Abstract

Background:

Hypertensives with a blunted nocturnal blood pressure (BP) decrease have increased risk of developing atherosclerotic disease. Soluble CD40 ligand (sCD40L) is involved in the pathogenesis of risk factor-related vascular damage. Therefore, we evaluated the relationship between circulating sCD40L levels, circadian BP profile, and early carotid atherosclerosis in essential hypertensives.

Methods:

Plasma sCD40L concentrations were assessed in two groups of 25 never-treated hypertensives, without additional cardiovascular risk factors, differentiated on the basis of a nocturnal decrease of BP either of >10% (dippers) or <10% (nondippers) of daytime values, and in 25 matched normotensives. Carotid intima–media thickness (IMT) was also measured in all participants.

Results:

Plasma sCD40L concentrations were higher in nondippers (4.9 ± 1.2 ng/mL) than in dippers (3.7 ± 0.7, P = .0005) and controls (1.6 ± 0.6, P < .0001). These latter had lower sCD40L concentrations than dippers (P < .0001). The IMT was higher in both hypertensive groups than in normotensives (P < .0001). In the entire hypertensive population IMT directly correlated with circulating levels of sCD40L (r = 0.365, P = .01) and inversely correlated with nocturnal systolic BP decreases (r = −0.286, P = .043). In a multivariate regression analysis sCD40L was the main determinant of IMT (r2 = 0.157, P = .004).

Conclusions:

Nondippers have enhanced plasma sCD40L levels, which may contribute to their increased susceptibility to develop vascular damage. Am J Hypertens 2007;20:70–76 © 2007 American Journal of Hypertension, Ltd.

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