Department of Infectious Diseases, Persian Gulf Tropical Medicine Research Centre, Bushehr University of Medical Sciences, Bushehr, Iran.
Am J Hypertens. 2013 Sep;26(9):1140-7. doi: 10.1093/ajh/hpt083. Epub 2013 Jun 6.
Chronic infection with cytomegalovirus (CMV), Chlamydia pneumoniae, herpes simplex virus 1 (HSV-1), and Helicobacter pylori may contribute to essential hypertension. However, the evidence now available does not clarify whether the aggregate number of pathogens (pathogen burden) may be associated with hypertension.
Sera from 1,754 men and women aged ≥25 years were analyzed for immunoglobulin G antibodies to C. pneumoniae, HSV-1, H. pylori, and CMV using enzyme-linked immunosorbent assay. The aggregate number of seropositives to the studied viral and bacterial agents was defined as pathogen burden. Hypertension was defined according to World Health Organization criteria.
A total of 459 (26.3%) of the subjects had hypertension. In the hypertensive group, 4.2% had 0 or 1 pathogens present, 20.6% had 2, 43.2% had 3, and 32.1% had 4; in the normotensive group, 7.9% had 0 or 1, 28.4% had 2, 42.7% had 3, and 21.0% had 4. Of the 4 studied pathogens, H. pylori seropositivity showed a significant independent association with hypertension (odds ratio (OR) =1.37; 95% confidence interval (CI) =1.05-1.79; P = 0.02). In multiple logistic regression analyses, the pathogen burden did not show a significant independent association with hypertension. Coinfection with H. pylori and C. pneumoniae was significantly associated with hypertension compared with double seronegativity after adjustment for age, sex, chronic low-grade inflammation, and cardiovascular risk factors (OR = 1.68; 95% CI = 1.14-2.47; P = 0.008].
The pathogen burden was not associated with hypertension. However, coinfection with C. pneumoniae and H. pylori showed a significant association with essential hypertension, independent of cardiovascular risk factors and chronic low-grade inflammation.
巨细胞病毒（CMV）、肺炎衣原体、单纯疱疹病毒 1 型（HSV-1）和幽门螺杆菌的慢性感染可能导致原发性高血压。然而，现有证据尚不清楚病原体总数（病原体负担）是否与高血压有关。
采用酶联免疫吸附试验检测 1754 名年龄≥25 岁的男性和女性血清中肺炎衣原体、HSV-1、幽门螺杆菌和 CMV 的 IgG 抗体。将研究中病毒和细菌病原体的血清学阳性总数定义为病原体负担。根据世界卫生组织标准定义高血压。
共有 459 名（26.3%）受试者患有高血压。在高血压组中，4.2%的人有 0 或 1 种病原体，20.6%的人有 2 种，43.2%的人有 3 种，32.1%的人有 4 种；在血压正常组中，7.9%的人有 0 或 1 种，28.4%的人有 2 种，42.7%的人有 3 种，21.0%的人有 4 种。在研究的 4 种病原体中，幽门螺杆菌血清阳性与高血压有显著的独立关联（比值比（OR）=1.37；95%置信区间（CI）=1.05-1.79；P=0.02）。在多因素逻辑回归分析中，病原体负担与高血压无显著独立关联。调整年龄、性别、慢性低度炎症和心血管危险因素后，幽门螺杆菌和肺炎衣原体合并感染与高血压显著相关（OR=1.68；95%CI=1.14-2.47；P=0.008）。
病原体负担与高血压无关。然而，肺炎衣原体和幽门螺杆菌合并感染与原发性高血压显著相关，与心血管危险因素和慢性低度炎症无关。
