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Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Endothelial function and oxidative stress in renovascular hypertension
Yukihito Higashi1, Shota Sasaki, Keigo Nakagawa
1First Department of Internal Medicine, Hiroshima University, Faculty of Medicine, Hiroshima, Japan. yhigashi@hiroshima-u.ac.jp
The New England Journal of Medicine
|June 21, 2002
Summary
Renal-artery angioplasty improved endothelial dysfunction in patients with renovascular hypertension by reducing oxidative stress. This procedure enhanced blood flow responses to acetylcholine, indicating improved endothelium-dependent vasodilation.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Vascular Biology
Background:
- Renovascular hypertension activates the renin-angiotensin system, increasing oxidative stress.
- Endothelial dysfunction is a known complication of renovascular hypertension.
Purpose of the Study:
- To investigate if renal-artery angioplasty improves endothelial dysfunction in renovascular hypertension patients.
- To determine if this improvement is mediated by a reduction in oxidative stress.
Main Methods:
- Forearm blood flow response to acetylcholine and isosorbide dinitrate was measured before and after angioplasty.
- 15 patients with renovascular hypertension and 15 controls were studied.
- Oxidative stress markers (8-hydroxy-2'-deoxyguanosine, malondialdehyde-modified LDL) were assessed.
Main Results:
- Patients with renovascular hypertension showed impaired acetylcholine-induced vasodilation compared to controls.
- Angioplasty reduced blood pressure, vascular resistance, and oxidative stress markers.
- Post-angioplasty, forearm blood flow response to acetylcholine significantly improved and correlated with reduced oxidative stress.
Conclusions:
- Impaired endothelium-dependent vasodilation in renovascular hypertension is partly due to excessive oxidative stress.
- Renal-artery angioplasty can ameliorate this dysfunction by reducing oxidative stress.
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