Abstract:Background-Studies in selected samples have linked impaired endothelial function with cardiovascular disease and its risk factors. The clinical correlates and heritability of endothelial function in the community have not been described. Methods and Results-We examined a measure of endothelial function, brachial artery flow-mediated dilation (FMD), expressed as both percent (FMD%) and actual dilation by ultrasound with the occlusion cuff below the elbow in 2883 Framingham Study participants (52.9% women; mean … Show more
“…These include brachial artery flow-mediated dilatation and venous occlusion plethysmography 1,23 . Severity of hypertension correlates with impairment of endothelial function and anti-hypertensive therapies that improve endothelial function in addition to lowering blood pressure may be associated with greater improvements in overall cardiovascular risk 1,24,25 .…”
Hypertension, the most common preventable risk factor for cardiovascular disease and death, is a growing health burden. Serious cardiovascular complications result from target organ damage including cerebrovascular disease, heart failure, ischaemic heart disease and renal failure. While many systems contribute to blood pressure elevation, the vascular system is particularly important, because vascular dysfunction is a cause and consequence of hypertension. Hypertension is characterised by a vascular phenotype of endothelial dysfunction, arterial remodelling, vascular inflammation and increased stiffness. Antihypertensive drugs that influence vascular changes associated with high blood pressure have greater efficacy for reducing cardiovascular risk than drugs that reduce blood pressure but have little or no effect on the adverse vascular phenotype. Angiotensin converting enzyme
Key Points• Hypertension is characterized by a vascular phenotype of endothelial dysfunction and structural remodeling.• Anti-hypertensive drugs that target the vascular changes associated with hypertension appear to be most efficacious• New anti-hypertensive drugs should promote vascular health as well as reducing blood pressure 3
“…These include brachial artery flow-mediated dilatation and venous occlusion plethysmography 1,23 . Severity of hypertension correlates with impairment of endothelial function and anti-hypertensive therapies that improve endothelial function in addition to lowering blood pressure may be associated with greater improvements in overall cardiovascular risk 1,24,25 .…”
Hypertension, the most common preventable risk factor for cardiovascular disease and death, is a growing health burden. Serious cardiovascular complications result from target organ damage including cerebrovascular disease, heart failure, ischaemic heart disease and renal failure. While many systems contribute to blood pressure elevation, the vascular system is particularly important, because vascular dysfunction is a cause and consequence of hypertension. Hypertension is characterised by a vascular phenotype of endothelial dysfunction, arterial remodelling, vascular inflammation and increased stiffness. Antihypertensive drugs that influence vascular changes associated with high blood pressure have greater efficacy for reducing cardiovascular risk than drugs that reduce blood pressure but have little or no effect on the adverse vascular phenotype. Angiotensin converting enzyme
Key Points• Hypertension is characterized by a vascular phenotype of endothelial dysfunction and structural remodeling.• Anti-hypertensive drugs that target the vascular changes associated with hypertension appear to be most efficacious• New anti-hypertensive drugs should promote vascular health as well as reducing blood pressure 3
“…38,39 Measurement of flow-mediated vasodilation (FMD) in the brachial artery using ultrasound is noninvasive and reflects NO production very well. 40,41 It is accepted that measurement of forearm blood flow responses to vasoactive agents and reactive hyperemia is an index of resistance artery endothelial function and that measurement of FMD is an index of conduit artery endothelial function. Recently, finger plethysmography peripheral arterial tonometry has also been used.…”
Hypertension is one of the common diseases in the elderly. The prevalence of hypertension markedly increases with advancing age. Both aging and hypertension have a critical role in cardiovascular and cerebrovascular complications. Although aging and hypertension, either independently or collectively, impair endothelial function, aging and hypertension may have similar cascades for the pathogenesis and development of endothelial dysfunction. Nitric oxide (NO) has an important role in regulation of vascular tone. Decrease in NO bioavailability by endothelial dysfunction would lead to elevation of blood pressure. An imbalance of reduced production of NO or increased production of reactive oxygen species, mainly superoxide, may promote endothelial dysfunction. One possible mechanism by which the prevalence of hypertension is increased in relation to aging may be advancing endothelial dysfunction associated with aging through an increase in oxidative stress. In addition, endothelial cell senescence is also involved in aging-related endothelial dysfunction. In this review, we focus on recent findings and interactions between endothelial function, oxidative stress and hypertension in aging.
“…Aging, smoking, obesity, hypertension, dyslipidemia, and diabetes mellitus are well‐known risk factors of endothelial dysfunction 1, 2, 3, 4, 7, 8, 9, 23, 24, 25. We previously showed that ezFMD was significantly correlated with cardiovascular risk factors and endothelial function assessed by FMD in relatively young participants 15.…”
Section: Discussionmentioning
confidence: 99%
“…It is clinically important to assess endothelial function for early detection of atherosclerosis. Several methods have been developed to evaluate endothelial function in humans 3, 4, 5, 6, 7, 8, 9. Measurement of flow‐mediated vasodilation (FMD) in the brachial artery is a noninvasive and broadly applicable method for assessing endothelial function 4, 5, 6, 7, 8, 9.…”
Section: Introductionmentioning
confidence: 99%
“…Several methods have been developed to evaluate endothelial function in humans 3, 4, 5, 6, 7, 8, 9. Measurement of flow‐mediated vasodilation (FMD) in the brachial artery is a noninvasive and broadly applicable method for assessing endothelial function 4, 5, 6, 7, 8, 9. It has been shown that endothelial dysfunction evaluated by FMD is an independent predictor of cardiovascular events 10, 11, 12, 13, 14…”
BackgroundA new device for automatic measurement of flow‐mediated vasodilation (FMD) using an oscillometric method has been developed to solve technical problems of conventional FMD measurement. This device measures enclosed zone FMD (ezFMD). The purpose of this study was to evaluate the prognostic value of endothelial function assessed by ezFMD for future cardiovascular events.Methods and ResultsWe measured ezFMD in 272 participants who underwent health‐screening examinations. First, we investigated cross‐sectional associations between ezFMD and cardiovascular risk factors, and then we assessed the associations between ezFMD and first major cardiovascular events (death from cardiovascular causes, stroke, and coronary revascularization). Univariate regression analysis revealed that ezFMD was significantly correlated with age, triglycerides, glucose, smoking pack‐years, estimated glomerular filtration rate, high‐sensitivity C‐reactive protein, and Framingham risk score. During a median follow‐up period of 36.1 months (interquartile range 18.8–40.1 months), 12 participants died (6 from cardiovascular causes), 3 had stroke, 8 had coronary revascularization, and 10 were hospitalized for heart failure. There was no episode of acute coronary syndrome during the study period. Participants were divided into tertiles (low, intermediate, and high) based on ezFMD. Kaplan–Meier curves for first major cardiovascular events among the 3 groups were significantly different (P=0.004). After adjustment for cardiovascular risk factors, the low group was significantly associated with an increased risk of first major cardiovascular events compared with the high group (hazard ratio 6.47; 95% CI 1.09–125.55; P=0.038).ConclusionsThese findings suggest that endothelial function assessed by ezFMD may be useful as a surrogate marker of future cardiovascular events.Clinical Trial Registration
URL: https://upload.umin.ac.jp. Unique identifier: UMIN000004902.
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