Central obesity and hypertension: the role of plasma endothelin.
Hypertension and central obesity are two conditions closely linked, but the mechanisms responsible for obesity-associated hypertension are still unclear. In the last few years, several studies addressed the role of endothelin-1 (ET-1) in the development and maintenance of hypertension. This study was designed to evaluate plasma ET-1 in normotensive and hypertensive central obese subjects compared with a lean healthy group. Our final goal was to analyze the relationship between plasma ET-1, blood pressure, and left ventricular structure and function in central obese subjects (both normotensives and hypertensives). ET-levels have been assessed by the radioimmunoassay method in 20 lean normotensives and in 57 central obese subjects; 30 of them were hypertensives and 27 of them were normotensives. Twenty-four-hour mean blood pressure (MBP/24 h) by noninvasive ambulatory blood pressure monitoring, left ventricular mass/ height (LVM/H), and left ventricular ejection fraction (LVEF) by echocardiography and peak filling rate (PFR) by radionuclide study were also measured. ET levels were significantly (P < .05) higher in obese hypertensives and obese normotensives than in lean normotensives. In addition, ET levels were significantly (P < .05) higher in obese hypertensives than in obese normotensives. ET were directly related to LVM/ H (r = 0.86; P < .001) and MBP/24 h (r = 0.48; P < .009) but only in obese hypertensives. Multiple regression analysis indicated that ET-1 plasma levels remain an independent predictor of MBP/ 24 h and LVM/H also when age was included in the analysis. These data suggest that obesity-associated hypertension is characterized by an endothelial dysfunction that may contribute to the higher cardiovascular risk detectable in these patients.
Parrinello
G
G
Department of Internal Medicine, University of Palermo, Italy.
Scaglione
R
R
Pinto
A
A
Corrao
S
S
Cecala
M
M
Di Silvestre
G
G
Amato
P
P
Licata
A
A
Licata
G
G
D000328:Adult; D018660:Blood Pressure Monitoring, Ambulatory; D001824:Body Constitution; D001827:Body Height; D015992:Body Mass Index; D004452:Echocardiography; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008297:Male; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D011863:Radioimmunoassay; D011875:Radionuclide Angiography; D012044:Regression Analysis; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology
D019332:Endothelin-1