK . C-reactive protein: risk marker or mediator in atherothrombosis? Hypertension 2004; 44: 6–11.

    Article  CAS  Google Scholar 

  12. Packard RR, Libby P . Inflammation in atherosclerosis: from vascular biology to biomarker discovery and risk prediction. Clin Chem 2008; 54: 24–38.

    Article  CAS  Google Scholar 

  13. McDermott MM, Liu K, Ferrucci L, Tian L, Guralnik JM, Tao H et al. Relation of interleukin-6 and vascular cellular adhesion molecule-1 levels to functional decline in patients with lower extremity peripheral arterial disease. Am J Cardiol 2011; 107: 1392–1398.

    Article  CAS  Google Scholar 

  14. Boos CJ, Lip GY . Elevated high-sensitive C-reactive protein, large arterial stiffness and atherosclerosis: a relationship between inflammation and hypertension? J Hum Hypertens 2005; 19: 511–513.

    Article  CAS  Google Scholar 

  15. Pober JS . Warner-Lambert/Parke-Davis award lecture. Cytokine-mediated activation of vascular endothelium. Physiology and pathology. Am J Pathol 1988; 133: 426–433.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Cines DB, Pollak ES, Buck CA, Loscalzo J, Zimmerman GA, McEver RP et al. Endothelial cells in physiology and in the pathophysiology of vascular disorders. Blood 1998; 91: 3527–3561.

    CAS  PubMed  Google Scholar 

  17. Schnabel R, Larson MG, Dupuis J, Lunetta KL, Lipinska I, Meigs JB et al. Relations of inflammatory biomarkers and common genetic variants with arterial stiffness and wave reflection. Hypertension 2008; 51: 1651–1657.

    Article  CAS  Google Scholar 

  18. Nakhai-Pour HR, Grobbee DE, Bots ML, Muller M, van der Schouw YT . C-reactive protein and aortic stiffness and wave reflection in middle-aged and elderly men from the community. J Hum Hypertens 2007; 21: 949–955.

    Article  CAS  Google Scholar 

  19. Yasmin, McEniery CM, Wallace S, Mackenzie IS, Cockcroft JR, Wilkinson IB . C-reactive protein is associated with arterial stiffness in apparently healthy individuals. Arterioscler Thromb Vasc Biol 2004; 24: 969–974.

    Article  CAS  Google Scholar 

  20. Amar J, Ruidavets JB, Sollier CB, Bongard V, Boccalon H, Chamontin B et al. Relationship between C reactive protein and pulse pressure is not mediated by atherosclerosis or aortic stiffness. J Hypertens 2004; 22: 349–355.

    Article  CAS  Google Scholar 

  21. Rodondi N, Marques-Vidal P, Butler J, Sutton-Tyrrell K, Cornuz J, Satterfield S et al. Markers of atherosclerosis and inflammation for prediction of coronary heart disease in older adults. Am J Epidemiol 2010; 171: 540–549.

    Article  Google Scholar 

  22. Pietri P, Vyssoulis G, Vlachopoulos C, Zervoudaki A, Gialernios T, Aznaouridis K et al. Relationship between low-grade inflammation and arterial stiffness in patients with essential hypertension. J Hypertens 2006; 24: 2231–2238.

    Article  CAS  Google Scholar 

  23. Kampus P, Muda P, Kals J, Ristimäe T, Fischer K, Teesalu R et al. The relationship between inflammation and arterial stiffness in patients with essential hypertension. Int J Cardiol 2006; 112: 46–51.

    Article  Google Scholar 

  24. Mahmud A, Feely J . Arterial stiffness is related to systemic inflammation in essential hypertension. Hypertension 2005; 46: 1118–1122.

    Article  CAS  Google Scholar 

  25. Llauradó G, Ceperuelo-Mallafré V, Vilardell C, Simó R, Freixenet N, Vendrell J et al. Arterial stiffness is increased in patients with type 1 diabetes without cardiovascular disease: a potential role of low-grade inflammation. Diabetes Care 2012; 35: 1083–1089.

    Article  Google Scholar 

  26. Mitchell GF, Hwang SJ, Vasan RS, Larson MG, Pencina MJ, Hamburg NM et al. Arterial stiffness and cardiovascular events: the Framingham Heart Study. Circulation 2010; 121: 505–511.

    Article  Google Scholar 

  27. Gunarathne A, Patel JV, Hughes EA, Lip GY . Measurement of stiffness index by digital volume pulse analysis technique: clinical utility in cardiovascular disease risk stratification. Am J Hypertens 2008; 21: 866–872.

    Article  Google Scholar 

  28. McEniery CM, Yasmin, McDonnell B, Munnery M, Wallace SM, Rowe CV et al Anglo-Cardiff Collaborative Trial Investigators. Central pressure: variability and impact of cardiovascular risk factors: the Anglo-Cardiff Collaborative Trial II. Hypertension 2008; 51: 1476–1482.

    Article  CAS  Google Scholar 

  29. Altman DG . Practical Statistics for Medical Research. Chapman and Hall: London, 1991.

    Google Scholar 

  30. Machin D, Campbell M . Chapter 8: significance of the correlation coefficient. Statistical Tables for the Design of Clinical Trials. Blackwell Scientific: Oxford, 1987 pp 89–93.

    Google Scholar 

  31. Pigott R, Dillon LP, Hemingway IH, Gearing AJ . Soluble forms of E-selectin, ICAM-1 and VCAM-1 are present in the supernatants of cytokine activated cultured endothelial cells. Biochem Biophys Res Commun 1992; 187: 584–589.

    Article  CAS  Google Scholar 

  32. Newman W, Beall LD, Carson CW, Hunder GG, Graben N, Randhawa ZI et al. Soluble E-selectin is found in supernatants of activated endothelial cells and is elevated in the serum of patients with septic shock. J Immunol 1993; 150: 644–654.

