Prognostic role of flow-mediated dilatation of the brachial artery in hypertensive patients

Muiesan, María Lorenza; Salvetti, Massimo; Paini, Anna; Monteduro, Cristina; Galbassini, Gloria; Poisa, Paolo; Porteri, Enzo; Agabiti-Rosei, Claudia; Paderno, Valentina; Belotti, Eugenia; Rizzoni, Damiano; Castellano, Maurizio; Agabiti‐Rosei, Enrico

doi:10.1097/hjh.0b013e328304b083

Cited by 88 publications

(75 citation statements)

References 40 publications

(66 reference statements)

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“…Several clinical studies have shown that endothelial function assessed by FMD can serve as an independent predictor of cardiovascular events. 14,26,27 The present results, showing that endothelium-dependent vasodilation as measured by FMD appears lower in NSS subjects compared with NSR subjects, are consistent with previous measurements of forearm blood flow, 23 which further suggests that endothelium-dependent vasodilation is implicated in the development of salt sensitivity in humans.…”

Section: Discussionsupporting

confidence: 91%

“…Recently, Muiesan et al 26 assessed the technique of FMD as a measure of endothelial function in a group of 172 hypertensive patients at medium cardiovascular risk, which were followed up for fatal and non-fatal cardiovascular events. The results of that study showed that the incidence of cardiovascular events was more than double in those with compromised endothelial function, as defined by the cohort having an FMD value below the median.…”

Section: Discussionmentioning

confidence: 99%

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Endothelial dysfunction in normotensive salt-sensitive subjects

et al. 2011

J Hum Hypertens

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Salt-sensitivity is associated with a more severe target organ injury and higher mortality, even in normotensive subjects. As endothelial dysfunction is predictive for future cardiovascular events, we evaluated whether normotensive salt-sensitive (NSS) subjects have more pronounced endothelial dysfunction compared with normotensive salt-resistant (NSR) subjects. Normotensive subjects (n ¼ 99, aged 25-50 years) were selected from a rural community in northern China. Salt sensitivity was assigned if mean BP increased by X10% from a 1-week high salt (18 g/day, NaCl) to low-salt diet (3 g/day, NaCl). Endothelial function was assessed by testing the flow-mediated dilatation (FMD) of the brachial artery using high-resolution ultrasound, as well as nitrogen oxide (NOx) levels, in plasma and urine at baseline. Blood pressure at baseline was similar between NSS and NSR subjects, but diverged during salt intervention. Furthermore, FMD was significantly lower in 17 NSS subjects (10.2 ± 2.5 vs 14.5 ± 1.6%, P ¼ 0.037) compared with NSR subjects. In addition, average plasma NOx levels were lower in NSS subjects than NSR subjects (61.2 ± 3.23 lM vs 82.5 ± 1.61 lM, P ¼ 0.034). Moreover, Both FMD and plasma NOx levels were negatively correlated with the degree of salt sensitivity (r ¼ À0.435 and r ¼ À0.459, respectively, Po0.01). However, there was no difference in urine NOx between the two groups. Our study indicates that endothelial dysfunction could contribute to the long-term higher levels of target organ injury and higher mortality observed in NSS subjects.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Endothelial dysfunction in normotensive salt-sensitive subjects

et al. 2011

J Hum Hypertens

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“…5,10 Endothelial dysfunction has been clearly shown in essential hypertension and in patients at risk of atherosclerotic events, such as diabetics and patients with coronary artery disease. 1,2,5-8 Two independent studies measuring endothelial function in hypertensives, using acetylcholine-dependent forearm vasodilation 5 or the noninvasive flow-mediated dilation, 26 have suggested a worse cardiovascular prognosis in patients with a more impaired endothelial function, in a similar way as has been clearly shown in patients with coronary heart disease. 7,10 Endothelial dysfunction has a pivotal role in the development of atherosclerosis and cardiovascular diseases.…”

Section: Discussionmentioning

confidence: 94%

Endothelial dysfunction is associated with increased levels of biomarkers in essential hypertension

