PROGRESSIVE VASCULAR DAMAGE IN HYPERTENSION IS ASSOCIATED WITH INCREASED LEVELS OF CIRCULATING P-SELECTIN

Objective To assess whether increased shedding of adhesion molecules i n plasma provides an index for endothelial damage in hypertension. Des ign and methods Three groups of hypertensive patients with increasing severity of vascular damage were studied: 20 essential hypertensives, 21 atherosclerotic, renovascular hypertensives and four malignant hype rtensives. Twenty healthy subjects were included as a control group. L evels of P-selectin, E-selectin, intracellular adhesion molecule 1, va scular cell adhesion molecule and von Willebrand factor in venous bloo d were measured, using sandwich-type enzyme-linked immunosorbent assay . Results For essential hypertensives a trend for increased P-selectin and E-selectin values compared with those in controls was observed (1 59 +/- 44 versus 132 +/- 40 ng/ml, P = 0.062 and 40 +/- 13 versus 34 /- 17 ng/ml, P = 0.055, respectively). P-selectin (210 +/- 84 ng/ml, P = 0.0021) and E-selectin (42 +/- 12 ng/ml, P = 0.012) levels in renov ascular hypertensives were significantly higher than those in healthy controls. There were no significant increases in circulating levels of intracellular adhesion molecule 1, vascular cell adhesion molecule an d von Willebrand factor either in essential hypertensives or in renova scular hypertensives. Marked increases in circulating levels of adhesi on molecules and von Willebrand factor relative to those in controls w ere observed in malignant hypertensives (P-selectin 634 +/- 332 versus 132 +/- 40 ng/ml, P = 0.0004; vascular cell adhesion molecule 968 +/- 187 versus 493 +/- 139 ng/ml, P = 0.0004; and von Willebrand factor 2 59 +/- 75 versus 130 +/- 72 U/dl, P = 0.016). Conclusions Progression of vascular damage in essential, renovascular and malignant hypertensi on is associated with a rise in circulating levels of P-selectins and, to a lesser extent, E-selectins, whereas levels of intracellular adhe sion molecule 1, vascular cell adhesion molecule and von Willebrand fa ctor are elevated only in diseases associated with acute severe vascul ar damage, including malignant hypertension. Our data suggest that sel ectins may be useful as indicators of vascular damage in hypertension. (C) 1998 Rapid Science Ltd.