    CAS  PubMed  Google Scholar 

  33. Schuetz P, Jones AE, Aird WC, Shapiro NI . Endothelial cell activation in emergency department patients with sepsis-related and non-sepsis-related hypotension. Shock 2011; 36: 104–108.

    Article  Google Scholar 

  34. Kaski JC, Fernández-Bergés DJ, Consuegra-Sánchez L, Fernández JM, García-Moll X, Mostaza JM et al. A comparative study of biomarkers for risk prediction in acute coronary syndrome-Results of the SIESTA (Systemic Inflammation Evaluation in non-ST-elevation Acute coronary syndrome) study. Atherosclerosis 2010; 212: 636–643.

    Article  CAS  Google Scholar 

  35. van Bussel BC, Schouten F, Henry RM, Schalkwijk CG, de Boer MR, Ferreira I et al. Endothelial dysfunction and low-grade inflammation are associated with greater arterial stiffness over a 6-year period. Hypertension 2011; 58: 588–595.

    Article  CAS  Google Scholar 

  36. Ferri C, Bellini C, Desideri G, Giuliani E, De Siati L, Cicogna S et al. Clustering of endothelial markers of vascular damage in human salt-sensitive hypertension: influence of dietary sodium load and depletion. Hypertension 1998; 32: 862–868.

    Article  CAS  Google Scholar 

  37. De Caterina R, Ghiadoni L, Taddei S, Virdis A, Almerigogna F, Basta G et al. Soluble E-selectin in essential hypertension: a correlate of vascular structural changes. Am J Hypertens 2001; 14: 259–266.

    Article  CAS  Google Scholar 

  38. Kayal S, Jaïs JP, Aguini N, Chaudière J, Labrousse J . Elevated circulating E-selectin, intercellular adhesion molecule 1, and von Willebrand factor in patients with severe infection. Am J Respir Crit Care Med 1998; 157: 776–784.

    Article  CAS  Google Scholar 

  39. McGill SN, Ahmed NA, Christou NV . Increased plasma von Willebrand factor in the systemic inflammatory response syndrome is derived from generalized endothelial cell activation. Crit Care Med 1998; 26: 296–300.

    Article  CAS  Google Scholar 

  40. Stormorken H, Erikssen J . Plasma antithrombin III and factor VIII antigen in relation to angiographic findings, angina and blood groups in middle-aged men. Thromb Haemost 1977; 38: 874–878.

    Article  CAS  Google Scholar 

  41. Reference Values for Arterial Stiffness’ Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’. Eur Heart J 2010; 31: 2338–2350.

  42. Cecelja M, Chowienczyk P . Dissociation of aortic pulse wave velocity with risk factors for cardiovascular disease other than hypertension: a systematic review. Hypertension 2009; 54: 1328–1336.

    Article  CAS  Google Scholar 

  43. Schalkwijk CG, Poland DC, van Dijk W, Kok A, Emeis JJ, Dräger AM et al. Plasma concentration of C-reactive protein is increased in type I diabetic patients without clinical macroangiopathy and correlates with markers of endothelial dysfunction: evidence for chronic inflammation. Diabetologia 1999; 42: 351–357.

    Article  CAS  Google Scholar 

  44. Osman R, L’Allier PL, Elgharib N, Tardif JC . Critical appraisal of C-reactive protein throughout the spectrum of cardiovascular disease. Vasc Health Risk Manag 2006; 2: 221–237.

    Article  CAS  Google Scholar 

  45. Kusche-Vihrog K, Urbanova K, Blanqué A, Wilhelmi M, Schillers H, Kliche K et al. C-reactive protein makes human endothelium stiff and tight. Hypertension 2011; 57: 231–237.

    Article  CAS  Google Scholar 

  46. Antonopoulos AS, Margaritis M, Lee R, Channon K, Antoniades C . Statins as anti-inflammatory agents in atherogenesis: molecular mechanisms and lessons from the recent clinical trials. Curr Pharm Des 2012; 18: 1519–1530.

    Article  CAS  Google Scholar 

  47. Mäki-Petäjä KM, Booth AD, Hall FC, Wallace SM, Brown J, McEniery CM et al. Ezetimibe and simvastatin reduce inflammation, disease activity, and aortic stiffness and improve endothelial function in rheumatoid arthritis. J Am Coll Cardiol 2007; 50: 852–858.

    Article  Google Scholar 

  48. Shahin Y, Khan JA, Chetter I . Angiotensin converting enzyme inhibitors effect on arterial stiffness and wave reflections: a meta-analysis and meta-regression of randomised controlled trials. Atherosclerosis 2012; 221: 18–33.

    Article  CAS  Google Scholar 

  49. Olsen MH, Christensen MK, Hansen TW, Gustafsson F, Rasmussen S, Wachtell K et al. High-sensitivity C-reactive protein is only weakly related to cardiovascular damage after adjustment for traditional cardiovascular risk factors. J Hypertens 2006; 24: 655–661.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

Dr Kuzniatsova was supported by a Fellowship from the European Cardiology Society.

Author information

Authors and Affiliations

  1. University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK

    A D Blann, N Kuzniatsova & G Y H Lip

Authors
  1. A D Blann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N Kuzniatsova
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G Y H Lip
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A D Blann.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Blann, A., Kuzniatsova, N. & Lip, G. Inflammation does not influence arterial stiffness and pulse-wave velocity in patients with coronary artery disease. J Hum Hypertens 27, 629–634 (2013). https://doi.org/10.1038/jhh.2013.17

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2013.17

Keywords

This article is cited by

Search

Advanced search

Quick links