title: Brachial flow-mediated dilation predicts subclinical target organ damage progression in essential hypertensive patients: a 3-year follow-up study.
abstract: OBJECTIVE
  We found impaired brachial flow-mediated dilation (FMD) was associated with the number of target organ damage (TOD) in 2007. The present study investigated whether FMD predicted TOD progression in essential hypertension.
  
  
  RESULTS
  Endothelium-dependent FMD was measured in 280 adults in 2007. At the third year of examination, 199 patients (mean age 62.5 ± 9.5, men 59.3%) were approached for participation in our study. Patients were divided into two groups: normal FMD group (FMD ≥10) and impaired FMD group (FMD <10). In patients with 0-1 TOD at baseline, impaired FMD group (n = 65) led to thicker intima-media thickness (P = 0.02), increased carotid-to-femoral pulse wave velocity (P = 0.03), increased urinary albumin/creatinine ratio (P = 0.04) and increased TOD number (P = 0.02), as compared with the normal FMD group (n = 59) at the end of the follow-up, even after adjusting for age and sex, whereas the relationship did not exist in 2-4 TOD group at baseline. TOD number increase was associated with the prevalence of diabetes mellitus (β = 0.180, P = 0.035), blood pressure control (β = -0.277, P = 0.001), low-density lipoprotein cholesterol (β = 0.234, P = 0.006) and baseline FMD (β = -0.168, P = 0.043) in stepwise multivariate regression analysis. FMD remained a significant predictor of TOD number increase in multiple logistic regression analysis after adjustment for several known risk factors (relative risk 0.92, 95% confidence interval 0.85-0.99, P = 0.042, for each 1% increase in FMD).
  
  
  CONCLUSIONS
  FMD is a predictor of future TOD progression in low-risk essential hypertensive patients, but has little predictive value in the late stage of TOD.
authors.affiliation: aState Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Vascular Biology, Department of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine bLaboratory of Vascular Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Yang
authors.forename: Jian-zhong
authors.initials: JZ
authors.lastname: Xu
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.forename: Xiao-feng
authors.initials: XF
authors.lastname: Tang
authors.forename: Ping-jin
authors.initials: PJ
authors.lastname: Gao
mesh_terms: D001783:Blood Flow Velocity; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000379:methods; D001916:Brachial Artery / Q000503:physiopathology*; D018450:Disease Progression; D000075222:Essential Hypertension; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D012039:Regional Blood Flow; D012307:Risk Factors; D012720:Severity of Illness Index