Noninvasive detection of vascular dysfunction in alcoholic patients

Vasodilation is impaired in various conditions, such as hypercholesterolemi a and tobacco use. We evaluated brachial artery flow-mediated vasodilation (FMD) after blood pressure (BP) cuff occlusion using high-resolution B-mode ultrasound in 20 alcoholics, without any coexisting conditions such as smo king, hypertension, or cholesterolemia, after a 3-month period of abstinenc e. They were compared with a control group of 20 alcohol-free healthy subje cts. We measured the diameter of the brachial artery under baseline conditi ons, during reactive hyperemia (with increased flow causing endothelium-dep endent dilatation), and after administration of sublingual glyceryl trinitr ate (GTN), an endothelium-independent dilator. We performed an echocardiogr aphic study (Esaote Au3) according to guidelines of the American Society of Echocardiography to assess left ventricular mass (LVM), wall thickness, sy stolic stress, and diastolic function changes. FMD (% diameter change) was significantly less in the alcoholic patients than in the controls (6.03 +/- 3.67 v 13.7 +/- 4.65; P <.05), whereas no difference was noted after GTN a dministration (13.7 +/- 7.97 v 16.0 +/- 5.12, P = NS). Echocardiographic st udy showed no differences between the study group for LVM, wall thickness, and systolic stress; diastolic function expressed as EIA ratio inversion wa s significantly impaired, These data demonstrate an impairment of endotheli al-dependent vasodilatation in chronic alcohol abusers, which may contribut e to the excess prevalence of cardiovascular diseases in these individuals. Am J Hypertens 1999;12:137-144 (C) 1999 American Journal of Hypertension, Ltd.