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INFLUENCE OF ANTIHYPERTENSIVE TREATMENT ON MMP-9 LEVELS IN CONTROLLED HYPERTENSIVE INDIVIDUALS

Objective: Ambulatory blood pressure monitoring (ABPM), in addition to peripheral blood pressure (BP) measurements, provides data on central hemodynamic, such as pulse wave velocity (PWV), augmentation index (AI 75%) and central pressure, which are associated with arterial stiffness. The development of arterial stiffness is related to an extracellular matrix enzyme called metalloproteinase-9 (MMP-9). The aim of the current study is to evaluate the correlation between the variables obtained by ABPM and levels of MMP-9 at different BP levels. Design and method: On-hundred and one individuals were enrolled: 21 normotensive (NT), 36 prehypertensive (PH), and 44 controlled hypertensive (CHT). Peripheral and central BP parameters were evaluated by ABPM using Mobil-O-Graph® 24-hour monitor and MMP-9 levels were determined in all participants. The levels of MMP-9 were assessed using the Human Matrix metalloproteinase-9 Quantikine ELISA kit (R & D Systems, Inc., Minneapolis, MN, USA) with a calculation of medians being presented as nanograms per milliliter (ng/mL). Subsequently, MMP-9 values were transformed into logarithms to reflect normal distribution for statistical analysis. Results: Age of the participants ranged from 30–71 years. MMP-9 concentration was significantly higher in the PH (log 4.74 ± 0.5) compared to CHT group (log 4.41 ± 0.5; p = 0.02). Mean PWV was greater in CHT than PH (8.1 ± 1.2 m/s vs. 6.9 ± 1 m/s; p-value = 0.0003, respectively), but no differences were found in AI 75% between CHT and PH groups. On the other hand, PH individuals had higher mean PWV than NT individuals (8.1 ± 1.2 m/s vs. 6.9 ± 1 m/s; p-value = 0.0003, respectively). MMP-9 levels correlated with cardiac output and peripheral vascular resistance in the three periods evaluated by ABPM (24 h, wakefulness and sleep). Conclusions: Prehypertensive individuals present greater arterial stiffness and MMP-9 levels than normotensive subjects, fact that demonstrate already structural alterations in this group. In its turn, higher levels of MMP-9 are observed in prehypertensive compared to controlled hypertensive subjects, suggesting that antihypertensive therapy may reduce MMP-9 plasma levels.