Endothelial dysfunction in African-Americans

Patel, Pawan; Velazquez, Jose L.; Arora, Rohit

doi:10.1016/j.ijcard.2008.10.007

Cited by 24 publications

(20 citation statements)

References 218 publications

(173 reference statements)

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“…To explain this, various mechanisms such as a generalized defect in vasodilator function, impaired NO-dependent relaxation could be related to a reduced bioavailability of NO/NTG to the smooth muscle cells; a selective defect of vascular smooth muscle cell function, in particular of the soluble guanylate cyclase /cyclic guanosine monophosphate signaling system have been postulated. 15, 16 Moreover, for any given BP value, endothelial function is diminished, tends to occur early, is more severe and is associated with higher CV risk including premature onset of CV complications in African-Americans when compared to their white counterparts. 15, 16 It is also possible that impairment of endothelial-dependent dilation which seems to occur early in the evolution of high BP, namely, in the prehypertension BP range, may infact be representative of a more advanced pathological process within the vasculature of African-American subjects with masked-hypertension.…”

Section: Discussionmentioning

confidence: 99%

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Endothelial-Dependent Flow-Mediated Dilation in African Americans With Masked-Hypertension

Veerabhadrappa

Diaz

Feairheller

et al. 2011

American Journal of Hypertension

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BACKGROUND Office-blood pressure (BP) measurements alone overlook a significant number of individuals with masked-hypertension (office-BP: 120/80 -139/89 mmHg & 24-hr ambulatory BP monitoring, ABPM: daytime >135/85 mmHg or nighttime >120/70 mmHg). Diminished endothelial function contributes to the pathogenesis of hypertension. To better understand the pathophysiology involved in the increased cardiovascular disease (CVD) risk associated with masked-hypertension, we estimated the occurrence, assessed the endothelial function, compared plasma levels of inflammatory markers, white blood cell count, tumor necrosis factor-α and high sensitivity C-reactive protein (hsCRP) and examined the possible relationship between endothelial function and inflammatory markers in apparently healthy prehypertensive (office-BP: 120/80-139/89 mmHg) African-Americans. METHODS 50 African-Americans who were sedentary, non-diabetic, non-smoking, devoid of CVD were recruited. Office-BP was measured according to JNC-7 guidelines to identify prehypertensives in whom ABPM was then assessed. Fasting plasma samples were assayed for inflammatory markers. Brachial artery flow-mediated dilation at rest and during reactive hyperemia was measured in a subset of prehypertensives. RESULTS Subjects in the masked-hypertension sub-group had a higher hsCRP (P=0.04) and diminished endothelial function (P=0.03) compared to the true-prehypertensive sub-group (office-BP: 120/80-139/89 mmHg & ABPM: daytime <135/85 mmHg or nighttime <120/70 mmHg). Regression analysis showed that endothelial function was inversely related to hsCRP amongst the masked-hypertensive sub-group (R2=0.160; P=0.04). CONCLUSIONS Masked-hypertension was identified in 58% of African-Americans which suggests that a masking phenomenon may exist in a sub-group of prehypertensives who also seem to have a diminished endothelial function that could be mediated by an elevated subclinical inflammation leading to the increased CVD.

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Section: Discussionmentioning

confidence: 99%

“…14 Prior studies have also provided compelling evidence that African-Americans have an early onset of diminished endothelial function. 15, 16 …”

Section: Introductionmentioning

confidence: 99%

Endothelial-Dependent Flow-Mediated Dilation in African Americans With Masked-Hypertension

Veerabhadrappa

Diaz

Feairheller

et al. 2011

American Journal of Hypertension

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“…To explain this, some mechanisms have been postulated such as the impairment of vascular smooth muscle cell function, or the soluble guanylate cyclase/cyclic guanosine monophosphate signaling system. 17) Overall, it is suggested that impairment of the arterial wall is not limited to the endothelium layer only. The vascular smooth muscle may also be damaged simultaneously.…”

Section: A B Cmentioning

confidence: 99%

The Role of Microalbuminuria in Arterial Endothelial Dysfunction in Hypertensive Patients With Carotid Plaques

Lin

Zhang

et al. 2014

Int. Heart J.

