Serum Cholinesterase Level as a Marker of Systemic Low-Grade Inflammation in Isolated Systolic Hypertension: A Cross-Sectional Study

Background: Autonomic regulation of local and systemic inflammation through the ‘cholinergic anti-inflammatory pathway’ may have role in persistence of low-grade systemic inflammation in isolated systolic hypertension (ISH). The augmented activity of the enzyme cholinesterase (ChE) leads to degradation of the main anti-inflammatory neurotransmitter ‘acetylcholine’ of this pathway. Despite the role of inflammation in hypertension, serum level of cholinesterase enzyme has not been determined till now in ISH. The study aimed to measure the serum levels of inflammatory marker ChE in comparison to high sensitivity C-reactive protein (hsCRP) to predict the presence of low-grade systemic inflammation and their correlation with blood pressure in ISH patients. Methods: A cross-sectional study was conducted in ISH patients (n=30; mean age, 51.00±1.24 years; male/female (M/F) number=18/12). Age and sex matched healthy subjects (n=30, mean age, 51.86±1.40 years; M/F=16/14) were taken as control. Subjects were divided into three groups based on hsCRP levels; group I (healthy: hsCRP≤1.0mg/L), group IIa (patients with mild inflammation: hsCRP≤1.0mg/L), group IIb (patients with moderate to severe inflammation: hsCRP 1.0-10.0mg/L). Overnight fasting blood samples were collected and ChE and hsCRP were assessed using Cholinesterase Liqui-Check and hsCRP turbi-latex diagnostic kits, respectively. Results: hsCRP and ChE levels were found significantly high in hypertensive patients than in healthy subjects (p