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(Hypertension. 1998;32:862-868.)
© 1998 American Heart Association, Inc.
Scientific Contributions |
Clustering of Endothelial Markers of Vascular Damage in Human Salt-Sensitive Hypertension
Influence of Dietary Sodium Load and Depletion
From the University "La Sapienza," Chair of I Clinica Medica, Andrea Cesalpino Foundation (C.F., G.D., L. De S.), and Departments of Experimental Medicine (C.B.) and Internal Medicine and Cardiology (E.G., S.C., A.S.), University of L'Aquila, L'Aquila, Italy.
Correspondence to Claudio Ferri, MD, Università "La Sapienza, " Cattedra di I Clinica Medica, Fondazione Andrea Cesalpino, Viale del Policlinico 155, 00161 Roma, Italy. E-mail clferri{at}axrma.uniroma1.it
Abstract—The contributing role of vascular endothelium in the development of hypertension-related vascular damage is well accepted. Salt-sensitive hypertension is characterized by a cluster of renal, hormonal, and metabolic derangements that might favor the development of cardiovascular and renal damage. To evaluate endothelial involvement in salt-sensitive essential hypertension, plasma levels of several markers of endothelial damage such as endothelin-1 (ET-1), von Willebrand factor (vWf), and soluble (S-) adhesion molecules E-selectin, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and 24-hour urinary albumin excretion (UAE) were measured in 39 nondiabetic, nonobese, never-treated essential hypertensive patients after intermediate (120 mmol/d), high (220 mmol/d), and low (20 mmol/d) NaCl diets. Patients were classified as salt sensitive (n=18) or salt resistant (n=21) according to their blood pressure responses to changes in dietary NaCl intake. Salt-sensitive hypertensives showed higher plasma ET-1 (P<0.05), vWf (P<0.005), and S-E-selectin levels (P<0.04) and increased UAE (P<0.05) than salt-resistant hypertensives. By contrast, circulating S-ICAM-1 and S-VCAM-1 concentrations were not significantly higher in salt-sensitive (596.56±177.05 ng/mL and 541.06±157.84 ng/mL, respectively) than salt-resistant patients (516.86±147.99 ng/mL and 449.48±158.91 ng/mL, respectively). During the intermediate NaCl diet, plasma ET-1 responses to oral glucose load were greater in salt-sensitive (P<0.05) than in salt-resistant patients. A marked (P<0.05) hyperinsulinemic response to oral glucose load was evident in salt-sensitive but not salt-resistant patients after each diet. This study shows increased plasma levels of the endothelium-derived substances E-selectin, vWf, and ET-1 in salt-sensitive hypertensives. Our findings support the hypothesis that salt sensitivity is correlated with an increased risk for developing hypertension-related cardiovascular damage.
Key Words: endothelium • cell adhesion molecules • vasorelaxation • sodium • blood pressure
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