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(Circulation. 1998;98:1092-1098.)
© 1998 American Heart Association, Inc.

Clinical Investigation and Reports

Antibodies to Endothelial Cells in Borderline Hypertension

Johan Frostegård, MD, PhD; Ruihua Wu, MD, PhD; Caroline Gillis-Haegerstrand, MD, PhD; Carola Lemne, MD, PhD; ; Ulf de Faire, MD, PhD

From the Department of Medicine, Unit of Rheumatology, Karolinska Hospital and Center of Molecular Medicine (J.F., R.W.); the Department of Thoracic and Cardiovascular Surgery, Karolinska Hospital (C.G.-H.); the Department of Medicine, Unit of Cardiovascular Medicine, Karolinska Hospital (C.L., U.d.F.); and the Department of Epidemiology, Institute of Environmental Medicine (U.d.F.); Karolinska Institutet, Stockholm, Sweden.

Correspondence to Johan Frostegård, Department of Medicine, Karolinska Hospital, 17176 Stockholm, Sweden.

Background—Antibodies to endothelial cells (aECs) and to cardiolipin (aCLs) are implicated in autoimmune diseases like systemic lupus erythematosus vasculitis. ß₂-Glycoprotein 1 (ß2GP1) is a cofactor for aCLs. The present study investigated the possible role of aECs, aCLs, and aß2GP1 in borderline hypertension.

Methods and Results—Seventy-three men with borderline hypertension (BHT) and 73 age-matched normotensive (NT) men (diastolic blood pressure, 85 to 94 and <80 mm Hg, respectively) were recruited from a population screening program. Antibody levels were determined by ELISA. Presence of carotid atherosclerosis was determined by B-mode ultrasonography, and 29 individuals had atherosclerotic plaques. BHT men had significantly higher aEC and aß2GP1 levels of IgG class than NT control subjects (P=0.029 and P=0.0001, respectively). aEC levels of IgM class were higher in BHT (P=0.012), but not aß2GP1 levels. There was no correlation between aCL levels and BHT. Individuals with atherosclerotic plaques had significantly higher aEC levels of both IgG (P=0.042) and IgM subclasses (P=0.018) than those without plaques, but no difference was found in aCL and aß2GP1 levels. Endothelin and aECs of IgM class were significantly associated.

Conclusions—We demonstrate the first evidence of a significant elevation of aEC and aß2GP1 levels in borderline hypertension. These findings provide a new link between hypertension and atherosclerosis and indicate that humoral immune reactions to the endothelium may play an important role in both conditions.

Key Words: endothelium • antibodies • glycoproteins • atherosclerosis • hypertension

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