School of Infection & Immunity, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK; Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy.
School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK.
Pharmacol Res. 2024 Feb;200:107050. doi: 10.1016/j.phrs.2023.107050. Epub 2023 Dec 29.
Immune responses play a significant role in hypertension, though the importance of key inflammatory mediators remains to be defined. We used a systematic literature review and meta-analysis to study the associations between key cytokines and incident hypertension.
We performed a systematic search of Pubmed/Medline, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL), for peer-reviewed studies published up to August 2022. Incident hypertension was defined as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg and/or the use of antihypertensive medications. Random effects meta-analyses were used to calculate pooled hazard ratios (HRs)/risk ratios (RRs) and 95% confidence intervals by cytokine levels (highest vs. lowest quartile).
Only IL-6 and IL-1β levels have evidence allowing for quantitative evaluation concerning the onset of hypertension. Six studies (10406 participants, 2932 incident cases) examined the association of IL-6 with incident hypertension. The highest versus lowest quartile of circulating IL-6 was associated with a significant HR/RR of hypertension (1.61, 95% CI: 1.00 to 2.60; I =87%). After adjusting for potential confounders, including body mass index (BMI), HR/RR was no longer significant (HR/RR: 1.24; 95% CI, 0.96 to 1.61; I = 56%). About IL-1β, neither the crude (HR/RR: 1.03; 95% CI, 0.60 to 1.76; n = 2) nor multivariate analysis (HR/RR: 0.97, 95% CI, 0.60 to 1.56; n = 2) suggested a significant association with the risk of developing hypertension.
A limited number of studies suggest that higher IL-6, but not IL-1β, might be associated with the development of hypertension.
免疫反应在高血压中起着重要作用，尽管关键炎症介质的重要性仍有待确定。我们使用系统文献综述和荟萃分析研究了关键细胞因子与高血压发病之间的关系。
我们对 Pubmed/Medline、Embase、Web of Science 和 Cochrane 对照试验中心注册库（CENTRAL）进行了系统搜索，以检索截至 2022 年 8 月发表的同行评议研究。高血压定义为收缩压≥140mmHg 或舒张压≥90mmHg 和/或使用抗高血压药物。按细胞因子水平（最高与最低四分位数）采用随机效应荟萃分析计算合并危险比（HR）/风险比（RR）和 95%置信区间。
只有白细胞介素 6（IL-6）和白细胞介素 1β（IL-1β）的水平有证据可以进行定量评估与高血压发病的关系。六项研究（10406 名参与者，2932 例高血压发病）探讨了 IL-6 与高血压发病的关系。与循环 IL-6 的最低四分位相比，最高四分位与高血压的显著 HR/RR 相关（1.61，95%CI：1.00 至 2.60；I =87%）。调整潜在混杂因素（包括体重指数（BMI））后，HR/RR 不再显著（HR/RR：1.24；95%CI：0.96 至 1.61；I = 56%）。关于 IL-1β，无论是未调整（HR/RR：1.03；95%CI：0.60 至 1.76；n=2）还是多变量分析（HR/RR：0.97，95%CI：0.60 至 1.56；n=2）均未提示与高血压发病风险有显著关联。
少数研究表明，较高的 IL-6，但不是 IL-1β，可能与高血压的发展有关。
