title: Non-invasive evaluation of endothelial function in hypertensive elderly patients.
abstract: Impaired endothelium-dependent vasomotion is a diffuse disease process resulting in abnormal regulation of blood vessel tone and loss of several atheroprotective effects of the normal endothelium. The aim of the present study was to investigate the effects of aging and hypertension on endothelial function. Sixty-six geriatric subjects with ages over 60 (48 hypertensive and 18 healthy) and 40 middle-aged subjects (16 hypertensive and 24 healthy) were included in the study. Systemic vascular endothelial function was evaluated through measuring brachial arterial vasodilation, a physiologic answer to reactive hyperemia occured with increased blood flow in the vessel after transient ischemia (flow-mediated dilation, FMD%), and with carotid artery intima-media thickness (IMT) measurement, using high-resolution ultrasonography. Endothelial independent vasodilation was also measured after administration of sublingual isosorbide dinitrate (isosorbide dinitrate mediated dilation, IDNMD%). FMD% was significantly decreased in elderly and/or hypertensive (HT) patients (geriatric HT: 9.5 +/- 4.7%, geriatric non-HT: 12.7 +/- 5.5%, middle-aged HT: 12.9 +/- 4.3% and middle-aged non-HT: 18.9 +/- 8.1%) (geriatric HT versus geriatric non-HT (P = 0.02), geriatric HT versus middle-aged HT (P = 0.01), geriatric non-HT versus middle-aged non-HT (P = 0.008)). Both FMD% and IDNMD% were inversely correlated with age, baseline vessel diameter and carotid artery intima-media thickness. FMD% was also inversely correlated with diastolic blood pressure. No correlation was found between FMD% and systolic blood pressure, serum cholesterol and triglyceride levels. Endothelium dependent (EDD) and independent dilatation of large arteries decreased with aging even in the healthy elderly, and FMD further declined in HT elderly patients, indicating that age and hypertension independently impair endothelial function. Positive correlations with age and hypertension, and significant inverse correlation with FMD, makes carotid artery IMT a possible indicator of endothelial function.
authors.affiliation: Department of Internal Medicine, Istanbul Medical School, Istanbul University, 34270 Capa, Istanbul, Turkey. sakab@medscape.com
authors.forename: Bulent
authors.initials: B
authors.lastname: Saka
authors.forename: Huseyin
authors.initials: H
authors.lastname: Oflaz
authors.forename: Nilgun
authors.initials: N
authors.lastname: Erten
authors.forename: Gulistan
authors.initials: G
authors.lastname: Bahat
authors.forename: Memduh
authors.initials: M
authors.lastname: Dursun
authors.forename: Burak
authors.initials: B
authors.lastname: Pamukcu
authors.forename: Fehmi
authors.initials: F
authors.lastname: Mercanoglu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Meric
authors.forename: M Akif
authors.initials: MA
authors.lastname: Karan
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000502:physiology; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography; D014664:Vasodilation / Q000502:physiology