Abstract 145: Clinical and Vascular Changes Related to Endothelial Dysfunction in Treated Hypertensive Patients
Background: It is widely recognized that endothelial dysfunction is commonly associated to hypertension but the parameters linked to this condition among hypertensive subjects are not established yet.
Objective: To identify clinical, metabolic and vascular changes related to endothelial dysfunction in treated hypertensive patients
Methods: A cross-sectional study was carried out to evaluate hypertensive patients on stable drug therapy over at least 4 weeks, both genders, aged 40-70 years. Blood pressure (BP) was measured by oscilometric method, and vascular tests were performed using high-resolution ultrasonography for brachial flow-mediated dilation (FMD), Sphygmocor to obtain central hemodynamic parameters and Complior SP to determine carotid-femoral pulse wave velocity (cfPWV) which was normalized by mean BP (cfPWV-N). The 10-year risk for general cardiovascular disease from Framingham Heart Study was used to calculate vascular age. Patients (n=81) were distributed into two groups according to brachial FMD values: FMD < 10% (n=54) or FMD >= 10% (n=27).
Results: The mean age was not different among the groups (55.1±8.3 vs 55.7±7.0 years, p>0.05). Systolic BP (142±19 vs 137±13, p>0.05) and diastolic BP (94±14 vs 92±13 mmHg, p>0.05) were similar in the two groups. The group with FMD < 10% presented greater carotid media-to-lumen ratio (0.12±0.03 vs 0.10±0.02, p<0.05), vascular age (77±14 vs 70±12, p<0.05) and higher duration of hypertension (9.9±9.19 vs 5.9±4.2, p<0.05) than the group with normal FMD. There was an inverse correlation between FMD and vascular age (r=-0.235, p<0.05). No significant differences in biochemical variables, parameters of vascular stiffness and number of criteria of metabolic syndrome were observed.
Conclusion: The characterization of endothelial dysfunction in treated hypertensive patients was not related to age but it was more associated to duration of hypertension and vascular age. There was no evidence of vascular stiffness in these patients but the increased carotid media-to-lumen ratio may indicate the beginning of atherosclerotic process.
- © 2012 by American Heart Association, Inc.