Increased arterial intima-media thickness and in vivo LDL oxidation in young men with borderline hypertension

We used borderline hypertension as a model for prehypertension to examine t he early influences of elevated blood pressure on subclinical atheroscleros is, lipoprotein oxidation, and cardiac adaptation. Healthy men (age 37+/-4 years) were classified prospectively into 2 groups on the basis of having e ither borderline hypertension (systolic 130 to 140 mm Hg or diastolic 85 to 89 mm Hg, n=16) or normal (<130/85 mm Hg, n=22) blood pressure values duri ng the previous 2 years. The groups were matched for age, body size, and se rum cholesterol levels. High-resolution ultrasound was used to measure inti ma-media thickness (IMT) of the carotid and brachial arteries, cardiac dime nsions, and brachial artery endothelial function. Baseline low-density lipo protein (LDL)-diene conjugation was measured as an estimate of in vivo LDL oxidation (ox-LDL). Compared with normotensive controls, men with borderlin e hypertension had higher IMT of the carotid artery (0.58+/-0.06 versus 0.7 5+/-0.07 mm, P<0.001) and IMT of the brachial artery (0.45+/-0.05 versus 0. 57+/-0.07 mm, P<0.001), and increased levels of ox-LDL (29+/-9 Versus 47+/- 17 mol/L, P<0.001), but similar endothelial function. Left ventricular mass was similar in both groups, but there were significant differences in left ventricular geometry. In multivariate analyses, the predictors of carotid IMT were 24-hour systolic blood pressure (P<0.001) and ox-LDL (P=0.10). The current study demonstrates evidence of increased subclinical atheroscleros is and ox-LDL in borderline hypertension. These results are consistent with the idea that enhanced ox-LDL may be one of the pathophysiological events related to development of atherosclerosis in men with borderline elevated b lood pressure.