Platelet-derived extracellular vesicles correlate with therapy-induced nocturnal blood pressure changes

Abstract

Introduction: Elevated nocturnal blood pressure (BP) is closely associated with increased risk of cardiovascular (CV) events. Circulating extracellular vesicles (EVs) have been proposed as a potential CV risk biomarker and shown to correlate with BP. The present study aimed to assess whether a reduction in BP is paralleled by respective changes in EVs.Methods: Fifty-five hypertensive patients (age: 57.7 AE 14.1 years) were included in the study. EVs and BP were assessed at baseline and at 12 weeks follow-up. Interventions to lower BP included advice on life-style modification only or life-style advice combined with additional pharmacotherapy. EVs were evaluated by flow cytometry (CD41R/Annexin VR) and BP by unobserved automated office BP and ambulatory BP monitoring.Results: Nocturnal systolic BP correlated with EV levels at baseline (P ¼ 0.01). Multivariable regression models showed that changes in nocturnal systolic BP (adjusted R 2 ¼ 0.23; P ¼ 0.01) and diastolic BP (adjusted R 2 ¼ 0.18; P ¼ 0.02) were associated with respective changes in EV levels. Furthermore, intervention-induced improvement of systolic dipping was associated with a reduction in EVs in the univariate analysis (adjusted R 2 ¼ 0.06; P ¼ 0.03). In contrast, systolic office, 24 h-and daytime-BP did not show significant associations with EVs. Patients whose medication was up-titrated at baseline showed a trend towards lower EV levels at follow-up (absolute change of À1.7 AE 1.3 EV/ml; P ¼ 0.057) Conclusions: Circulating platelet-derived EVs were positively associated with nocturnal BP and therapyinduced changes over a 12-week treatment period. EVs may provide an integrated measure of BP changes achieved with pharmacotherapy.

Evaluation of Circulating Platelet Extracellular Vesicles and Hypertension Mediated Organ Damage

“…Using gold standard BP evaluation (office and ambulatory BP). we have previously demonstrated a positive correlation between the pEV levels and BP and PWV [ 13 , 14 , 15 ]. Other studies have previously investigated EVs in the context of vascular damage and blood pressure, with a special focus on endothelial-derived EVs.…”

Emerging topics on basic research in hypertension: interorgan communication and the need for interresearcher collaboration

“…Ochiai-Homma et al showed that pendrin in urinary EVs can be a useful biomarker for the diagnosis and treatment of primary aldosteronism, and this finding was supported by studies using a rat model of aldosterone excess [ 46 ]. Lugo-Gavidia et al indicated that circulating platelet-derived EVs were positively associated with nocturnal blood pressure at baseline and therapy-induced blood pressure changes over a 12-week treatment period with ambulatory blood pressure monitoring [ 47 ]. Platelet-derived EVs may provide an integrated measure of blood pressure changes achieved with pharmacotherapy.…”