Endothelial function in normotensive and high-normal hypertensive subjects

Plavnik, FL; Ajzen, Sérgio Aron; Christofalo, Dejaldo M. J.; Barbosa, Cristiane; Kohlmann, Oswaldo

doi:10.1038/sj.jhh.1002164

Cited by 20 publications

(25 citation statements)

References 14 publications

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“…11 More recently, Plavnik et al showed that in a healthy normotensive (SBP <140 mmHg) population aged 35-50 years, without any risk factor for atherosclerotic disease, subjects with SBP ≥115 mmHg, when compared with subjects with SBP <115 mmHg, had a significant reduction in FMD for every 10 mmHg increase in SBP. 22 In agreement with them, our study demonstrated that FMD was lower in subjects with SBP <120 mmHg than in those with >120 mmHg in the non-smoking group.…”

Section: Discussionsupporting

confidence: 79%

Influence of Systolic Blood Pressure and Cigarette Smoking on Endothelial Function in Young Healthy People

Yufu

Takahashi

Okada

et al. 2009

Circ J

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ndothelial dysfunction is a disease process that occurs throughout the vascular system and results in abnormal regulation of blood vessel tone and the loss of the atheroprotective properties of normal endothelium. 1,2 Endothelial dysfunction is, therefore, emerging as an important pathogenic mechanism for atherosclerosis and may be an early manifestation of certain cardiovascular diseases. 3 Flow-mediated dilatation (FMD) of the brachial artery, as induced by reactive hyperemia, has been convincingly demonstrated to reflect systemic endothelium-dependent vasodilatory capacity, which is mediated by nitric oxide (NO). [4][5][6][7][8] FMD correlates with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in relatively young healthy individuals, 9,10 and FMD of the brachial artery is known to be impaired by hypertension in middle-aged individuals. 11 However, less is known regarding the relationship between FMD and blood pressure (BP) profile in young healthy individuals. Cigarette smoking is an established risk factor for cardiovascular disease and the leading preventable cause of coronary artery disease and death. 12 It reduces FMD in asymptomatic, young adults, consistent with an early stage of endothelial dysfunction, 13,14 which we recently confirmed. 15 In the present study, therefore, we investigated whether an inverse relationship between FMD and SBP would be observed even in young healthy subjects, with special attention to the effects of cigarette smoking. Methods Study PopulationWe enrolled 62 healthy subjects, 20-40 years of age (mean 29.7±5.5 years; 14 females, 48 males). None of the participants had a history of hypertension (SBP ≥140 mmHg or DBP ≥90 mmHg), a pulse pressure (PP) >60 mmHg, hypercholesterolemia, dyslipidemia, thyroid disease, or diabetes mellitus. Further, none of the participants took antioxidants or cardiovascular medications before or during this study. Of the 62 subjects, 30 (30.1±5.5 years) were active cigarette smokers with a mean cumulative nicotine consumption of 10.3±8.1 pack/years, and were thus assigned to the smoking group. The remaining 32 subjects (29.3±5.5 years) did not have a history of cigarette smoking and were assigned to the non-smoking group. Based on the Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2004), the subjects in each group were subdivided into those with SBP <120 mmHg (optimal) or SBP >120 mmHg (normal/high-normal). One pack/year was defined as smoking 20 cigarettes per day for 1 year. 13 The study conformed to the principles outlined in the Declaration of Helsinki and was approved by the institutional ethics review board. Written informed consent was given by all subjects. Assessment of FMD and NMDEndothelium-dependent FMD in response to reactive hyperemia and endothelium-independent nitroglycerininduced dilatation (NMD) were examined in the brachial (Received May 8, 2008; revised manuscript received August 26, 2008; accepted August 28, 2008; released online November 29, 2008) Departments of Internal...

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Section: Discussionsupporting

confidence: 79%

Influence of Systolic Blood Pressure and Cigarette Smoking on Endothelial Function in Young Healthy People

Yufu

Takahashi

Okada

et al. 2009

Circ J

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“…4 As with LVH, a defect EDV has also been shown to predict future cardiovascular events. 5,6 Previous studies have shown LVH to be related to an impaired EDV in hypertensive subjects.…”

Section: Introductionmentioning

confidence: 99%

Left ventricular mass is related to endothelium-dependent vasodilation in the forearm, but not in the brachial artery, in elderly subjects: the Prospective Investigation of the Vasculature in Uppsala Seniors study

Lind

2008

J Hum Hypertens

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Left ventricular hypertrophy (LVH) is a powerful cardiovascular risk factor and has previously been related to endothelium-dependent vasodilation (EDV) in hypertensive patients. In the Prospective Investigation of the Vasculature in Uppsala Seniors study, different techniques to evaluate EDV in different types of vessels were applied and were related to left ventricular mass index (LVMI) in the general population. In 1016 subjects aged 70 years, EDV was evaluated by the invasive forearm technique with acetylcholine given in the brachial artery, the brachial artery ultrasound technique with measurement of flow-mediated dilatation (FMD) and the pulse wave analysis method with b-2-agonist (terbutaline) provocation. LVMI was determined by echocardiography. LVMI was related to both EDV and the pulse wave-based technique (both r ¼ À0.14, Po0.0001) in univariate analysis. LVMI was also weakly related to FMD (r ¼ À0.07, P ¼ 0.046). However, in multiple regression analysis adjusted for gender, systolic and diastolic blood pressure and use of antihypertensive medication, only EDV was associated with LVMI (P ¼ 0.016). EDV was mainly reduced in those with left ventricular concentric hypertrophy (P ¼ 0.0012). In conclusion, in a population-based sample of elderly subjects, EDV, but not FMD, was inversely correlated with LVM independent of blood pressure, suggesting that EDV in resistance arteries is of more importance for LVH than endothelial vasodilatory function in conduit arteries in the elderly.

