Amplified biochemical activation of endothelial function in hypertension associated with moderate to severe renal failure.
BACKGROUND
Arterial hypertension and endothelial dysfunction have a role in the development of athero-sclerosis. This study assessed autocrine-paracrine endothelial function in patients with hypertension associated with renal failure.


METHODS
Angiotensin II (Ang II), endothelin-1 ( ET-1), basic fibroblast growth factor (bFGF), transforming growth factor-beta (TGF-beta), soluble forms of adhesion molecules (ICAM-1, VCAM-1), E-selectin, von Willebrand factor (vWf) and nitric oxide (NO) were measured in 26 patients with hypertension and chronic renal failure (CRF), in 19 essential hypertensives (EH) and in 28 normotensive healthy subjects.


RESULTS
Plasma concentrations of Ang-II, ET-1, ICAM-1, VCAM-1, E-selectin, bFGF and TGF-beta all were significantly higher in patients than in healthy subjects and EH. Furthermore, in CRF, serum creatinine correlated negatively with NO plasma levels (r = - 0.51; p < 0.0) and this relationship held true after adjusting the data for potential confounders. Plasma NO was inversely related with ET-1 and bFGF (P < 0.01).


CONCLUSIONS
Hypertension in CRF is characterized by biochemical evidence of marked endothelial dysfunction, apparently more pronounced than in patients with EH. Amplified endothelial activation in CRF probably contributes to the high rate of atherosclerotic complications in CRF.
Cottone
Santina
S
Department of Internal Medicine, Cardiovascular and Renal Diseases, Chair of Internal Medicine, University of Palermo, Palermo, Italy. Sancott@tin.it
Mulè
Giuseppe
G
Amato
Felicita
F
Riccobene
Raffaella
R
Vadalà
Anna
A
Lorito
Maria C
MC
Raspanti
Francesco
F
Cerasola
Giovanni
G
D000328:Adult; D000804:Angiotensin II / Q000097:blood; D016022:Case-Control Studies; D015331:Cohort Studies; D019040:E-Selectin / Q000032:analysis; D019332:Endothelin-1 / Q000097:blood; D004730:Endothelium, Vascular / Q000378:metabolism* / Q000473:pathology*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000150:complications*; D018799:Intercellular Adhesion Molecule-1 / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D051437:Renal Insufficiency / Q000097:blood* / Q000150:complications*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016212:Transforming Growth Factor beta / Q000032:analysis; D015854:Up-Regulation; D019010:Vascular Cell Adhesion Molecule-1 / Q000032:analysis; D014841:von Willebrand Factor / Q000032:analysis
D019040:E-Selectin; D019332:Endothelin-1; D016212:Transforming Growth Factor beta; D019010:Vascular Cell Adhesion Molecule-1; D014841:von Willebrand Factor; D000804:Angiotensin II; D018799:Intercellular Adhesion Molecule-1; D009569:Nitric Oxide