Circulating intercellular cell adhesion molecule-1, endothelin-1 and von Willebrand factor-markers of endothelial dysfunction in uncomplicated essential hypertension: the effect of treatment with ACE inhibitors

Abstract

The aim of the study was to examine whether the circulating cell adhesion molecules, von Willebrand factor (vWf) and endothelin-1, are elevated in patients with essential hypertension with no other risk factors for atherosclerosis and thus may serve as a markers of endothelial dysfunction in uncomplicated hypertension. Furthermore, the effect of treatment with the ACE inhibitor, quinapril, on levels of endothelial dysfunction markers were studied. The levels of adhesion molecules (intercellular cell adhesion molecule-1 [ICAM-1], E-selectin, P-selectin), von Wilebrand factor (vWf) and endothelin-1 were measured in patients with hypertension without any other risk factors of atherosclerosis before and after treatment with quinapril (n = 22) and in normotensive controls (n = 22). Compared with normotensive subjects, the hypertensive patients had significantly higher levels of ICAM-1 (238 vs 208 ng/ml, P = 0.02), vWf (119 vs 105 IU/dl, P Ͻ 0.05) and endothelin-1 (5.76 vs 5.14 fmol/ml, P Ͻ 0.05). Three-month treatment of hyper-

Haemorheological, platelet and endothelial factors in essential hypertension

“…Rilmenidine therapy significantly reduced platelet aggregation and levels of βTG and vWf, whilst failing to significantly affect fibrinogen or TM levels. 4 Results from the three studies confirm that, in the early stages of hypertension, blood viscosity is increased, although the pathophysiological significance of this increase is unknown. In theory, it should contribute to increased peripheral resistance and should also increase cardiac afterload and promote left ventricular hypertrophy.…”

“…4 In addition, after quinapril treatment, the levels of ICAM-1, vWf and endothelin-1 among the hypertensives were no longer significantly different from the control group. Rilmenidine therapy significantly reduced platelet aggregation and levels of βTG and vWf, whilst failing to significantly affect fibrinogen or TM levels.…”

“…Hlubocká et al 4 noted significantly higher levels of ICAM-1, vWf, and endothelin-1 among the hypertensives compared to the normotensives, whilst no significant difference was found in levels of E-selectin, P-selectin, fibrinogen, tissue plasminogen activator (tPA) and plasminogen activator inhibitor type 1 (PAI-1). The hypertensives in the study by Ciuffetti et al 3 showed significantly higher blood vis- Table 1 Haemorheological and endothelial factors found to differ significantly between hypertensives and normotensives in three studies [3][4][5] von Willebrand factor Beta thromboglobulin Soluble thrombomodulin P-selectin Intracellular cell adhesion molecule-1 Endothelin-1 Blood viscosity Plasma viscosity Fibrinogen Red cell filterability Leucocyte filterability Red cell deformability Red cell aggregation Platelet aggregation cosity, plasma viscosity, fibrinogen and soluble Pselectin levels, together with significantly increased red blood cell filterability, unfractionated leucocyte filterability, erythrocyte deformability and erythrocyte aggregation. Furthermore, among the hypertensives, similar differences were seen for both the low and high capillary density subgroups.…”

“…[3][4][5] In addition, Ciuffetti et al 3 further divided their hypertensives into two groups based on skin capillary density (which may contribute to the increase in total peripheral resist-Journal of Human Hypertension ance among hypertensives). Moreover, Hlubocká et al 4 examined the effects of antihypertensive treatment with quinapril (an angiotensin-converting enzyme (ACE) inhibitor) on cell adhesion molecules, whilst Remková and Kratochvíl'ová 5 reported the impact of rilmenidine (a second-generation sympatholytic) therapy on endothelial and platelet function.…”

“…Hlubocká et al 4 examined 22 men (aged 35-66 years) from the Czech Republic who had mild hypertension (mean ± SD systolic blood pressure (SBP) 143 ± 18 and diastolic blood pressure (DBP) 94 ± 8 mm Hg) and 22 agematched controls (BP below 140/90 mm Hg). Remková and Kratochvíl'ová 5 selected 23 (10 women and 13 men) newly diagnosed hypertensives (SBP у140 and/or DBP у90 mm Hg) from the Slovak Republic who were aged 20-73 and an equal number of age-sex matched controls.…”