Is hypertension an inflammatory disease?

Hypertension has been recognized as a multi-factorial trait resulting from the effect of a combination of environmental and genetic factors, including excess dietary salt or alcohol intake, stress, age, genetics and family history, obesity, physical inactivity, as well as high saturated fat diet. During the past few years, however, a large amount of information has been collected on the vascular inflammation, indicating that inflammation may involve in the initiation as well as development of hypertension and allowing us to reconsidering the pathogenic mechanisms of hypertension. Evidence from animal models as well as patients, have indicated that hypertension, an established major risk factor for coronary artery disease, has been suggested to exert pro-inflammatory actions through the increased expression of several mediators, including leukocyte adhesion molecules, chemokines, specific growth factors, heat shock proteins, endothelin-1, and angiotensin. The association between inflammation and hypertension recalls also a similar association between low-grade inflammation and other components of the metabolic syndrome, and endothelial dysfunction as well as increased serum levels of C-reactive protein in patients with hypertension. Is hypertension an inflammatory disease? This question has stimulated research on the role of vascular inflammation in hypertension. A better understanding of the inflammatory mechanism in hypertension may, therefore, contribute to novel therapeutic strategies to decrease the morbidity as well as mortality of hypertension, and alleviated hypertensive target organ damage. (C) 2004 Elsevier Ltd. All rights reserved.