Abnormal Endothelium-Dependent Vascular Relaxation in Patients with Essential Hypertension

Panza, Julio A.; Quyyumi, Arshed A.; Brush, John E.; Epstein, Stephen E.

doi:10.1056/nejm199007053230105

Cited by 2,233 publications

(1,176 citation statements)

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“…12 Moreover, these findings in BS/GS patients are the opposite of those found in hypertensive patients, who have reduced EPCs number, 3,38 increased oxidative stress 42 and altered FMD. 39 Furthermore, the increased number of EPC in BS/GS patients further strengthens the role of Ang II type 1 receptor signaling in EPC biology as BS/GS patients have blunted Ang II type 1 receptor signaling. [21][22][23][24][25][26][27][28] This linkage is further highlighted by the recent report of the beneficial effects of Ang II type 1 receptor blockers on EPCs number and function in hypertensive patients.…”

Section: Discussionmentioning

confidence: 81%

“…The correlations noted are likely the result of previously reported relationships between endothelial function and EPC numbers, and function 35,36 along with the relationship between endothelial number and FMD. 37 All of these are altered in hypertension, 3,38,39 and in these alterations oxidative stress has a pivotal role. 40 Relationships between EPCs, FMD and HO-1 LA Calò et al in BS/GS patients.…”

Section: Discussionmentioning

confidence: 99%

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Endothelial progenitor cells relationships with clinical and biochemical factors in a human model of blunted angiotensin II signaling

et al. 2011

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Angiotensin II (Ang II) is essential for endothelial progenitor cells (EPCs) function as Ang-II-induced oxidative stress causes senescence of EPCs and endothelial dysfunction and Ang II type 1 receptor blockers increase EPCs. Moreover, EPCs activity is dependent on nitric oxide (NO) and heme oxygenase (HO)-1 as these correlate with EPCs senescence and are reduced in hypertensives. Bartter's/Gitelman's syndrome patients (BS/GS), have increased Ang II yet normo/hypotension along with blunted Ang II signaling, reduced oxidative stress, increased NO and HO-1, thus presenting a unique system to explore EPC biology and its relationship with vascular clinical and biochemical correlates. Circulating EPCs, NO-dependent vasodilation (flow-mediated dilation (FMD)) and HO-1 gene expression were characterized in 10 BS/GS patients and in 10 normotensive subjects. EPCs defined by cell surface antigens CD34+kinase-insert domain receptor (KDR+), CD133+KDR+ and CD133+CD34+KDR+ cells were quantitiated via direct three-color flow-cytometry analysis, HO-1 gene expression by reverse transcription-PCR and FMD by B-mode echo scan of the right brachial artery. Correlation analysis was carried out regarding FMD and EPCs, FMD and HO-1 and EPCs and HO-1. In BS/GS, CD34+KDR+ cell numbers did not differ from controls while CD133+KDR+ and CD133+CD34+ KDR+ cell numbers were higher. HO-1 gene expression, as well as FMD, was higher in BS/GS compared with controls. Both CD133+KDR+ and CD133+CD34+KDR+ strongly correlated with both FMD and HO-1. FMD and HO-1 were also strongly correlated. These results document in a human system that EPC numbers and specific populations are related to important clinical and biochemical factors involved in cardiovascular (CV) status and reaffirm the utility of BS/GS patients as a useful system to investigate EPC's role(s) in the pathophysiology of cardiovascular remodeling in humans.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Endothelial progenitor cells relationships with clinical and biochemical factors in a human model of blunted angiotensin II signaling

et al. 2011

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“…Aging, smoking, obesity, hypertension, dyslipidemia, and diabetes mellitus are well‐known risk factors of endothelial dysfunction 1, 2, 3, 4, 7, 8, 9, 23, 24, 25. We previously showed that ezFMD was significantly correlated with cardiovascular risk factors and endothelial function assessed by FMD in relatively young participants 15.…”

Section: Discussionmentioning

confidence: 99%

“…It is clinically important to assess endothelial function for early detection of atherosclerosis. Several methods have been developed to evaluate endothelial function in humans 3, 4, 5, 6, 7, 8, 9. Measurement of flow‐mediated vasodilation (FMD) in the brachial artery is a noninvasive and broadly applicable method for assessing endothelial function 4, 5, 6, 7, 8, 9.…”

Section: Introductionmentioning

confidence: 99%

Endothelial Function Assessed by Automatic Measurement of Enclosed Zone Flow‐Mediated Vasodilation Using an Oscillometric Method Is an Independent Predictor of Cardiovascular Events

Morimoto

Kajikawa

Oda

et al. 2016

JAHA

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BackgroundA new device for automatic measurement of flow‐mediated vasodilation (FMD) using an oscillometric method has been developed to solve technical problems of conventional FMD measurement. This device measures enclosed zone FMD (ezFMD). The purpose of this study was to evaluate the prognostic value of endothelial function assessed by ezFMD for future cardiovascular events.Methods and ResultsWe measured ezFMD in 272 participants who underwent health‐screening examinations. First, we investigated cross‐sectional associations between ezFMD and cardiovascular risk factors, and then we assessed the associations between ezFMD and first major cardiovascular events (death from cardiovascular causes, stroke, and coronary revascularization). Univariate regression analysis revealed that ezFMD was significantly correlated with age, triglycerides, glucose, smoking pack‐years, estimated glomerular filtration rate, high‐sensitivity C‐reactive protein, and Framingham risk score. During a median follow‐up period of 36.1 months (interquartile range 18.8–40.1 months), 12 participants died (6 from cardiovascular causes), 3 had stroke, 8 had coronary revascularization, and 10 were hospitalized for heart failure. There was no episode of acute coronary syndrome during the study period. Participants were divided into tertiles (low, intermediate, and high) based on ezFMD. Kaplan–Meier curves for first major cardiovascular events among the 3 groups were significantly different (P=0.004). After adjustment for cardiovascular risk factors, the low group was significantly associated with an increased risk of first major cardiovascular events compared with the high group (hazard ratio 6.47; 95% CI 1.09–125.55; P=0.038).ConclusionsThese findings suggest that endothelial function assessed by ezFMD may be useful as a surrogate marker of future cardiovascular events.Clinical Trial Registration URL: https://upload.umin.ac.jp. Unique identifier: UMIN000004902.

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“…Considering the key role that the vascular endothelium plays in atherogenesis, it is not surprising that major cardiovascular risk factors such as hypercholesterolaemia, 8 type 2 diabetes, 21 hypertension, 22 ageing, male gender and smoking, 23 are all accompanied by vascular endothelial dysfunction.…”

Section: Vascular Endothelial Functionmentioning

confidence: 99%

Endothelial dysfunction and arterial abnormalities in childhood obesity

Skilton

Celermajer

2006

Int J Obes

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Abnormal Endothelium-Dependent Vascular Relaxation in Patients with Essential Hypertension

Abstract: Endothelium-mediated vasodilation is impaired in patients with essential hypertension. This defect may play an important part in the functional abnormalities of resistance vessels that are observed in hypertensive patients.

Cited by 2,233 publications

References 32 publications

Endothelial progenitor cells relationships with clinical and biochemical factors in a human model of blunted angiotensin II signaling

Endothelial progenitor cells relationships with clinical and biochemical factors in a human model of blunted angiotensin II signaling

Endothelial Function Assessed by Automatic Measurement of Enclosed Zone Flow‐Mediated Vasodilation Using an Oscillometric Method Is an Independent Predictor of Cardiovascular Events

Endothelial dysfunction and arterial abnormalities in childhood obesity

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