Impaired endothelial function in hypertensive patients with target organ damage.
To evaluate the correlation between endothelial dysfunction and multiple target organ damage (TOD), we measured endothelial function using high-resolution ultrasonography in hypertensive patients with or without TOD. Two hundred and eighty patients with hypertension were divided into four groups as follows: no TOD (Group I, n=61); 1 TOD (Group II, n=113); 2 TOD (Group III, n=59); and >or=3 TOD (Group IV, n=47). Endothelial function was assessed by endothelium-dependent flow-mediated dilatation (FMD) and -independent vasodilation (after sublingual administration of nitroglycerin) of the brachial artery using high-resolution vascular ultrasound. We also assessed the intima-media thickness (IMT) of the common carotid, carotid to femoral pulse wave velocity (cf-PWV) and left ventricular mass index (LVMI). FMD was inversely associated with the number of affected organs. FMD was lower in the patient groups with >or=3 TOD (Group IV: 6.85+/-4.70% vs Group II: 10.00+/-6.15%, P<0.01), 2 TOD (Group III: 7.37+/-5.02% vs Group II, P<0.01) and 1 TOD as compared with patients with no TOD (Group I: 11.88+/-7.11% vs Group II, P<0.05). In univariate correlation analysis, there was a significant relationship between FMD and IMT, serum creatinine, LVMI and cf-PWV. In stepwise multivariate regression analysis, FMD still correlated with waist size (beta=-0.283, P<0.01), age (beta=-0.231, P<0.05) and IMT (beta=-0.197, P=0.05). These findings suggested that reduced FMD was associated with the number of TOD and may be considered an indicator for evaluating TOD.
Xu
J-Z
JZ
Department of Hypertension, Ruijin Hospital, Shanghai Institute of Hypertension, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Zhang
Y
Y
Wu
S-N
SN
Niu
W-Q
WQ
Zhu
D-L
DL
Gao
P-J
PJ
D000284:Administration, Oral; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects / Q000503:physiopathology*; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003401:Creatine / Q000097:blood; D015150:Echocardiography, Doppler; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage; D011673:Pulsatile Flow; D018570:Risk Assessment; D012307:Risk Factors; D018617:Ultrasonography, Doppler, Pulsed; D014664:Vasodilation / Q000187:drug effects; D014665:Vasodilator Agents / Q000008:administration & dosage; D055105:Waist Circumference; D055815:Young Adult
D015415:Biomarkers; D014665:Vasodilator Agents; D005996:Nitroglycerin; D003401:Creatine