Abstract Body: Introduction: Having high blood pressure despite using multiple drugs is frequently linked to chronic low-grade inflammation. The association between inflammation and treatment outcomes in resistant hypertension has not yet been thoroughly studied. To study inflammation and resistant hypertension, we performed a systematic review that explored the effects of anti-inflammatory treatments on blood pressure regulation.
Hypothesis: Persistent, low-level inflammation in resistant hypertension forms a recurring cycle by affecting the endothelium, increasing sympathetic nervous system activity, enhancing IL-1β-induced oxidative stress, and leading to increased sodium retention in the kidneys, as well as dysfunction in specific molecular targets of conventional antihypertensive medications.
Methods: We adhered to the PRISMA standards for this review when gathering papers about inflammatory factors or anti-inflammatory approaches in resistant hypertension. Of the 12 studies included, two were randomized, and ten were observational studies. Information on inflammation-related blood markers (e.g., C-reactive protein and interleukins) was collected for both groups, as were outcomes arising from interventions working on inflammation. Risk of bias was assessed for RCTs through the Cochrane tool, and the Newcastle-Ottawa Scale was used for observational studies.
Results: Observational studies indicated that people with resistant hypertension show more signs of inflammation and increased stiffness of their arteries than those with regular hypertension. Blood pressure dropped a little, and inflammatory markers decreased when tested against controls in two small anti-inflammatory therapy (with an IL-1β inhibitor or low-dose corticosteroids) pilot studies. Overall, the evidence is modest; research studies show that battling inflammation may help the heart, and the earliest investigations indicate blood pressure advantages.
Conclusions: According to this research, resistant hypertension is marked by excessive inflammation, which likely plays a major role in causing the condition. Early research on anti-inflammatory therapies suggests they may help control blood pressure in people with resistant conditions. Because of these findings, researchers believe inflammation should be a new target for treatment, and larger trials should be done to test their conclusions.