Sierra

Larrousse

2009

J Hum Hypertens

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To assess the correlation between endothelial dysfunction and the serum levels of biomarkers of inflammation, remodelling and oxidative stress in essential hypertension, 78 treatment-naïve essential hypertensives (mean age 43 years) underwent measurement of endothelial dysfunction, using the maximal acetylcholine-induced forearm vasodilation and serum levels of adhesion molecules, selectins, chemokines, metalloproteinases, copper, zinc, selenium, vitamins, homocysteine, malondialdehyde, erythrocyte glutathione peroxidase and erythrocyte superoxide dismutase. Mean ( ± s.e.m.) maximal acetylcholine-induced vasodilation was 367± 20%. Patients with a more impaired acetylcholine-dependent vasodilation (first tertile) had increased levels of e-selectin (P ¼ 0.009), p-selectin (Po0.001), monocyte chemotactic protein type 1 (MCP-1; P ¼ 0.012) and the tissue inhibitor of metalloproteinases type 1 (TIMP-1; P ¼ 0.044), which in turn showed significant inverse correlations with maximal endothelium-dependent vasodilation. Serum levels of selenium (P ¼ 0.012), vitamin C (P ¼ 0.038), erythrocyte glutathione peroxidase (Po0.001) and superoxide dismutase (P ¼ 0.022) activities were reduced in patients with a more impaired endothelium-dependent vasodilation. Recently diagnosed treatment-naïve essential hypertensives showed a relationship between the endothelial dysfunction, serum markers of inflammation and remodelling and levels of antioxidant substances. These could be potentially helpful markers of high risk in hypertensive patients.

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“…The most commonly used method to assess endothelial function in humans is flow-mediated dilatation (FMD), which measures the ability of the blood vessels to accommodate increases in flow by altering their internal diameter, and is dependent on nitric oxide (NO) release by endothelial cells. 62 Several studies document a direct independent relationship between the risk for cardiovascular events and the degree of brachial FMD in non-SCI individuals, [63][64][65] whereby the degree of cardiovascular risk is increased as the degree of brachial FMD is reduced.…”

Section: Conduit Arterial Function After Sci Structural Adaptationsmentioning

confidence: 99%

Peripheral vascular function in spinal cord injury: a systematic review

et al. 2012

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Background: During the past 20 years, significant advances in patient care have resulted in individuals with spinal cord injury (SCI) living longer than before. As lifespan increases, cardiovascular complications are emerging as the leading cause of mortality in this population, and individuals with SCI develop cardiovascular disease at younger ages than their able-bodied counterparts. To address this increasing clinical challenge, several recent studies investigated the central cardiovascular adaptations that occur following SCI. However, a somewhat less recognized component of cardiovascular dysfunction in this population is the peripheral vascular adaptations that also occur as a result of SCI. Study design: Literature review.Objective: To present a comprehensive overview of changes in arterial structure and function, which occur after SCI. Setting: Canada. Methods: A systematic literature review was conducted to extract studies that incorporated measures of arterial structure or function after SCI in animals or humans. Results: Individuals with SCI exhibit vascular dysfunction below the lesion that is characterized by a reduction in conduit artery diameter and blood flow, increased shear rate and leg vascular resistance, and adrenoceptor hyper-responsiveness. There is also recent alarming evidence for central arterial stiffening in individuals with SCI. Conclusion: Although physical deconditioning is the primary candidate responsible for the maladaptive remodeling of the peripheral vasculature after SCI, there is emerging evidence that blood pressure oscillations, such as those occurring in the large majority of individuals with SCI, also exacerbates vascular dysfunction in this population.

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Prognostic role of flow-mediated dilatation of the brachial artery in hypertensive patients

Abstract: The presence of endothelial dysfunction, as evaluated by flow-mediated vasodilatation of the brachial artery, identifies hypertensive patients at increased risk of nonfatal and fatal cardiovascular events.

Cited by 88 publications

References 40 publications

Endothelial dysfunction in normotensive salt-sensitive subjects

Endothelial dysfunction in normotensive salt-sensitive subjects

Endothelial dysfunction is associated with increased levels of biomarkers in essential hypertension

Peripheral vascular function in spinal cord injury: a systematic review

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