Obesity-hypertension synergy and cardiovascular risk: interactions between ACE gene expression, inflammatory burden and thyroid axis dysregulation

Obesity and hypertension frequently coexist and together increase cardiovascular disease (CVD) risk through interrelated endocrine, inflammatory, and vascular pathways. The aim – evaluated selected biochemical, thyroid, inflammatory, and genetic markers, with a particular focus on angiotensin-converting enzyme (ACE) gene expression, in individuals with obesity-associated hypertension.Materials and methods. A case-control design was used, including 360 participants (180 hypertensive-obese cases and 180 normotensive controls). Fasting blood samples were analyzed for thyroid-stimulating hormone (TSH), high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and ACE gene expression quantified using the 2–ΔΔCt method, along with routine metabolic, renal, and cardiac parameters. Group differences were assessed using non-parametric tests. Receiver operating characteristic (ROC) curves were constructed to evaluate diagnostic performance, and multivariable logistic regression was applied to identify independent predictors of obesity-related hypertension. Correlation and linear regression analyses were used to examine factors influencing ACE gene expression.Results. Individuals with hypertensive obesity showed significantly higher levels of TSH, hs-CRP, IL-6, and ACE gene expression compared with controls. ACE gene expression demonstrated the greatest discriminatory ability on ROC analysis (AUC 0.86). Significant positive correlations were observed between ACE gene expression and both hs-CRP and IL-6. In regression analysis, ACE gene expression, hs-CRP, and IL-6 emerged as independent predictors, with ACE gene expression showing the strongest association.Conclusions. Obesity-hypertension is characterized by heightened inflammatory activity, endocrine alterations, and increased ACE gene expression. ACE gene expression may have potential value for identifying individuals at elevated cardiometabolic risk, although further longitudinal studies are needed to confirm its clinical relevance.