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Biochemical endothelial markers and cardiovascular remodeling in refractory arterial hypertension
Máira Cittadino1, Márcio Gonçalves de Sousa, Juan Carlos Ugar-Toledo
1Department of Pharmacology, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, SP, Brazil.
Insights
This study found no link between cardiovascular changes and specific endothelial function markers in refractory hypertension. Further research is needed to understand endothelial dysfunction in these patients.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Vascular Biology
Background:
- Hypertension is a primary risk factor for atherosclerosis.
- Refractory hypertension is associated with vascular and cardiac remodeling linked to endothelial dysfunction.
- The mechanistic link between endothelial function markers, cardiovascular remodeling, and refractory hypertension remains unclear.
Purpose of the Study:
- To investigate the relationship between biochemical markers of endothelial function and cardiovascular remodeling in patients with refractory hypertension.
- To compare endothelial function markers and cardiovascular structural changes between refractory hypertensive and healthy individuals.
Main Methods:
- Evaluated left ventricular mass and function, carotid artery thickness, and plasma levels of nitrate/nitrite, cyclic guanosine monophosphate (cGMP), and thromboxane B2 (TXB2).
- Used duplex scan ultrasound for structural assessments and enzymatic immunoassay (EIA) for biochemical analyses.
- Compared 20 refractory hypertensive (RH) patients with 20 healthy controls (CONTROL).
Main Results:
- RH patients exhibited significantly higher left ventricular mass index (LVMI), pulse pressure, and carotid artery thickness compared to controls.
- No significant differences were observed in left ventricular ejection fraction (LVFE) between the groups.
- Plasma concentrations of nitrate/nitrite (NO2/NO3), cGMP, and TXB2 were similar in both refractory hypertensive and healthy subjects.
Conclusions:
- The study found no association between cardiovascular remodeling (e.g., LVMI, carotid thickness) and the assessed biochemical markers of endothelial function in refractory hypertensive patients.
- These findings suggest that the specific endothelial dysfunction markers measured do not explain the observed cardiovascular remodeling in this patient group.
Background:
Hypertension is the most important and well established risk factor for atherosclerosis. The vascular and cardiac remodeling present in refractory hypertensive patients are related to endothelial dysfunction, a key factor in early atherogenesis and cardiovascular disease. However the mechanistic relationship among biochemical endothelial function markers, cardiovascular remodeling, and refractory hypertension is unknown.
Methods:
We evaluated the left ventricular mass and function, carotid thickness, and plasma nitrate/nitrite (NO2/NO3), cyclic 3'-5'-guanosine monophosphate (cGMP), and thromboxane B2 (TXB2) levels in refractory hypertensive (RH; n = 20) and healthy (CONTROL; n = 20) subjects 22-65 years old. Carotid thickness, left ventricular mass index (LVMI), and left ventricular fraction ejection (LVFE) were estimated by duplex scan ultrasound. Nitrates/nitrites were assayed using the Griess reaction, and plasma cGMP and thromboxane B2 were determined by enzymatic immunoassay (EIA).
Results:
Left ventricular mass index was higher in the RH group (138 +/- 20 vs. 108 +/-17 g/m2, p < 0.001) but there was no significant difference in the ejection fraction (67 +/- 5% vs. 69 +/- 4%). Pulse pressure (61 +/- 9 mmHg vs. 46 +/- 10 mmHg) and carotid thickness (1.59 +/- 0.22m vs. 1.04 +/- 0.14mm) were significantly higher (p < 0.001) in RH patients whereas NO2/NO3, cGMP, and thromboxane B2 plasma concentrations were similar in bot groups.
Conclusion:
There was no association between cardiovascular remodeling and the particular biochemical markers of endothelial function we assessed in refractory hypertensive patients.