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(Hypertension. 2006;48:602.)
© 2006 American Heart Association, Inc.

Original Articles

Endothelial Function Is Associated With Pulse Pressure, Pulse Wave Velocity, and Augmentation Index in Healthy Humans

Carmel M. McEniery; Sharon Wallace; Isla S. Mackenzie; Barry McDonnell; Yasmin; David E. Newby; John R. Cockcroft; Ian B. Wilkinson

From the Clinical Pharmacology Unit (C.M.M., S.W., I.S.M., Y., I.B.W.), University of Cambridge, Addenbrooke’s Hospital, Cambridge, United Kingdom; Department of Medicine (D.E.N.), University of Edinburgh, Edinburgh Royal Infirmary, Edinburgh, United Kingdom; and the Department of Cardiology (B.M., J.R.C.), Wales Heart Research Institute, Cardiff, United Kingdom.

Correspondence to Carmel M. McEniery, University of Cambridge, Addenbrooke’s Hospital, Box 110, Cambridge CB2 2QQ, United Kingdom. E-mail cmm41{at}cam.ac.uk

Arterial stiffness is an independent predictor of mortality and is regulated by a number of factors, including vascular smooth muscle tone. However, the relationship between endothelial function and definitive measures of arterial stiffness and wave reflections has not been described in healthy individuals. Therefore, we tested the hypothesis that endothelial function is inversely correlated with aortic pulse wave velocity (PWV), central pulse pressure, and augmentation index in healthy individuals. Peripheral and central pulse pressure and augmentation index were determined at rest, and global endothelial function was measured using pulse wave analysis and administration of sublingual nitroglycerin and inhaled albuterol. Aortic PWV was also determined at baseline in a subset of 89 subjects. In a separate group of subjects (n=89), aortic PWV was measured and brachial artery flow-mediated dilatation assessed as a measure of conduit artery endothelial function. Global endothelial function was significantly and inversely correlated with aortic PWV (r=–0.69; P<0.001), augmentation index (r=–0.59; P<0.001), and central (r=–0.34; P<0.001) and peripheral pulse pressure (r=–0.15; P=0.03). Moreover, there was a stronger correlation between central rather than peripheral pulse pressure. After adjusting for potential confounders, global endothelial function remained independently and inversely associated with aortic PWV and augmentation index. There was also a significant, inverse relationship between conduit artery endothelial function and aortic PWV (r=0.39, P<0.001), which remained independent after adjusting for confounding factors. In healthy individuals, a decline in endothelial function is associated with increased large artery stiffness, wave reflections, and central pulse pressure.

Key Words: nitric oxide • endothelium-derived factors • blood pressure • pulse • arteries

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