title: Predictors of vascular remodelling in hypertensive subjects with well-controlled blood pressure levels.
abstract: We evaluated the structural/functional characteristics of the arterial wall in a cohort of hypertensives with well-controlled blood pressure (BP) levels. We studied 40 hypertensives with well-controlled BP. We assessed by B-mode ultrasound the mean intima-media thickness (mean-IMT) and maximum-IMT (M-MAX) of carotid artery (common, bulb, internal) bilaterally. Endothelial function was evaluated by post-occlusion flow-mediated dilation (FMD) of the brachial artery. Along with traditional risk factors, we studied the impact of serum high-sensitivity C-reactive protein (hs-CRP) and osteoprotegerin (OPG). Forty normotensive subjects served as controls. In the hypertensives, the BP levels were well controlled (office BP: 129/79 mm Hg, ambulatory BP monitoring: 121/75 mm Hg). Compared with controls, higher BP levels and body mass index were present in hypertensives, whereas age and metabolic parameters were similar. In hypertensives, the IMT (mean-IMT 0.68 mm, M-MAX 0.81 mm) was significantly higher than in controls (mean-IMT 0.60 mm, M-MAX 0.71 mm). FMD was impaired in hypertensives (5.9%) compared with controls (9.2%). In multivariate analyses, it turned out that in hypertensives IMT parameters were related to age, hs-CRP and OPG. Low-density lipoprotein (LDL) cholesterol was the only factor related to FMD. IMT and FMD had no relationship with BP levels. In conclusion, in hypertensives with well-controlled BP, the pro-atherogenic remodelling (IMT) is mainly dependent on age and the inflammatory cytokines, OPG in particular. The functional impairment of the arterial wall (FMD) was related to the levels of LDL cholesterol. Under these conditions, when the impact of BP is minimized, the role of inflammatory cytokines and lipids on structural/functional remodelling becomes predominant.
authors.affiliation: Department of Medicine, DMED, University of Padova, Padova, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Puato
authors.affiliation: 1] Department of Medicine, DMED, University of Padova, Padova, Italy [2] Medicina I, Ospedale Ca' Foncello, Treviso, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rattazzi
authors.affiliation: Department of Medicine, DMED, University of Padova, Padova, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Zanon
authors.affiliation: Department of Medicine, DMED, University of Padova, Padova, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Benetti
authors.affiliation: Department of Medicine, DMED, University of Padova, Padova, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Faggin
authors.affiliation: Department of Medicine, DMED, University of Padova, Padova, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Palatini
authors.affiliation: 1] Department of Medicine, DMED, University of Padova, Padova, Italy [2] Medicina I, Ospedale Ca' Foncello, Treviso, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Pauletto
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects*; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D002097:C-Reactive Protein / Q000032:analysis; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D053244:Osteoprotegerin / Q000097:blood; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016896:Treatment Outcome; D066253:Vascular Remodeling / Q000187:drug effects*; D014664:Vasodilation / Q000187:drug effects*
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D008078:Cholesterol, LDL; D018836:Inflammation Mediators; D053244:Osteoprotegerin; C506030:TNFRSF11B protein, human; D002097:C-Reactive Protein