The role of inflammation in the development of arterial hypertension in patients with metabolic syndrome

Objective. To establish the role of inflammation in the development of arterial hypertension (AH) in patients with metabolic syndrome (MS).

Materials and methods. Аn open case-control study was conducted with the formation of group 1 (control) – 60 patients (healthy donors) and group 2 (main) – 34 patients with MS and AH. A total of 94 patients. A comparison of serum levels of interleukin (IL-1β), interleukin-6 (IL-6), interleukin-17 (IL-17), tumor necrosis factor alpha (TNF-α), endothelial cells to the expression of intracellular adhesion molecules (ICAM-1) and vascular cell adhesion molecules (VCAM-1), monocyte chemotactic factor-1 (MCP-1) was carried out using enzyme-linked immunosorbent assay (ELISA).

Results. In patients with HA and MS, the levels of IL-6 (p <0.001), MCP-1 (p=0.03), VCAM (p=0.05), CRP (p=0.001), and TNF-α (p=0.002) were higher compared to healthy individuals. When comparing the level of IL-1β (p=0.05), higher values were observed in the group of healthy patients compared to the group of patients with MS and HA. Further study of cytokine levels in the study and control groups will help clarify these data.

Conclusion. Elevated serum levels of proinflammatory cytokines, such as IL-6 (p<0.001), TNF-α (p=0.002), and CRP (p=0.001), in patients with AH and MS compared to similar values in the control group indicate the role of inflammation in the development of hypertension. Moreover, some cytokines, such as IL-6, appear to determine the hypertensive response to angiotensin II, regardless of blood pressure values. The observed increase of VCAM-1 (p=0.05) and MCP-1 (p=0.03) levels in the blood of patients with AH associated with MS allows us to assess the involvement of endothelial dysfunction (ED) in the pathogenesis of the development and progression of hypertension and can be used as a laboratory marker of ED [1].

1. Vikhareva NM, Kalinin AL, Kovalev AA, et al. The role of endothelial dysfunction in the development of arterial hypertension. In: Actual problems of medicine: Collection of scientific articles of the Republican scientific and practical conference with international participation, Gomel, October 10, 2025. - Gomel: Gomel State Medical University; 2025. P. 20-24. (In Russ.).

2. Stanciu S, Rusu E, Miricescu D, et al. Links between Metabolic Syndrome and Hypertension: The Relationship with the Current Antidiabetic Drugs. Metabolites. 2023 Jan 5;13(1):87. DOI: https://doi.org/10.3390/metabo13010087

3. Ramezankhani A, Tohidi M, Hadaegh F. Association between the systemic immune-inflammation index and metabolic syndrome and its components: results from the multi-ethnic study of atherosclerosis (MESA). Cardiovasc Diabetol. 2025 Feb 15;24(1):78. DOI: https://doi.org/10.1186/s12933-025-02629-4

4. Morgado F, Valado A, Metello J, Pereira L. Laboratory markers of metabolic syndrome. Explor Cardiol. 2024;2:114-133. DOI: https://doi.org/10.37349/ec.2024.00026

5. Fahed G, Aoun L, Bou Zerdan M, et al. Metabolic Syndrome: Updates on Pathophysiology and Management in 2021. Int J Mol Sci. 2022 Jan 12;23(2):786. DOI: https://doi.org/10.3390/ijms23020786

6. Józkowiak M, Niebora J, Domagała D, et al. New insights into endothelial cell physiology and pathophysiology. Biomed Pharmacother. 2025 Sep; 190:118415. DOI: https://doi.org/10.1016/j.biopha.2025.118415

7. Rahimi M, Faridi L, Nikniaz L, et al. Effect of Endothelial Adhesion Molecules on Atrial Fibrillation: A Systematic Review and Meta-analysis. Heart Int. 2022 Aug 31;16(2):75-84. DOI: https://doi.org/

8. Morgado F, Valado A, Metello J, Pereira L. Laboratory markers of metabolic syndrome. Explor Cardiol. 2024;2:114-133. DOI: https://doi.org/10.37349/ec.2024.00026

9. Burrello J, Monticone S, Losano I, et al. Prevalence of Hypokalemia and Primary Aldosteronism in 5100 Patients Referred to a Tertiary Hypertension Unit. Hypertension. 2020 Apr;75(4):1025-1033. DOI: https://doi.org/10.1161/HYPERTENSIONAHA.119.14063

10. Alferova VI, Mustafina SV. Prevalence of obesity in the adult population of the Russian Federation (literature review). Obesity and Metabolism. 2022; 19(1):96-105. DOI: https://doi.org/10.14341/omet12809

11. Garcia Fragas M, Gastão Davanzo G. Cross-Talk between TNF-α and Angiotensin II in the Neural Control of Hypertension. J. Neurosci. 2021;41(36):7512-7513; DOI: https://doi.org/10.1523/JNEUROSCI.0193-21.2021

12. Polozova EI, Puzanova EV, Seskina AA. “Relationship between immunological alterations, hypoxia and inflammation in arterial hypertension combined with metabolic syndrome”. Medical Immunology=Meditsinskaya Immunologiya. 2020;22(5):1003-1008. (In Russ.). DOI: https://doi.org/10.15789/1563-0625-RBI-2059

13. Caiazzo E, Sharma M, Asma O.M. Rezig, et al. Circulating cytokines and risk of developing hypertension: A systematic review and meta-analysis. Pharmacological Research. 2024;200:107050. DOI: https://doi.org/10.1016/j.phrs.2023.107050

14. Thangaraj SS, Oxlund CS, Fonseca MPD, et al. The mineralocorticoid receptor blocker spironolactone lowers plasma interferon-γ and interleukin-6 in patients with type 2 diabetes and treatment-resistant hypertension. J Hypertens. 2022 Jan 1;40(1):153-162. DOI: https://doi.org/10.1097/HJH.0000000000002990

15. John GD, Jeremiah ZA, Echonwere-Uwikor B.E. Assessment of Endothelial Cell Adhesion Molecules in Hypertensive Patients in Port Harcourt, Nigeria. International Journal of Research and Reports in Hematology. 2025;8(2):338-343. DOI: https://doi.org/10.9734/ijr2h/2025/v8i2194

16. Cortez A, Muxfeldt E. Monocyte chemoattractant protein-1 and hypertension. Hipertensión y Riesgo Vascular. 2022;39(1):14-23. DOI: https://doi.org/10.1016/j.hipert.2021.11.003