Impaired endothelial-dependent forearm vascular relaxation in black Americans

Jones, Drew; Andrawis, Nabil S.; Abernethy, Darrell R.

doi:10.1016/s0009-9236(99)70135-9

Cited by 48 publications

(39 citation statements)

References 30 publications

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“…Endothelial function in normal healthy adults is influenced by variables such as race (17,21), age (22), and prandial state (23). Endothelial dysfunction has been associated with several disease states, including obesity (24), diabetes mellitus (25), and hypertension (26).…”

Section: Discussionmentioning

confidence: 99%

Impaired Vascular Reactivity in African-American Patients with Type 2 Diabetes Mellitus and Microalbuminuria or Proteinuria Despite Angiotensin-Converting Enzyme Inhibitor Therapy

Jawa

Nachimuthu

Pendergrass

et al. 2006

The Journal of Clinical Endocrinology & Metabolism

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Our study clearly demonstrates that African-American type 2 diabetic subjects with persistent microalbuminuria have severely impaired FMD and NDD, compared with matched patients who had microalbuminuria that was eliminated by ACEI. This may explain the poor prognosis for cardiovascular disease in patients who have persistent microalbuminuria. Alternative strategies for reducing microalbuminuria in high-risk patients who do not respond adequately to ACEI therapy such as African-Americans are needed.

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Section: Discussionmentioning

confidence: 99%

Impaired Vascular Reactivity in African-American Patients with Type 2 Diabetes Mellitus and Microalbuminuria or Proteinuria Despite Angiotensin-Converting Enzyme Inhibitor Therapy

Jawa

Nachimuthu

Pendergrass

et al. 2006

The Journal of Clinical Endocrinology & Metabolism

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“…Studies in the forearm circulation have found important racial differences in vasoreactivity, including a higher minimum forearm vascular resistance, depressed vasodilation in response to ␤-adrenergic stimulation, attenuation in cyclic nucleotide-mediated vascular smooth muscle relaxation, depressed postischemic vasodilation, and an increased median effective concentration in response to acetylcholine among African American subjects. [47][48][49][50][51] These studies were all performed in healthy, young or middle-aged volunteer subjects. Our study differs because of its performance in the coronary circulation in subjects with angiographically normal arteries referred because of symptoms suggestive of coronary insufficiency.…”

Section: Discussionmentioning

confidence: 99%

African Americans With LVH Demonstrate Depressed Sensitivity of the Coronary Microcirculation to Stimulated Relaxation

Houghton

Strogatz²,

Torosoff³

et al. 2003

Hypertension

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Abstract-Excess coronary heart disease morbidity and mortality among African Americans remains an important yet unexplained public health problem. We hypothesized that adverse outcome is in part due to intrinsic or acquired abnormalities in coronary endothelial function and vasoreactivity. We compared dose-response curves relating changes in coronary blood flow and epicardial diameter to graded infusions of acetylcholine in 50 African American and 65 white subjects with hypertensive left ventricular hypertrophy (LVH) and normal coronary arteries. These groups were similar for age, body mass index, mean arterial pressure, and indexed left ventricular mass. The same protocol was conducted in 24 normotensive African American and 56 similar white subjects. We found significant depression in the coronary blood flow dose-response curve relation among African Americans when compared with white subjects with similar LVH (PϽ0.03). Racial differences were observed at all doses of acetylcholine but were less precisely estimated at the highest dose. The same testing among normotensive subjects revealed similar dose-response curves with no significant effect of race. Qualitatively similar results were found with respect to coronary diameter. Adenosine responses, a measure of endothelium-independent function, were similar after partitioning by LVH. Our study demonstrates that there are racial differences in sensitivity of coronary arteries to acetylcholine-stimulated relaxation among those with LVH. These results provide a mechanism whereby racial differences in coronary vasoreactivity might contribute to adverse coronary heart disease outcome among African Americans, a group in whom LVH is prevalent.

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“…28 However, another study has shown that the response to sodium nitroprusside is normal in blacks similar in age to those in the present study and younger than the population examined by other authors when vasodilatation is assessed by measurement of forearm vascular resistance. 29 To try to explain this discrepancy in the endotheliumindependent NO-mediated vasodilatory response of blacks when assessed by different methods, we reviewed existing literature on assessment of endothelial function. In most of the studies, the findings regarding the endothelium-dependent and endothelium-independent NO mediated vasodilatory responses in a population were consistent, irrespective of the methodology used to assess endothelial function.…”

Section: Discussionmentioning

confidence: 99%

Brachial Vascular Reactivity in Blacks

et al. 2000

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Abstract-Endothelial function was studied ultrasonographically in a healthy subset of African Americans (blacks) because they have an increased risk of hypertension and vascular disease. Twenty-four healthy black and 28 well-matched white subjects were investigated. Ischemia was induced by inflating a cuff over the forearm to 40 mm Hg higher than systolic pressure for 5 minutes. Brachial artery diameter and blood flow velocity were measured at baseline and at 15, 45, and 60 seconds after deflation by use of an Acuson 128XP10 ultrasonograph with a 7.

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Impaired endothelial-dependent forearm vascular relaxation in black Americans

Cited by 48 publications

References 30 publications

Impaired Vascular Reactivity in African-American Patients with Type 2 Diabetes Mellitus and Microalbuminuria or Proteinuria Despite Angiotensin-Converting Enzyme Inhibitor Therapy

Impaired Vascular Reactivity in African-American Patients with Type 2 Diabetes Mellitus and Microalbuminuria or Proteinuria Despite Angiotensin-Converting Enzyme Inhibitor Therapy

African Americans With LVH Demonstrate Depressed Sensitivity of the Coronary Microcirculation to Stimulated Relaxation

Brachial Vascular Reactivity in Blacks

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