Abstract Background Obesity is associated with chronic low-grade inflammation that predisposes to development of hypertension. Purpose We aimed at exploring the plasma inflammatory proteomic profile in obese subjects in relation to blood pressure (BP) categories. Methods Clinical data and biobank samples were analysed in 332 women and men in the FAT associated CardiOvasculaR dysfunction study. The study included participants with a body mass index (BMI) 27 kg/m² free from cardiovascular disease. Standardised office BP was categorised as normal (BP 120-129/80-84 mmHg), high-normal BP (130-139/85-89 mmHg), grade 1 hypertension (BP 140-159/90-99 mmHg) and grade 2 hypertension (BP 160-179/100-109 mmHg). Biobank samples were analysed using the Olink Target 96 inflammation panel, profiling 92 proteins associated with inflammation and immune responses using proximity extension assay technology. Associations between BP categories and protein markers were identified by correlation analyses. The repositories Kyoto Encyclopedia of Genes and Genomes and Gene Ontology were used to assess the functional significance of the differentially regulated proteins. Results Normal BP was present in 28%, high-normal BP in 30%, grade 1 hypertension in 35% and grade 2 hypertension in 7% of the participants. The proportion of women (53%) and average BMI (32.0 kg/m²) did not differ between BP categories (all p0.05). The normal BP group was younger compared with hypertensive groups (both p0.05). Distinct inflammatory protein profiles were identified for different BP categories. Normotension was characterised by increased T-cell differentiation antigen CD6, interleukin-2 receptor subunit beta, macrophage colony-stimulating factor 1, neurotrophin-3 and C-C motif chemokine 25, reflecting immune- and hematopoietic activity. High-normal BP was associated with downregulation of fibroblast growth factor 23 and interleukin-22 receptor subunit alpha 1, contrasting the upregulation of these in grade 2 hypertension. Grade 1 hypertension was associated with increased abundance of delta and notch-like epidermal growth factor-related receptor and tumour necrosis factor ligand superfamily member 12. These may reflect early inflammatory and neurogenic changes that occur as BP rises. Grade 2 hypertension was associated with the upregulation of fibroblast growth factors 5, 19 and 23, CUB domain-containing protein 1, eukaryotic translation initiation factor 4E-binding protein 1, interleukin-22 receptor subunit alpha-1 and STAM-binding protein, which are relevant in pathways involving cell growth, differentiation and inflammation. Conclusion A progressive inflammatory profile was identified in parallel with increasing BP category. The differentially regulated proteins identified in more severe hypertension may be of importance for the development of hypertension-associated organ damage, as they are implicated in pathways that can promote vascular remodelling and renal dysfunction.
Halland et al. (2025) studied this question.