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Hypertension Management in the High Cardiovascular Risk Population
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It has been documented that most of the drugs which are used for treatment of hypertension and CAD play key roles as anti-inflammatory agents. Previous investigations also confirmed the anti-inflammatory effects of the components. For example, it has been demonstrated that Atorvastatin modulates the innate immune responses by activation of endothelial [ 17 ], macrophage [ 18 ], monocyte [ 19 ], NK cell [ 19 ], and neutrophil function [ 20 ].
Accordingly, Blankier et al. Decreased expression of pro-inflammatory cytokines by immune cells under treatment of other drug components including Aspirin, Clopidogrel, Metoprolol, Nitrates, Losartan, Captopril and Carvedilol have also been reported previously [ 23 — 25 ]. Thus, it has been hypothesized that the drugs may downregulate pro-inflammatory cytokines in the patients suffering from hypertension and CAD.
Our results showed that all four groups have received all the mentioned drugs, but the control group has received lower doses of Atorvastatin, Losartan and Captopril when compared to other groups group 1, 2 and 3. Thus, although, we have not evaluated the cytokines serum levels before and after treatment with Atorvastatin, Losartan and Captopril, but based on the results it may be hypothesized that alterations in the cytokine serum levels in the groups suffering from hypertension and CAD in comparison to controls may be associated with the higher doses of the drugs.
Thus, more clinical trial investigations using Atorvastatin, Losartan and Captopril can shed light on the understanding of the main mechanisms played by the drugs.
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The cytokine is an angiogeneic factor which actively participates in the development of vessels [ 5 ]. It has also been reported that IL-6 is a potential inducer of addressing molecules on the inflamed vessels [ 21 ]. Increased expression of the cytokine in the patients suffering from hypertension and CAD has been reported in the previous investigations [ 26 ]. Our results revealed that Atorvastatin, Losartan and Captopril may have an indirect therapeutic manner via downregulation of IL Besides, cytokines play important roles in the cells proliferation and also fibrogenic features disorders like atherosclerosis [ 30 ].
It appears that the drugs show various features when they are used alone or in combination with other components. Thus, more clinical trials are needed to improve our knowledge regarding the in vivo effects of the drug components on human immune system. While no significant association between evaluated cytokines and gender was observed among other groups. Results revealed that age, BMI and weight have no or poor correlations with the cytokine production. Thus, although the groups differed regarding age and BMI, it seems that the interfered criteria have not affected expression of evaluated cytokines.
The cytokines are the main cause of macrophage activator and induction of arthrosclerosis. The strengths of the our study is the fact that this study is conducted on human samples and simultaneous analysis of plasma levels of several important cytokines in different conditions in individuals treated with various ranges of drugs. However, the potential limitations of our results were due to the fact that the study were recruited in one centre, which may limit the external validity of our findings, and also some data of the study was limited by questions and observation.
Regarding to wide spread of hypertension and CAD in the world and various ranges of drugs accessible, it is suggested to perform similar study on the other populations to attain more evidences. The authors wish to express their sincere thanks to all participants who helped us to perform the project.
National Center for Biotechnology Information , U. Published online Dec Author information Article notes Copyright and License information Disclaimer. The authors have declared that no competing interests exist. Received Feb 15; Accepted Nov This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
This article has been corrected. This article has been cited by other articles in PMC. Results With regard to the medications, Atorvastatin, Losartan and Captopril were administered more in patients groups 1, 2 and 3 than the patients without hypertension and CAD. Introduction Cytokines which are mostly produced by immune cells, are the main arm of immune system and play several roles from inflammation to tissue damage or regeneration [ 1 ].
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Results With regard to oral medications before coronary angiography, although administration of Aspirin 80mg daily, Clopidogrel 75mg daily, Betablockers and Nitrates was similar between patients groups 1, 2 and 3 and control group 4 , Losartan, Captopril and Atorvastatin were administered more to patients in comparison to control group, and these differences were significant Table 1.
Table 1 Comparison of drug usage frequencies across the four studied groups. Open in a separate window. Table 2 Demographic information of participants. Discussion It has been documented that most of the drugs which are used for treatment of hypertension and CAD play key roles as anti-inflammatory agents. Acknowledgments The authors wish to express their sincere thanks to all participants who helped us to perform the project.
Data Availability Based on the ethical and local rules restriction, data are available from Zabol University of Medical Sciences, and Ethical Committee of the University.
Hypertension Management in the High Cardiovascular Risk Population
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