Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/200289
Type: Artigo de periódico
Title: Vascular Stiffness And Endothelial Dysfunction: Correlations At Different Levels Of Blood Pressure.
Author: Figueiredo, Valéria Nasser
Yugar-Toledo, Juan Carlos
Martins, Luiz Cláudio
Martins, Leandro Boer
de Faria, Ana Paula Cabral
de Haro Moraes, Carolina
Sierra, Cristina
Coca, Antonio
Moreno, Heitor
Abstract: Resistant hypertensive (RHTN) patients have endothelial dysfunction and aldosterone excess, which contribute to the development of resistance to antihypertensive treatment and cardiovascular complications. Biophysical forces within the arterial wall provide functional regulation of arterial stiffness. Carotid-femoral pulse wave velocity (PWV) and flow-mediated brachial artery dilation (FMD) can be used to evaluate vascular stiffness and endothelial function. Although both techniques have been used in several studies in hypertensive patients, it is unknown whether endothelial dysfunction is also associated with vascular stiffness in RHTN patients. One hundred and ninety-three consecutive subjects were divided in three groups: 44 RHTN, 35 well-controlled hypertensive patients (HTN) and 25 normal healthy volunteers (NT). FMD was measured by high-resolution ultrasound and PWV was calculated from measurements of the pulse transit time and the distance traveled by the pulse between carotid and femoral arteries. No significant differences were observed in respect to body mass index, age or other biochemical variables among the three groups. FMD (NO-dependent) values were statistically different when comparing RHTN and well controlled HTN patients (respectively, 8.3 ± 4.7% and 10.1 ± 5.9%) and 12.3 ± 6.3% in normal subjects (p < 0.05). One-way analysis of variance (ANOVA) showed a significant difference in BP-adjusted PWV between RHTN and HTN (13.9 ± 1.0 and 11.5 ± 1.1 m/s, respectively; p < 0.05). FMD (NO-dependent) and PWV-adjusted values were strongly correlated in well-controlled HTN and NT subjects (r = - 0.74 and - 0.83, respectively). Although statistically significant, this correlation was lower in RHTN patients (r = - 0.43). We found a close relationship among high BP levels, endothelial dysfunction and vascular rigidity in hypertensive patients, demonstrated by a significantly higher increase in carotid-femoral PWV and a decrease in brachial artery FMD in RHTN when compared with well-controlled hypertensive patients. Although this study was not designed to test the prognostic, the vascular damage differences observed between patients with controlled vs uncontrolled hypertension suggest that the latter group may have a worse cardiovascular prognosis, requiring prospective assessment tests.
Subject: Adult
Aged
Analysis Of Variance
Antihypertensive Agents
Blood Flow Velocity
Blood Pressure
Blood Pressure Determination
Brachial Artery
Carotid Arteries
Case-control Studies
Endothelium, Vascular
Female
Femoral Artery
Humans
Hypertension
Male
Middle Aged
Nitric Oxide
Prospective Studies
Pulsatile Flow
Vascular Stiffness
Rights: fechado
Identifier DOI: 10.3109/08037051.2011.617045
Address: http://www.ncbi.nlm.nih.gov/pubmed/22029740
Date Issue: 2012
Appears in Collections:Artigos e Materiais de Revistas Científicas - Unicamp

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