Early activation of vascular endothelium in nonobese, nondiabetic essential hypertensive patients with multiple metabolic abnormalities.

Abstract

Circulating soluble E-selectin, intercellular adhesion molecule-1 (ICAM-1), and vascular adhesion molecule-1 (VCAM-1) concentrations were evaluated in 93 nonobese essential hypertensive patients, of whom 16 had impaired glucose tolerance and hyperlipidemia (group I); 25 had impaired glucose tolerance (group II); 28 had hyperlipidemia (group III); and 24 had no metabolic abnormalities (group IV). A group of 22 healthy volunteers served as a control group. All groups were without clinical or ultrasound evidence of vascular lesion and were matched for age, sex, and BMI. Endothelial soluble adhesion molecules were measured at baseline, during an oral glucose tolerance test, and after 12 weeks of either enalapril or placebo treatments. Plasma soluble E-selectin, ICAM-1, and VCAM-1 were higher (P < 0.05) in group I and II than in the other groups (group I: E-selectin, 96.1+/-27.1; ICAM-1, 304.0+/-102.1; VCAM-1, 626.1+/-156.2 microg/l. Group II: E-selectin, 88.0+/-18.0; ICAM-1, 268.0+/-84.1; VCAM-1, 594.1+/-140.9 microg/I. Group III: E-selectin, 70.1+/-18.1; ICAM-1, 195.1+/-68.0; VCAM-1, 495.9+/-110.1 microg/l. Group IV: E-selectin, 65.1+/-16.1; ICAM-1, 168.1+/-64.0; VCAM-1, 472.1+/-108.2 microg/l). Soluble adhesins levels were not higher than normal in groups III and IV. Plasma soluble ICAM-1 concentrations increased in group I after glucose administration and were directly correlated with 2-h insulin levels (r=0.648, P=0.007). Compared with placebo, 12 weeks of enalapril treatment significantly (P < 0.0001) reduced soluble E-selectin, ICAM-1, and VCAM-1. Decrements of soluble adhesins were not dependent on enalapril-related blood pressure changes. Therefore, an early endothelial activation was present in essential hypertensive patients with impaired glucose tolerance, regardless of the presence of hyperlipidemia. ACE inhibition counteracted such endothelial activation.

Circulating intercellular cell adhesion molecule-1, endothelin-1 and von Willebrand factor-markers of endothelial dysfunction in uncomplicated essential hypertension: the effect of treatment with ACE inhibitors

“…9 Patients with hypertension associated with other risk factors for atherosclerosis have been shown to exhibit elevated plasma levels of soluble ICAM-1, VCAM-1, E-selectin and von Willebrand factor (vWf). 10,11 Elevated levels of soluble P-selectin were associated with increased risk of future myocardial infarction and cardiovascular death in apparently healthy women. 12 Increase plasma levels of P-selectin were also reported in patients with renovascular and malignant hypertension while the authors did not observe statistically significant changes in P-selectin levels in patients with primary hypertension.…”

“…Increased levels of soluble adhesion molecules have been reported in a number of studies in patients with overt atherosclerosis or with accumulation of risk factors of atherosclerosis [8][9][10][11] and are thought to be markers of endothelial dysfunction in the early stages of atherosclerosis.…”

Biomarkers of inflammation and endothelial dysfunction as predictors of pulse pressure and incident hypertension in type 1 diabetes: a 20 year life-course study in an inception cohort

“…In addition, endothelial dysfunction/inflammation may lead to smooth muscle cell proliferation and increased synthesis of structural proteins such as collagen within the vascular wall, leading to structural stiffening of large arteries [3,9]. Previous studies on soluble CAMs and BP have produced contradictory findings but have been mostly cross-sectional and not focused on the pulsatile component of BP [44][45][46][47][48][49][50]. Appreciation of the BP curve as a summation of a steady component (MAP) and a pulsatile component (pulse pressure) has provided additional information in terms of CVD risk prediction to that traditionally obtained on the basis of elevated SBP and/or DBP alone [5].…”

The polycystic ovary syndrome: an example of obesity-related cardiovascular complication affecting young women

“…Uno dei primi segni di lesione CV è la lesione endoteliale [53,54], che rappresenta un segno precoce di aterosclerosi.…”