Hypertrophic vascular remodeling and cardiac collagen deposition were significantly evident in MSG-induced obese rats. Metformin treatment was able to reduce insulin resistance and attenuated this adverse cardiac and vascular remodeling.

Recent findings indicate an inverse relationship between cardiovascular disease and consumption of flavonoids. We aimed to identify clinical and vascular parameters of treated hypertensive who present beneficial effects of dark chocolate for one-week period on vascular function. Twenty-one hypertensive subjects, aged 40–65 years, were included in a prospective study with measurement of blood pressure (BP), brachial flow-mediated dilatation (FMD), peripheral arterial tonometry, and central hemodynamic parameters. These tests were repeated after seven days of eating dark chocolate 75 g/day. Patients were divided according to the response in FMD: responders (n = 12) and nonresponders (n = 9). The responder group presented lower age (54 ± 7 versus 61 ± 6 years, P = 0.037), Framingham risk score (FRS) (2.5 ± 1.8 versus 8.1 ± 5.1%, P = 0.017), values of peripheral (55 ± 9 versus 63 ± 5 mmHg, P = 0.041), and central pulse pressure (PP) (44 ± 10 versus 54 ± 6 mmHg, P = 0.021). FMD response showed negative correlation with FRS (r = −0.60, P = 0.014), baseline FMD (r = −0.54, P = 0.011), baseline reactive hyperemia index (RHI; r = −0.56, P = 0.008), and central PP (r = −0.43, P = 0.05). However, after linear regression analysis, only FRS and baseline RHI were associated with FMD response. In conclusion, one-week dark chocolate intake significantly improved endothelial function and reduced BP in younger hypertensive with impaired endothelial function in spite of lower cardiovascular risk.

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It has been previously documented that carotid intima-media thickness (cIMT) is a predictor of cardiovascular disease. The aim of this study was to identify clinical parameters associated with an increased cIMT treated hypertensive women. Female patients (n = 116) with essential hypertension, aged 40–65 years, were included in this study. Vascular ultrasound was performed and the patients were divided into two groups according to the values of cIMT (< or ≥0.9 mm). Patients with greater cIMT presented significantly higher systolic blood pressure and pulse pressure. Serum HDL-cholesterol was significantly lower and CRP was significantly higher in the same group. There was a significant correlation between cIMT and age (r = 0.25, P = 0.007), systolic blood pressure (r = 0.19, P = 0.009), pulse pressure (r = 0.30, P = 0.001), and LDL-cholesterol (r = 0.19, P = 0.043). cIMT was correlated to CRP (r = 0.31, P = 0.007) and negatively correlated to HDL-cholesterol (r = 0.33, P = 0.001). In logistic regression, only HDL-cholesterol, CRP, and pulse pressure were shown to be independent variables associated to increased cIMT. In conclusion, pulse pressure, HDL-cholesterol, and CRP are variables correlated with cIMT in treated hypertensive women.

The objective of this study was to compare the effect of insulin resistance, hypertension and aging on cardiac fibrosis and intramyocardial arteries (IMA). Twenty eight male rats were divided into four groups: control (CON), insulin resistance induced by monosodium glutamate (MSG) administered in neonatal period, spontaneously hypertensive rats (SHR), middle-aged rats (MAR). The first three groups were 22 weeks-old and the older group was 30 weeks-old. The heart was fixed and stained with picro Sirius red to evaluate myocardial collagen density. The lumen diameter, media thickness and media cross- sectional area (CSA) of the IMA were measured with the Image Pro Plus image analysis software. The Lee index was slightly increased in MSG group. The systolic blood pressure was significantly elevated in SHR group (CON 113±2, MSG 122±3, SHR 202±3, MAR 115±3 mmHg). The diameter of the IMA was significantly smaller in SHR (29.8±2.4 μm, p<0.01) vs MAR (35.3±2.2 μm), CON (34.0±2.3 μm) and MSG (34.7±2.4 μm). The media-to-lumen ratio was 29.5 ± 1.2% in CON, 39.8 ± 1.3% in MSG, 30.3 ± 0.6% in MAR and 46.5 ± 4.0% in SHR (P<0.001 vs CON/ MAR, P<0.01 vs MSG). The CSA of IMA was significantly increased in SHR and MSG compared to CON showing growing index of 38.5 and 33.0%, respectively. Interstitial subendocardial collagen density of the left ventricle was 2.8±.0.3% in CON, 3.1±.0.7% in SHR, 2.6±0.6 in MAR and 4.0±.0.8% in MSG (P<0.05 vs SRH, P<0.01 vs CON and MAR).The perivascular collagen density was greater in MSG group (48.4±.2.3%, p<0.001 vs other groups) but was also significantly increased in SHR (42.6±.2.3%) and MAR (36.4±1.4 %) groups compared to CON (29.8±.3.0%, p<0.01). In conclusion, hypertrophic vascular remodeling was more associated to hypertension while cardiac fibrosis was more observed when insulin resistance and obesity were present. There were no significant cardiovascular changes in older animals without hypertension and insulin resistance.

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Background: It is widely recognized that endothelial dysfunction is commonly associated to hypertension but the parameters linked to this condition among hypertensive subjects are not established yet. Objective: To identify clinical, metabolic and vascular changes related to endothelial dysfunction in treated hypertensive patients Methods: A cross-sectional study was carried out to evaluate hypertensive patients on stable drug therapy over at least 4 weeks, both genders, aged 40-70 years. Blood pressure (BP) was measured by oscilometric method, and vascular tests were performed using high-resolution ultrasonography for brachial flow-mediated dilation (FMD), Sphygmocor to obtain central hemodynamic parameters and Complior SP to determine carotid-femoral pulse wave velocity (cfPWV) which was normalized by mean BP (cfPWV-N). The 10-year risk for general cardiovascular disease from Framingham Heart Study was used to calculate vascular age. Patients (n=81) were distributed into two groups according to brachial FMD values: FMD < 10% (n=54) or FMD >= 10% (n=27). Results: The mean age was not different among the groups (55.1±8.3 vs 55.7±7.0 years, p>0.05). Systolic BP (142±19 vs 137±13, p>0.05) and diastolic BP (94±14 vs 92±13 mmHg, p>0.05) were similar in the two groups. The group with FMD < 10% presented greater carotid media-to-lumen ratio (0.12±0.03 vs 0.10±0.02, p<0.05), vascular age (77±14 vs 70±12, p<0.05) and higher duration of hypertension (9.9±9.19 vs 5.9±4.2, p<0.05) than the group with normal FMD. There was an inverse correlation between FMD and vascular age (r=-0.235, p<0.05). No significant differences in biochemical variables, parameters of vascular stiffness and number of criteria of metabolic syndrome were observed. Conclusion: The characterization of endothelial dysfunction in treated hypertensive patients was not related to age but it was more associated to duration of hypertension and vascular age. There was no evidence of vascular stiffness in these patients but the increased carotid media-to-lumen ratio may indicate the beginning of atherosclerotic process.