Batuo Hillman, van der Linden Eva, Galenkamp Henrike, Moll van Charante Eric, Born Bert-Jan van der, Chilunga Felix P
Department of Public and Occupational Health, Amsterdam Public health Research Institute, Amsterdam university Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
Department of Vascular Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Int J Cardiol Cardiovasc Risk Prev. 2024 Dec 11;24:200358. doi: 10.1016/j.ijcrp.2024.200358. eCollection 2025 Mar.
Chronic inflammation is a well-recognized contributor to hypertension pathogenesis. However, the role of targeting inflammation in hypertension treatment, particularly through modulation of inflammatory markers like interleukin-6 (IL-6), remains less understood. We investigated the effects of antihypertensive medications with and without IL-6-lowering properties on long-term blood pressure (BP) control in a multi-ethnic cohort in the Netherlands.
Participants from HELIUS cohort receiving hypertension treatment were followed over six years. BP control at follow-up was determined using WHO criteria. Due to unavailability of IL-6 data, a literature review was conducted to classify antihypertensives based on their IL-6-lowering properties - a proxy approach. Logistic regression models were used to assess associations between the IL-6-lowering potential of antihypertensives and BP control, both within and between antihypertensive classes. Effect modification by ethnicity was explored.
A total of 1510 participants were included (mean age 57 years, 62 % women). Within the calcium channel blocker (CCB) class, medications with IL-6-lowering properties (amlodipine and barnidipine) were associated with superior BP control (aOR 1.41, 95 % confidence interval 1.05-1.90) compared to other CCBs (lercanidipine, nifedipine, verapamil, clevidipine, diltiazem). No significant associations were observed within angiotensin receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors (ACEIs), between different antihypertensive drug classes, nor across ethnic groups.
Amlodipine and barnidipine were associated with better BP control compared to other CCBs. Our findings provide an important starting point for understanding the role of IL-6 in hypertension management. Further studies are warranted to confirm these observations by directly measuring IL-6 levels and investigating underlying mechanisms.
慢性炎症是高血压发病机制中一个公认的促成因素。然而，在高血压治疗中针对炎症的作用，尤其是通过调节白细胞介素-6（IL-6）等炎症标志物来实现的作用，仍不太清楚。我们在荷兰的一个多民族队列中研究了具有和不具有降低IL-6特性的抗高血压药物对长期血压（BP）控制的影响。
对接受高血压治疗的HELIUS队列参与者进行了六年的随访。使用世界卫生组织标准确定随访时的血压控制情况。由于无法获得IL-6数据，因此进行了一项文献综述，以根据抗高血压药物降低IL-6的特性对其进行分类——一种替代方法。使用逻辑回归模型评估抗高血压药物降低IL-6的潜力与血压控制之间的关联，包括在抗高血压药物类别内部和之间。探讨了种族的效应修饰作用。
总共纳入了1510名参与者（平均年龄57岁，62%为女性）。在钙通道阻滞剂（CCB）类别中，与其他CCB（乐卡地平、硝苯地平、维拉帕米、左西孟旦、地尔硫卓）相比，具有降低IL-6特性的药物（氨氯地平和巴尼地平）与更好的血压控制相关（调整后的比值比为1.41，95%置信区间为1.05-1.90）。在血管紧张素受体阻滞剂（ARB）或血管紧张素转换酶抑制剂（ACEI）类别内部、不同抗高血压药物类别之间以及不同种族之间均未观察到显著关联。
与其他CCB相比，氨氯地平和巴尼地平与更好的血压控制相关。我们的研究结果为理解IL-6在高血压管理中的作用提供了一个重要的起点。有必要进行进一步的研究，通过直接测量IL-6水平并研究潜在机制来证实这些观察结果。
