Published Online
on February 24, 2003

A more recent version of this article appeared on March 1, 2003

This Article Full Text (PDF) All Versions of this Article: 41/3/528    most recent 01.HYP.0000056997.40992.41v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Felmeden, D. C. Articles by Lip, G. Y.H. Search for Related Content PubMed PubMed Citation Articles by Felmeden, D. C. Articles by Lip, G. Y.H. Pubmed/NCBI databases Medline Plus Health Information High Blood Pressure Related Collections Lipids Thrombosis risk factors Clinical Studies Lipid and lipoprotein metabolism Other Vascular biology

Submitted on May 30, 2002
Revised on July 17, 2002

Low-Density Lipoprotein Subfractions and Cardiovascular Risk in Hypertension. Relationship to Endothelial Dysfunction and Effects of Treatment

Dirk C. Felmeden; Charles G.C. Spencer; Andrew D. Blann; D. Gareth Beevers; and Gregory Y.H. Lip^*

From the Haemostasis, Thrombosis, and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, UK.

^* To whom correspondence should be addressed. E-mail: g.y.h.lip{at}bham.ac.uk.

Abstract--Although hypertensive patients are at particular risk of vascular complications, the possible contribution of an atherogenic lipoprotein profile and endothelial dysfunction to this risk is unclear. We investigated this by measuring LDL subfractions and flow-mediated dilation (FMD) (reflecting endothelial dysfunction) in a cohort of high-risk hypertensive patients. We studied 84 hypertensive patients (74 men; mean age, 64 years; SD 8). Chylomicron-free LDL subfractions were analyzed by disc polyacrylamide gel electrophoresis, producing an LDL score, with higher scores being equivalent to a greater proportion of the more atherogenic LDL subfractions. High-resolution ultrasound was used to assess endothelium-dependent brachial artery FMD after reactive hyperemia after vessel occlusion. Baseline levels were compared with 61 age- and gender-matched healthy normotensive control subjects. Mean LDL score was higher and FMD impaired in hypertensive subjects compared with control subjects. These indexes were significantly improved after 6 months of cardiovascular risk factor management. LDL score correlated significantly with the 10-year Framingham coronary heart disease risk score, with a negative correlation with FMD (both P<0.001). Abnormal atherogenesis and endothelial dysfunction are both present in hypertension and appear to be related to each other, potentially leading to vascular complications. The abnormal LDL scores also correlate with the 10-year cardiovascular risk and can be positively influenced by cardiovascular risk management.

Key words: endothelium • flow-mediated dilatation • LDL subfractions

This article has been cited by other articles:

				E. M. Urbina, R. V. Williams, B. S. Alpert, R. T. Collins, S. R. Daniels, L. Hayman, M. Jacobson, L. Mahoney, M. Mietus-Snyder, A. Rocchini, et al. Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents: Recommendations for Standard Assessment for Clinical Research: A Scientific Statement From the American Heart Association Hypertension, November 1, 2009; 54(5): 919 - 950. [Abstract] [Full Text] [PDF]

				M. A. Black, N. T. Cable, D. H.J. Thijssen, and D. J. Green Importance of Measuring the Time Course of Flow-Mediated Dilatation in Humans Hypertension, February 1, 2008; 51(2): 203 - 210. [Abstract] [Full Text] [PDF]

				R. Migliacci, C. Becattini, R. Pesavento, G. Davi, M. C. Vedovati, G. Guglielmini, E. Falcinelli, G. Ciabattoni, F. Dalla Valle, P. Prandoni, et al. Endothelial dysfunction in patients with spontaneous venous thromboembolism Haematologica, June 1, 2007; 92(6): 812 - 818. [Abstract] [Full Text] [PDF]

				M. Rodriguez-Porcel, J. Herrman, A. R. Chade, J. D. Krier, J. F. Breen, A. Lerman, and L. O. Lerman Long-Term Antioxidant Intervention Improves Myocardial Microvascular Function in Experimental Hypertension Hypertension, February 1, 2004; 43(2): 493 - 498. [Abstract] [Full Text] [PDF]