Essential hypertension is associated with Chlamydia pneumoniae but not Epstein-Barr antibodies

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Abstract
Conflicting data exist regarding the relationship between Chlamydia pneunoniae (C. pneumoniae) antibodies and essential hypertension. A positive association between C. pneumoniae immunoglobulin G (IgG) antibodies and severe essential hypertension has been first reported by Cook et al,1 whereas, Nishimura et al2 previously supported an inverse association between C. pneumoniae and high blood pressure (BP) in Japanese adults. We designed this study to investigate whether both IgA and IgG antibodies against this microorganism are elevated in patients with mild-to-severe hypertension defined by 24-h ambulatory BP monitoring. We also measured the following antibodies against Epstein-Barr virus (EPV), EPV IgM, EPV IgG, Epstein-Barr nuclear antigen (EBNA) IgG, EPV EA IgG to examine whether a possible association between essential hypertension and C. pneumoniae antibodies is specific. Three hundred forty-eight hypertensives (taking antihypertensive medication or not) were recruited from outpatients attending the University Hypertension Clinic of the Department of Clinical Therapeutics at Alexandra Hospital of Athens. They were enrolled if all of the following criteria were met: clinical BP reading ≥140/90 mm Hg during their first and second (the next day) examination in the outpatient department or mean 24-h systolic/diastolic BP ≥125/80 mm Hg; no clinical or laboratory evidence of secondary hypertension; no clinical or laboratory evidence of other coexisting cardiovascular disease except for possible cardiovascular complications of the elevated BP; normal results of serum urea, electrolytes, creatinine, plasma renin activity at rest and after exercise, and urinary excretion of catecholamines; and normal renal imaging studies (radionuclide renogram, intravenous pyelography, or ultrasound scan). Fifty-four healthy subjects with no clinical or laboratory evidence of pulmonary or cardiovascular disease volunteered and were included as a control group. They were enrolled only if they had 1) no history of hypertension, based on previous and past BP measurements (subjects who reported even once in their life clinic BP values ≥140/90 mm Hg were excluded); and 2) clinic BP measurements C. pneumoniae antibody titers were measured by indirect microimmunofluorescence test. The enzyme-linked immunosorbent assay (ELISA) was used to detect EPV IgM, EPV IgG, EBNA IgG, and EPV EA IgG antibodies of Epstein-Barr virus in human serum.

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