COMPARISON OF TUMOR-NECROSIS-FACTOR AND ENDOTHELIN-1 BETWEEN ESSENTIAL AND RENAL HYPERTENSIVE PATIENTS

The present study was performed to compare circulating levels of tumou r necrosis factor-alpha (TNF alpha) and plasma endothelin 1 (ET-1), of hypertensive patients with or without renal failure and with those of normotensive healthy subjects. The study population consisted of 21 h ealthy normotensive subjects and 22 hypertensive patients, II with ess ential hypertension, and 11 with hypertension and chronic renal failur e (CRF). Plasma ET-1 levels, serum TNF alpha and creatinine, creatinin e clearance, 24-h urinary albumin excretion (UAE) were assayed, and 24 -h blood pressure monitoring was obtained in all subjects. Office bloo d pressure was similar between hypertensive patients with and without CRF. However, 24-h blood pressure was greater in patients with CRF tha n in those with essential hypertension and normal renal function. Pati ents with hypertension manifested greater ET-1 levels than normotensiv e subjects (P < 0.01). Serum TNF alpha and ET-1 levels were higher in hypertensive patients with CRF than in patients with essential hyperte nsion and normotensive subjects. In the 22 hypertensive patients, TNF alpha levels were negatively correlated with serum creatinine (r = 0.6 0; P < 0.01), and ET-1 levels were positively correlated with UAE (r = 0.47, P < 0.05). The present study has shown that hypertensive patien ts, and particularly those with renal insufficiency, manifest abnormal blood levels of ET-1 and TNF alpha. These factors could contribute to both cardiovascular and renal damage.