Association of Endothelial Function with Parental Hypertension in Normotensive-Obese African-American Women: A Pilot Study

Abstract

Obese African-American (AA) women are at high risk of hypertension (HT) and cardiovascular disease (CVD). Flow-mediated dilation (FMD) and arterial augmentation index (AI) are measures of endothelial function and arterial stiffness. Whether endothelial function and arterial stiffness predict risk of HT or CVD in obese African-American women with, versus without, parental histories of HT and whether aerobic exercise is an effective countermeasure remain unclear. The capacity for FMD is partly heritable. Therefore, we tested the hypotheses that less FMD and greater AI may be found in normotensive-obese, young-adult (18-26 year-old) AA women with hypertensive parents (n=10) than in a matched control group with normotensive parents (n=10) and that a single bout of aerobic exercise improves both endothelial function and arterial stiffness, with less improvement in the women with hypertensive parents. We studied each subject while at rest, 20 min before and 20 min after, 30 min of aerobic exercise. The exercise-induced changes and parental hypertension-related differences in AI were not significant. The exercise increased FMD in both of the groups with no significant difference in magnitude between the women with hypertensive and normotensive parents. FMD was significantly less in the women with hypertensive parents than in the women with normotensive parents after, but not before, the exercise (mean ±95% confidence interval of 11.3 ± 4.9% vs. 15.6 ± 4.9%, P=0.05). These findings suggest that a 30-min bout of aerobic exercise may improve FMD and unmask endothelial dysfunction in normotensive-obese, young-adult AA women with parental histories of HT. Future studies should determine whether regular aerobic exercise protects obese AA women from the endothelial dysfunction associated with diabetes and prevents CVD in this high-risk population.

Young healthy adults with a family history of hypertension have increased microvascular reactivity but decreased macrovascular function

“…Our finding of attenuated FMD in +FHH group are in agreement with some, 27 but not all previous data. 25,26 However, the current investigation is the only study to statically control for baseline brachial artery diameter or shear rate when examining FMD. Both of these variables impact FMD response 28 and should be accounted for to determine an unbiased assessment of endothelial function.…”

“…25 Previous studies examining the relationship between familial history of hypertension and FMD have shown mixed results. [25][26][27] However, none of these studies accounted for the baseline diameter of the brachial artery, or the stimulus for the FMD response, that is, shear rate. Both of these variables are generally believed to impact FMD response and should be accounted for to determine an unbiased assessment of endothelial function.…”

Endothelial dysfunction in metabolic syndrome patients with and without hypertension

“…There is a close relation between endothelial dysfunction, metabolic syndrome and hypertension, especially through oxidative stress in the vascular endothelium. 18,19…”

Endothelial dysfunction in hypertension: cause or effect?

“…В недавно опубликованном пилотном исследовании [14], объектом исследования которого являлись молодые женщины с ожирением и нормальным артериальным давлением (АД), были получены схожие результаты -ЭД предопределяется отягощенным анамнезом по АГ. Важным наблюдением авторов является тот факт, что у нормотензивных лиц ЭД была диагностирована не в покое, а после 30-минутной аэробной нагрузки.…”

“…В целом, анализ литературы выявил достаточное количество работ [11,14,16], демонстрирующих первичную роль ЭД в развитии АГ у лиц с отягощенной наследственностью по ССЗ, в т. ч. у подростков и молодых людей [17,18].…”