Tailored antihypertensive drug therapy prescribed to older women attenuates circulating levels of interleukin-6 and tumor necrosis factor-α

• Published in: Clinical interventions in aging Vol. 10; pp. 209 - 215
• Main Authors: Toledo, Juliana O, Moraes, Clayton F, Souza, Vinícius C, Tonet-Furioso, Audrey C, Afonso, Luís C C, Córdova, Cláudio, Nóbrega, Otávio T
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2015; Taylor & Francis Ltd; Dove Press; Dove Medical Press
• Subjects: Adrenergic beta-Antagonists - administration & dosage; Adrenergic beta-Antagonists - pharmacology; Aged; Analysis; Angiotensin-Converting Enzyme Inhibitors - administration & dosage; Angiotensin-Converting Enzyme Inhibitors - pharmacology; Antihypertensive Agents - administration & dosage; Antihypertensive Agents - pharmacology; Antihypertensive drugs; Antihypertensives; Blood pressure; Blood Pressure - drug effects; Brazil; Calcium Channel Blockers - administration & dosage; Calcium Channel Blockers - pharmacology; Cholesterol; Chronic illnesses; cytokine; Cytokines; Diabetes; Diuretics - administration & dosage; Diuretics - pharmacology; Dosage and administration; Drug dosages; Drug therapy; Drug Therapy, Combination; Enzymes; Female; guidelines; Health aspects; Humans; Hypertension; Hypertension - drug therapy; Hypertension - physiopathology; Inflammation; Inflammation Mediators - blood; Interferon gamma; Interferon-gamma - blood; Interleukin-6 - blood; Laboratories; Metabolism; Middle Aged; Middle aged women; Older people; Original Research; Patients; polymorphism; Postmenopause; Prospective Studies; renin-angiotensin system; Tumor necrosis factor; Tumor Necrosis Factor-alpha - blood; Tumor necrosis factor-TNF; Brazil; Germany; cytokine; guidelines; drug therapy; inflammation; hypertension; renin–angiotensin system
• ISSN: 1178-1998; 1176-9092; 1178-1998
• DOI: 10.2147/CIA.S74790

To test the hypothesis that antihypertensive drug therapy produces anti-inflammatory effects in clinical practice, this study investigated circulating levels of selected proinflammatory mediators (interleukin-6 [IL-6], tumor necrosis factor-alpha [TNF-α], and interferon-γ [INF-γ]) in response to multivariate drug directions for blood pressure (BP) control. Prospective study involving 110 hypertensive, community-dwelling older women with different metabolic disorders. A short-term BP-lowering drug therapy was conducted according to current Brazilian guidelines on hypertension, and basal cytokine levels were measured before and after intervention. Interventions were found to represent current hypertension-management practices in Brazil and corresponded to a significant reduction in systolic and diastolic BP levels in a whole-group analysis, as well as when users and nonusers of the most common therapeutic classes were considered separately. Considering all patients, mean IL-6 and TNF-α levels showed a significant decrease in circulating concentrations (P<0.01) at the endpoint compared with baseline, whereas the mean INF-γ level was not significantly different from baseline values. In separate analyses, only users of antagonists of the renin-angiotensin system and users of diuretics exhibited the same significant treatment-induced reduction in serum IL-6 and TNF-α observed in the whole group. Our data demonstrates that a clinically guided antihypertensive treatment is effective in reversing the low-grade proinflammatory state of serum cytokines found in postmenopausal women and support extracardiac benefits from diuretics and renin-angiotensin system antagonists.