The Number of Endothelial Progenitor Cells is Decreased in Patients With Non-Dipper Hypertension

Abstract

Background and ObjectivesCirculating endothelial progenitor cells (EPCs) play a key role in the maintenance of endothelial homeostasis and promote vascular repair. A reduced number of EPCs and the functional activity have been associated with several cardiovascular risk factors. However, the relationship between the number of EPCs and circadian rhythm of the blood pressure (BP) remains unclear. The purpose of the present study was to evaluate the relationship between the circadian rhythm of the BP and EPCs in patients with essential hypertension.Subjects and MethodsA total of 45 patients with essential hypertension who were newly identified by outpatient BP measurements, underwent 24-hour ambulatory BP monitoring. Among the 45 patients with essential hypertension, 20 were classified as dippers (12 men and 8 women; mean age 48±14 years) and 25 as non-dippers (14 men and 11 women; mean age 52±18 years). The EPC count was isolated from the peripheral bloodstream and quantified by flow cytometry.ResultsThe baseline clinical characteristics were similar between the dipper and non-dipper hypertensive patients. The circulating EPCs were statistically reduced in the non-dipper patients as compared to the dippers (104±60 vs. 66±47 EPCs per 106 mononuclear cells, p=0.027). The circulating EPC level correlated positively with the circadian changes in the systolic and diastolic BP (r=0.435, p=0.003, and r=0.310, p=0.038, respectively).ConclusionThe present study demonstrated that the EPC count was reduced in the peripheral bloodstream in non-dipper hypertensive patients.

Obstructive sleep apnoea as a cause of nocturnal nondipping blood pressure: recent evidence regarding clinical importance and underlying mechanisms

“…Nondipping nocturnal blood pressure is also associated with vascular endothelial dysfunction and reduced nitric oxide levels [36]. Furthermore, nocturnal nondippers demonstrate a reduced number of endothelial progenitor cells, which are responsible for repairing vascular damage and maintaining homeostasis [37], a finding also reported in patients with OSA [38].…”

Can neutrophil to lymphocyte ratio and platelet to lymphocyte ratio be used as biomarkers for non-dipper blood pressure?

“…Non-dipper blood pressure pattern is associated with cardiovascular mortality, endorgan damage and autonomic dysfunction [13][14][15]. There is evidence that number of endothelial progenitor cells is decreased in hypertensive non-dipper status meaning vascular repair mechanisms and endothelial homeostasis is disturbed [16]. Elevated blood pressure and decreased blood pressure variability may stimulate inflammation by increased expression of endothelial cytokines [6].…”

Serum Neutrophıl Gelatınase-Assocıated Lıpocalın Levels in Patients with Non-Dipper Hypertension

“…Impaired endothelial function is associated with cardiovascular and cerebrovascular diseases, both of which are more prevalent in non-dipper HT patients [35]. Kim et al [36] reported that endothelial progenitor cells, which play a key role in endothelial homeostasis and vascular repair, are less prevalent in the circulation of nondipper than dipper HT patients. In addition, aortic stiffness, which increases with atherosclerosis and endothelial dysfunction [37], has been shown to be increased in non-dipper HT patients compared with dipper HT patients [38,39].…”