Endothelium-dependent vasodilatation in forearm is impaired in stroke patients

To investigate endothelium-dependent vasodilatation (EDV) in stroke patients.

Cross-sectional.

University referral hospital.

We studied 23 stroke patients (65-75 years old) who did not have atrial fibrillation or Warfarin treatment. Forty-six age- and sex-matched healthy controls and another 32 controls matched also for hypertension and medication were used for comparisons. METHODS. Endothelium-dependent vasodilatation was measured with venous occlusive plethysmography of forearm blood flow during intra-brachial infusion of acetylcholine. Endothelium-independent vasodilatation (EIDV) was evaluated by infusion of sodium nitroprusside.

Stroke patients showed significantly lower EDV (P < 0.001) compared with healthy controls when measured with acetylcholine-stimulated forearm blood flow. The difference between these groups remained significant also after correction for blood pressure, body mass index, blood glucose and cholesterol. There was also significant difference in EDV between hypertension-matched controls and healthy controls. However, EIDV was significantly reduced in stroke patients (P < 0.01), but not in the hypertensive group, when compared with healthy controls.

An impaired EDV was seen in both stroke patients and hypertensive-matched controls, while an impaired EIDV was seen in the stroke patients only, suggesting a more severe vasodilatory dysfunction in stroke patients than could be explained by a high blood pressure only.