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“…In 2007, Plavnik et al [12] have analyzed the nitrate-mediated endothelium-dependent and -independent vasodilation response (FMD) in 33 normotensive subjects compared to 28 normal-high blood pressure subjects with age and BMI similar to those of the present study and the authors have demonstrated a flow-mediated vasodilation response about 30% lower in the first group, suggesting endothelial dysfunction at prehypertension levels. Nevertheless, there subjects were mainly males, and race and sedentary lifestyle were not study variables.…”

Section: Discussionmentioning

confidence: 88%

“…[9,10] Nevertheless, data on the influence of clinical and epidemiological profile of prehypertensive subjects on endothelial function is lacking and little is known about the relationship between intermediate cardiovascular phenotypes and race differences. Pulse wave velocity seems to be greater in Africans than in Europeans.[11] Plavnik et al [12], when comparing the endothelial function of prehypertensive and normotensive subjects, have showed no impact of body weight on FMD in either group.This study aimed at evaluating the endothelial function of prehypertensive subjects by FMD and investigating the association of demographic, anthropometric and clinical characteristics with endothelial dysfunction. …”

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confidence: 99%

Endothelial Dysfunction in Prehypertension and Associated Factors

Ribeiro

Ribeiro³

et al. 2016

Int Arch Med

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Background: Endothelial dysfunction precedes structural abnormalities and atherosclerosis clinical manifestations, and thus it is considered an early marker of cardiovascular diseases. The objectives of this cross-sectional study were to determine the frequency of endothelial dysfunction in prehypertensive subjects and its association with demographic, anthropometric and clinical characteristics of the population studied. Methods and Results:Endothelial function was assessed by flowmediated vasodilation (FMD) of the brachial artery in 60 non-smoking and non-diabetic prehypertensive subjects aged 30-70 years who were recruited from the community. Variables analyzed were gender, age, race, sedentary lifestyle, dyslipidemia, body mass index, abdominal circumference and blood pressure. In order to evaluate the relationship between endothelial dysfunction and study variables, Student t, Mann-Whitney and chi-square tests were used. Multivariate logistic regression of variables analyzed with respect to endothelial dysfunction was applied in unadjusted as well as adjusted models (p<0.20). Significance level was set at 5%. Mean age of prehypertensive subjects was 42.6±9.2 years; 60% were females, 33.3% were Black, 61.6% were overweight, and 68.3% had a sedentary lifestyle. Endothelial dysfunction was detected in 36.7% of the population; its frequency was higher for Black subjects (45%). Association was established between endothelial dysfunction and males as well as obesity, the latter even after adjustment of the model (p=0.010). Conclusions:In conclusion, frequency of endothelial dysfunction as determined by FMD was high in the population under study, even IntroductionEndothelial dysfunction is associated with atherosclerosis progression and complications, and thus it is an early marker of cardiovascular disease (CVD). [1] Endothelial dysfunction as detected by flow-mediated vasodilation (FMD) of the brachial artery was related to the presence of coronary artery disease in 122 subjects undergoing coronary angiography, with 71% sensitivity and 81% specificity.[2] The positive predictive value of abnormal brachial dilation with respect to coronary endothelial dysfunction is 95%.[3] Therefore, assessment of endothelial function can help in the identification of early changes in asymptomatic subjects with CVD risk factors, such as prehypertension.Despite controversies over the use of the term 'prehypertension', studies have demonstrated that this clinical condition is an independent risk factor for the development of systemic arterial hypertension (SAH) and arteriosclerotic vascular disease. [4][5][6][7] Weil et al [8] have shown that, regardless of other CVD risk factors, prehypertension is associated with decreased blood flow in the forearm in response to acetylcholine infusion, suggesting less endotheliumdependent vasodilation. Moreover, it is known that increased age is associated to decreased endothelium-dependent vasodilation in humans and such reduction occurs earlier in males than females. [9,10] Neverthel...

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Endothelial function in normotensive and high-normal hypertensive subjects

Cited by 20 publications

References 14 publications

Influence of Systolic Blood Pressure and Cigarette Smoking on Endothelial Function in Young Healthy People

Influence of Systolic Blood Pressure and Cigarette Smoking on Endothelial Function in Young Healthy People

Left ventricular mass is related to endothelium-dependent vasodilation in the forearm, but not in the brachial artery, in elderly subjects: the Prospective Investigation of the Vasculature in Uppsala Seniors study

Endothelial Dysfunction in Prehypertension and Associated Factors

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