Abstract P110: Low Dose Minocycline Lowers BP and Improves Inflammatory Status in Patients with Treatment Resistant Hypertension

Background: About 15% of hypertensive patients have treatment resistant hypertension (TRH), which substantially increases mortality risk. Based on our previous studies and evidence from literature, we have proposed that systemic and neuro-inflammation is crucial in development and establishment of TRH. This study was to test the hypothesis that minocycline (Mino), an anti-inflammatory antibiotic, would lower BP and inflammatory markers in patient with TRH. Selection of Mino was based on our preliminary studies showing that Mino can inhibit systemic inflammation and penetrate the blood brain barrier to attenuate neuroinflammation in addition to its antibiotic effects. Methods: A total of 29 subjects was recruited for this study. Exclusion and inclusion criteria are described at Clinicaltrials.gov (NCT02133872). Office and ambulatory BP measurements (ABPM) were used to confirm TRH diagnosis and subsequently measured 30d and 60 d after Mino administration (50mg/d). If BP failed to decline after 60 d Mino treatment (50mg/d), Mino was increased to 100mg/d and patients were monitored at 60 d. Circulating high-sensitivity C-reactive protein (hs-CRP), high-mobility group box 1 (HMGB1), and Th17 levels were measured. Results: Average BP of TRH patients was 149.5/78.5mmHg, 67% responded to 50mg/d Mino and 33% to 100mg/d. ABPM 24h average BP for all m-TRH was Conclusions: This study demonstrates that a low dose Mino has a significant antihypertensive effect and lowers inflammatory markers in TRH patients. Thus, Mino could be considered a promising therapeutic option for TRH patients.