title: Peripheral endothelium-dependent flow-mediated vasodilatation is associated with left ventricular mass in older persons with hypertension.
abstract: BACKGROUND
  Increased left ventricular (LV) mass is associated with greater cardiovascular disease risk. Recent studies have also shown an association of increased LV mass with attenuated endothelium-dependent coronary flow reserve. Less is known about the association between LV mass and endothelium-dependent flow-mediated dilatation (FMD) in peripheral arteries, a noninvasive measure of endothelial function.
  
  
  METHODS
  Sixty-two subjects with untreated mild hypertension, aged 55 to 75 years and otherwise healthy, were examined. Resting blood pressure was obtained by the average of 4 to 5 visits, each at least 1 week apart. LV mass was determined from magnetic resonance imaging and was indexed by body surface area, height and height(2.7). Body composition was assessed with dual energy x-ray absorptiometry. FMD was measured as the percent change of brachial artery diameter during reactive hyperemia by use of high-resolution ultrasound.
  
  
  RESULTS
  Median LV mass index was 63 g/m2 (interquartile range, 58-73). In bivariate analysis, LV mass was correlated to lean body mass (r = 0.63, P <.001), diastolic blood pressure (r = 0.35, P <.01), and FMD (r = -0.27, P <.05). In multivariate analysis, 44% of the variance in log-LV mass was explained by lean body mass. An additional 6% of the variance was explained by FMD (P <.05). For each 1% point decrease in FMD, LV mass increased by 1.1%.
  
  
  CONCLUSIONS
  In addition to the expected influences of body size, impairment of brachial artery FMD was independently related to LV mass in elderly subjects with mild hypertension who did not yet have LV hypertrophy. Whether mild hypertension is the common mechanism linking LV mass and endothelial function has yet to be determined.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Md, USA.
authors.forename: Jidong
authors.initials: J
authors.lastname: Sung
authors.forename: Pamela
authors.initials: P
authors.lastname: Ouyang
authors.forename: Anita C
authors.initials: AC
authors.lastname: Bacher
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Turner
authors.forename: Jamie R
authors.initials: JR
authors.lastname: DeRegis
authors.forename: Paul S
authors.initials: PS
authors.lastname: Hees
authors.forename: Harry A
authors.initials: HA
authors.lastname: Silber
authors.forename: Edward P
authors.initials: EP
authors.lastname: Shapiro
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Stewart
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015992:Body Mass Index; D004730:Endothelium, Vascular / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D014664:Vasodilation / Q000502:physiology*