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From the Department of Thoracic Medicine (P.J.C., D.H.); the University
Department of Medicine (G.Y.H.L., D.G.B.); and the Department of Microbiology
(R.W.), City Hospital, Birmingham, and the School of Mathematics and
Statistics, University of Birmingham (P.D.), United Kingdom.
Correspondence to Dr P.J. Cook, Department of Medicine, Queen Elizabeth Medical Centre, Edgbaston, Birmingham B15, United Kingdom.
Abstract—Several studies have
implied an association between Chlamydia pneumoniae (C.
pneumoniae) and cardiovascular disease. Our
study was designed to determine whether this organism is associated
with severe essential hypertension in a multiracial British population.
Antibodies to C. pneumoniae were measured by
microimmunofluorescence in 123 patients with
chronic severe hypertension and 123 control subjects, matched for
ethnic origin, age, sex, and smoking habit, admitted to the same
hospital with various noncardiovascular,
nonpulmonary disorders. Previous infection was defined by IgG
64 to 256, provided that there was no detectable IgM. Multiple
regression analyses of matched and unmatched data were used to
investigate the influences of antibody levels and potential confounding
factors (ethnic origin, age, sex, smoking habit, diabetes mellitus, and
social deprivation) on hypertension. A portion of the
hypertensive patients underwent echocardiography,
estimation of left ventricular mass index, and measurements
of fibrinogen, D-dimer, and von Willebrand factor
concentrations. Thirty-five percent of hypertensive patients and 17.9%
of matched control subjects had antibody titers consistent with
previous C. pneumoniae infection. The hypertensive
patients differed significantly from their matched control subjects in
their level of previous infection, with an odds ratio of 2.5 (95%
confidence interval, 1.3 to 4.7). There were no significant differences
in antibody levels between patients with left ventricular
hypertrophy and those without it. Fibrinogen, D-dimer, and
von Willebrand factor concentrations were not significantly
associated with antibody levels. These data support an association of
C. pneumoniae with severe essential hypertension. They
provide no evidence of a predisposition to develop left
ventricular hypertrophy in hypertensive
patients with C. pneumoniae infection or of associations
with hypercoagulability or endothelial dysfunction.
© 1998 American Heart Association, Inc.
Scientific Contributions
Chlamydia pneumoniae Antibodies in Severe Essential Hypertension
Key Words: hypertension, essential • cardiovascular diseases • infection
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