Elevated circulating endothelial microparticles and brachial–ankle pulse wave velocity in well-controlled hypertensive patients

Abstract

Vascular dysfunction in hypertensive condition is characterized by impaired endothelial function and reduced artery elasticity. Circulating endothelial microparticles (EMPs) and brachial-ankle pulse wave velocity (baPWV) are novel evaluation parameters for vascular function. However, their changes in patients with well-controlled blood pressure (BP) have not been fully acquired. To address this issue, circulating EMPs, defined as CD31 þ /CD42À MPs and baPWV were detected in 30 healthy subjects, 30 uncontrolled hypertensive (UCHT) patients and 23 well-controlled hypertensive (WCHT) patients. UCHT patients displayed elevated baPWV (Po0.01) and circulating EMPs (Po0.01) compared with healthy subjects. In WCHT patients, vascular damage represented by these two parameters constantly existed (Po0.01). Values of circulating EMPs were positively related to baPWV (Po0.01). Multivariate regression defined circulating EMPs as an independent contributor to the increase of baPWV value (Po0.05). Our study indicated that though BP was controlled, impaired endothelial function and arterial elasticity continued. The optimal therapy for patients with hypertension should include not only lowering BP but also improvement of vascular injury in parallel.

Endothelial microparticles: a universal marker of vascular health?

“…In this issue of the Journal of Human Hypertension, Wang et al 21 have shown that circulating EMPs in patients with hypertension are strongly associated with arterial stiffness, implying the possible involvement of these particles in processes of vascular remodelling. Such an observation is in accordance with experimental data on EMP's effects on matrix metalloproteinase activity.…”

“…11,22 Indeed, endothelial perturbation relevant to systemic inflammatory conditions (for example, in systemic lupus erythematosus) and immune disorders affecting the endothelium (for example, antiphospholipid antibody syndrome) have been reported, consistent with the universal nature of EMPs in relation to endothelial abnormalities. 23 Furthermore, Wang et al 21 show that even after normalization of blood pressure, at least in the relatively short term, arterial stiffness remains increased and these persistent abnormalities of arterial elastic properties still correlate significantly with EMPs. These findings imply the presence of mechanisms of vascular disturbance beyond immediate damage per se by high blood pressure.…”

“…EMP count is upregulated even in patients with mild hypertension but increase significantly further in those with severe hypertension. 21 However, the molecular mechanisms by which high blood pressure leads to vascular injury are not fully understood.…”

Endothelium-derived microparticles inhibit angiogenesis in the heart and enhance the inhibitory effects of hypercholesterolemia on angiogenesis

“…EMPs are present at relatively low concentrations under normal physiological conditions and, upon activation, are released from endothelial cells (6,7,26,39). Elevated plasma concentrations of EMPs have been reported in many cardiovascular diseases, such as coronary artery disease (20,30,51), acute coronary syndrome (2,3,25), and hypertension (16,29,36,48). Indeed, an increase in the concentration of EMPs has been suggested as a marker of endothelial dysfunction (15).…”

Increased plasma neopterin levels are associated with reduced endothelial function and arterial elasticity in hypertension

“…The baPWV was measured using an automatic device (VP-2000, Colin, Komaki, Japan) as described previously and expressed in cm s − 1 . 13,14 The intra-observer repeatability coefficient was 0.90 and the inter-observer repeatability coefficient was 0.95.…”