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Non-invasive Assessment of Microvascular and Endothelial Function
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Abnormalities of vascular function in resistant hypertension.

Alejandro de La Sierra1, María Larrousse, Anna Oliveras

  • 1Department of Internal Medicine, Hospital Mutua Terrassa, University of Barcelona, Spain. adelasierra@mutuaterrassa.es

Blood Pressure
|October 25, 2011
PubMed
Summary

True resistant hypertension (RH), identified by ambulatory blood pressure monitoring, shows more vascular dysfunction. This includes impaired hyperemia-induced forearm vasodilation and elevated inflammatory biomarkers, unlike white coat RH.

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Area of Science:

  • Cardiovascular Medicine
  • Hypertension Research
  • Vascular Biology

Background:

  • Resistant hypertension (RH) poses significant cardiovascular risks.
  • Understanding vascular dysfunction in RH is crucial for risk stratification.
  • Ambulatory blood pressure monitoring (ABPM) differentiates true RH from white coat RH.

Purpose of the Study:

  • To evaluate vascular dysfunction markers in patients with resistant hypertension.
  • To compare vascular function between true RH and white coat RH.
  • To identify associations between vascular dysfunction and biomarkers in RH.

Main Methods:

  • 144 patients with essential RH were classified using ABPM.
  • Assessed hyperemia-induced forearm vasodilation (HIFV).
  • Measured serum inflammatory biomarkers (hs-CRP, s-ICAM-1, s-VCAM-1, e-selectin, p-selectin, MCP-1) and arterial compliance (C1, C2).

Main Results:

  • True RH patients exhibited significantly impaired HIFV compared to white coat RH patients.
  • Elevated levels of e-selectin and MCP-1 were observed in true RH.
  • Maximal HIFV inversely correlated with urinary albumin excretion and inflammatory markers.

Conclusions:

  • True RH, confirmed by ABPM, is linked to more severe vascular dysfunction.
  • Impaired HIFV and specific inflammatory biomarkers characterize true RH.
  • Arterial compliance was not directly associated with the level of blood pressure in this cohort.