Jb. Park et al., Correlation of endothelial function in large and small arteries in human essential hypertension., J HYPERTENS, 19(3), 2001, pp. 415-420
Citations number
37
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Objectives The structure and function of blood vessels varies along the vas
cular tree, and alterations found in hypertension are also different. The a
im of this study was to determine whether non-invasive measurement of endot
helial function in conduit arteries reflects that of subcutaneous resistanc
e arteries measured in vitro.
Methods and Results Sixteen essential hypertensive patients (aged 50 +/- 2
years) were studied. Plow-mediated dilation (FMD) during reactive hyperemia
(endothelium-dependent) and sublingual nitroglycerin (NTG)-induced dilatat
ion (endothelium-independent) were assessed in brachial arteries by ultraso
und. Structure, and acetylcholine (10(-9) to 10(-4) mol/l) and sodium nitro
prusside (SNP, 10(-8) to 10(-3) mol/l)-induced vasorelaxation of resistance
arteries dissected from gluteal subcutaneous biopsies were measured in vit
ro using a pressurized myograph. Brachial artery FMD and NTG-induced dilata
tion were 8.4 +/- 1.0 and 18.1 +/- 1.4%, respectively. Resistance arteries
of hypertensive patients showed greater media:lumen ratio (8.6 +/- 0.4 vers
us 5.9 +/- 0.3% in normotensive subjects, P< 0.01), and maximal acetylcholi
ne responses was diminished to 75 +/- 6% compared to normotensive subjects
(97 +/- 2%, P< 0.01). FMD correlated with maximal acetylcholine responses (
r(2) = 0.57, P< 0.001). FMD did not correlate significantly with the media:
lumen ratio of resistance arteries (r(2) = -0.22, P= 0.07). By multivariat
e analysis, FMD predicted resistance artery endothelial function independen
tly of age, sex, body mass index, blood lipid status and lumen diameter of
brachial artery (<beta> = 0.81, p< 0.001).
Conclusions Endothelial dilatory responses are similar in large and small a
rteries in hypertensive patients. Abnormal FMD in the brachial artery predi
cts the presence of endothelial dysfunction in human resistance arteries, s
uggesting that impairment of endothelial function is a generalized alterati
on in hypertension. Ultrasound measurement of endothelial dysfunction in th
e brachial artery appears to be less sensitive than in-vitro measurement in
resistance arteries. I Hypertens 19:415-420 (C) 2001 Lippincott Williams &
Wilkins.