title: Circulating endothelial cells, arterial stiffness, and cardiovascular risk stratification in hypertension.
abstract: BACKGROUND
  Given the growing burden of cardiovascular disease, there is increasing interest in strategies to help predict future cardiovascular risk.
  
  
  OBJECTIVE
  To investigate the relationship between endothelial damage/dysfunction, arterial stiffness, and their association with predicted risk of future cardiovascular death among patients with hypertension.
  
  
  METHODS
  We studied three patient groups 35 to 74 years old: healthy control subjects (n=63), subjects with high-risk hypertension (HHT) [n=65], and patients with treated, previously diagnosed, malignant-phase hypertension (MHT) [n=43]. We measured comparative indexes of arterial stiffness (stiffness index [SI] using digital volume photoplethysmography), endothelial damage/dysfunction (venous circulating endothelial cells [CECs], immunobead technique), and 5-year predictive risk of future cardiovascular death (Pocock scoring system).
  
  
  RESULTS
  CEC counts, SI, and 5-year prediction of cardiovascular death were significantly higher in both hypertension groups (HHT and MHT), compared with healthy control subjects. CEC counts were significantly higher in the MHT group (p<0.05). There was a significant correlation between CECs and SI in the HHT group (r=0.61; p<0.0001) and the MHT group (r=0.59, p<0.0001) and between CEC, SI, and predicted 5-year risk of cardiovascular death in the two hypertension groups. On multiple linear regression analysis, arterial SI and CECs remained as significant predictors of the calculated 5-year risk of cardiovascular death (R2=0.37; p<0.0001).
  
  
  CONCLUSIONS
  There is a consistent association between CECs, arterial stiffness, and the predictive risk of cardiovascular death among a group of patients with HHT or previously treated MHT. Registration number 05/Q2709/1.
authors.affiliation: Haemostasis, Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, England, UK.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Boos
authors.forename: Deirdre A
authors.initials: DA
authors.lastname: Lane
authors.forename: Manas
authors.initials: M
authors.lastname: Karpha
authors.forename: D Gareth
authors.initials: DG
authors.lastname: Beevers
authors.forename: Ronnie
authors.initials: R
authors.lastname: Haynes
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001158:Arteries / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004548:Elasticity; D042783:Endothelial Cells; D004730:Endothelium, Vascular / Q000166:cytology / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000473:pathology* / Q000503:physiopathology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010991:Plethysmography / Q000379:methods; D011237:Predictive Value of Tests; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D014655:Vascular Resistance