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SummaryThe aim of this study was to evaluate the correlations between microalbuminuria (MAU) and endothelial function in hypertensive patients with carotid plaques (CP). A total of 71 hypertensive patients with CP (CP group) and 20 healthy people as normal controls (NC group) were enrolled in this study. The CP group was divided into an MAU group (MAU group, n = 33) and a non-microalbuminuria group (NM group, n = 38) according to their urinary albumin excretion rates (UAER). Endothelial function was assessed by fl ow-mediated dilation (FMD) in the brachial artery by ultrasonography, and nitroglycerin-mediated dilation (NMD) was used as a control test for FMD. Intima-media thickness (IMT) and biochemical parameters were evaluated. The ΔFMD% was signifi cantly lower in patients with and without MAU in the CP group compared to the NC group. All patients with MAU had signifi cantly lower ΔFMD% and ΔNMD% compared to the patients without MAU. ΔFMD% showed signifi cant negative correlations with IMT, systolic blood pressure, glucose, total cholesterol, low density lipoprotein, high-sensitivity C-reactive protein, and log UAER. ΔNMD% demonstrated signifi cant negative correlations with age, IMT, systolic blood pressure, glucose, and log UAER. Stepwise multiple linear regression analysis revealed that FMD was independently correlated with UAER and total cholesterol, while NMD was independently correlated with UAER and age. These results suggest that MAU might aggravate the arterial dysfunction and play a role in the arterial endothelial function in patients with hypertension and CP. Both endothelium-dependent and endothelium-independent vasodilatations were impaired in hypertensive patients with CP. ( 2) It is noteworthy that the risk increases as the number of damaged organs increases. Although the relationships between MAU and endothelial dysfunction, as well as with impaired endothelial function in hypertensive patients with CP, have been investigated in several studies, 3,4) the superposition of two OD parameters such as MAU and CP in association with endothelial function remains unclear.Carotid plaque-induced endothelial dysfunction is also indicated as a predictor for CVD events. 1) A recent study has found that vascular endothelium impairment, which is a key initial step in atherogenesis, 5) is also associated with hypertension, 6) and endothelial dysfunction is common in subjects with cardiovascular risk factors.7) Endothelial function can be assessed by fl ow-mediated dilation (FMD). Nitroglycerin-mediated dilation (NMD) has been used as a control test for FMD when evaluating endothelial function in humans. 8) FMD is an endothelium-dependent response while NMD is an endothelium-independent response. FMD is dependent on local nitric oxide (NO) bioavailability, and NMD is dependent on exogenous NO (eg, nitroglycerin). Both are well-established methods for noninvasive assessment of vascular function. 9) Recently, a few studies have demonstrated that not only FMD but also NMD is impaired in patients with atheroscler...

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“…The incidence of myocardial infarction among African-Americans may be lower than among Caucasians [7], but mortality is increased in African-Americans, particularly at younger ages. Hypertension, stroke, type 2 diabetes, and myocardial infarction are frequent outcomes of obesity and the metabolic syndrome.…”

Section: Introductionmentioning

confidence: 99%

Effect of Adolescent Obesity on Cardiometabolic Risk in African-Americans and Caucasians

Hoffman

2012

ISRN Obesity

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African-Americans have more hypertension, stroke, and type 2 diabetes than do Caucasians. Endothelial dysfunction and insulin resistance are precursors for each. Since these diseases have origins in pediatrics and are associated with obesity, this study was designed to determine if obesity has different effects on endothelial function, insulin sensitivity, and secretion in African-American and Caucasian adolescents. Thirty-three Caucasian and 25 African-Americans (10–18 years old) were subdivided by BMI into lean, overweight, and obesity groups. Endothelial function was measured as forearm vascular resistance (FVR) over 1 min following 5 min of upper arm vascular occlusion. Insulin sensitivity and secretion were measured using intravenous glucose tolerance test and minimal model. Postocclusive FVR was significantly increased in obese African-Americans. Insulin sensitivity was reduced in obese subjects but did not differ by race. Insulin secretion was increased in African-Americans but did not differ by obesity. Subjects were subdivided into risk groups based on 20th percentile for postocclusion FVR response in lean. Seven of nine obese African-Americans were in the high risk group compared to 0 of 5 obese Caucasians. These results demonstrate that obesity significantly impairs endothelial function in African-Americans. Endothelial dysfunction likely predisposes to future cardiometabolic disease in obese African-American adolescents.

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Endothelial dysfunction in African-Americans

Cited by 24 publications

References 218 publications

Endothelial-Dependent Flow-Mediated Dilation in African Americans With Masked-Hypertension

Endothelial-Dependent Flow-Mediated Dilation in African Americans With Masked-Hypertension

The Role of Microalbuminuria in Arterial Endothelial Dysfunction in Hypertensive Patients With Carotid Plaques

Effect of Adolescent Obesity on Cardiometabolic Risk in African-Americans and Caucasians

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