ORIGINAL ARTICLE: EPIDEMIOLOGY, CLINICAL PRACTICE AND HEALTH Association between human cytomegalovirus antibody levels, and essential hypertension and functional status in elderly Koreans Su Jin Jeong, Sang Hoon Han, Chang Oh Kim, Jun Yong Choi, Young Goo Song and June Myung Kim Department of Internal Medicine, AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea Aim: To evaluate the relationship between human cytomegalovirus (HCMV) antibody status, and hypertension and functional status among elderly Koreans. Methods: Patients aged ≥65 years were prospectively enrolled from March 2011 to February 2012 at a 2000-bed university hospital. We collected data including CD4+ and CD8+ T-lymphocyte count, and functional status by measuring basic activities of daily living and instrumental activities of daily living for all patients. In addition, HCMV immunoglobulin G levels were analyzed using enzyme-linked fluorescent assay. Results: During the study period, 103 patients (51 men), who were admitted for treatment of infections or other diseases, were enrolled. Multivariate analysis showed that body mass index and HCMV immunoglobulin G antibody titers were independent factors associated with hypertension in elderly patients (OR 1.347, 95% CI 1.113–1.630, P = 0.002; OR 1.023, 95% CI 1.001–1.047, P = 0.042, respectively). In univariate linear correlations, HCMV antibody levels were positively correlated with systolic blood pressure levels (r = 0.303, P = 0.002), CD8+ T-lymphocyte count (r = 0.313, P = 0.001) and instrumental activities of daily living scores (r = 0.217, P = 0.028). In addition, HCMV immunoglobulin G titers were inversely associated with estimated glomerular filtration rate (r = −0.268, P = 0.006). These four variables remained independently significant in multivariate correlation analysis. Conclusion: These findings could provide insight into the important role of HCMV in the pathogenesis of essential hypertension and decreased functional status in the elderly. Geriatr Gerontol Int 2016; 16: 21–27. Keywords: antibody, cytomegalovirus, elderly patients, functional status, hypertension. Introduction Essential hypertension is an independent risk factor for stroke, myocardial infarction, heart failure and arterial aneurysm, and is the leading cause of chronic renal failure. 1 Approximately 90%–95% of hypertension cases, affecting more than 1 billion adults worldwide, are a result of essential hypertension. 2 Both genetic and environmental factors are involved in the development of hypertension, but the underlying mechanism of essential hypertension is poorly understood. The signs of essential hypertension include elevated systemic levels of inflammatory markers and activated inflamma- tory cells. 3,4 These findings suggest that inflammation plays an important role in the pathogenesis of essential hypertension. Human cytomegalovirus (HCMV), a member of the beta herpes virus family, is a ubiquitous pathogen that infects only humans. 5 Although HCMV infection is usually asymptomatic in healthy adults, it can infect organs and tissues throughout the body. HCMV can infect endothelial cells, smooth muscle cells and mac- rophages, which are all considered important in the pathogenesis of vascular disease. 6,7 HCMV could also exacerbate inflammation in diseased vessels by altering the expression of cell adhesion molecules and by inter- fering with cytokine signaling. 8 Accepted for publication 17 October 2014. Correspondence: Prof Chang Oh Kim MD PhD, Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea. Email: cokim@yuhs.ac Geriatr Gerontol Int 2016; 16: 21–27 © 2014 Japan Geriatrics Society doi: 10.1111/ggi.12428 | 21