Biochemical markers of endothelial dysfunction in patients with endocrine and essential hypertension.
The aim of our study was to evaluate potential differences in the concentration of biochemical markers of endothelial dysfunction between essential hypertension, endocrine hypertension (pheochromocytoma, primary hyperaldosteronism) and control healthy group and to assess a potential relationship between these markers of endothelial dysfunction and vasopressor substances overproduced in endocrine hypertension. We have investigated 21 patients with moderate essential hypertension, 29 patients with primary hyperaldosteronism, 24 subjects with pheochromocytoma and 26 healthy volunteers. Following parameters of endothelial dysfunction were measured, von Willebrand factor (vWf), plasminogen activator (t-PA) and E-selectin (E-sel). Clinical blood pressure was measured according to the European Society of Hypertension recommendations. We found significantly higher levels of the von Willebrand factor in patients with essential hypertension in comparison with a control group (114+/-20 IU/dl vs 90+/-47 IU/dl; P=0.04) and patients with primary hyperaldosteronism (114+/-20 IU/dl vs 99+/-11 IU/dl; P=0.01). Patients with endocrine hypertension revealed increased levels of vWF compared to the control group, but these differences did not reach statistical significance. Levels of t-PA were increased in patients with pheochromocytoma in comparison with the control group (4.6+/-1.9 ng/ml vs 3.4+/-0.9 ng/ml; P=0.01) and with primary hyperaldosteronism (4.6+/-1.9 ng/ml vs 3.4+/-1.1 ng/ml; P<0.01). In case of E-selectin we found lower levels in patients with pheochromocytoma in comparison with other groups, but they differed significantly only with primary hyperaldosteronism (40.2+/-15.0 ng/ml vs 51.3+/-23.0 ng/ml; P=0.05). Our study did not reveal any convincing evidence of differences in the levels of biochemical markers of endothelial dysfunction between essential and endocrine hypertension. No correlation between the biochemical markers of endothelial dysfunction and vasopressor substances activated in endocrine hypertension was found.
Third Internal Department, First Faculty of Medicine, Charles University, General Faculty Hospital, Prague, Czech Republic. Ondrej.Petrak@vfn.cz
O
O
Petrák
J
J
Widimský
T
T
Zelinka
J
J
Kvasnicka
B
B
Strauch
R
R
Holaj
T
T
Stulc
T
T
Kvasnicka
J
J
Bílková
J
J
Skrha
D000310:Adrenal Gland Neoplasms / Q000150:complications; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D019040:E-Selectin / Q000097:blood*; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications; D006973:Hypertension / Q000097:blood* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000150:complications; D010959:Tissue Plasminogen Activator / Q000097:blood*; D014841:von Willebrand Factor / Q000378:metabolism*
D015415:Biomarkers; D019040:E-Selectin; D014841:von Willebrand Factor; D010959:Tissue Plasminogen Activator