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Effect of intensive multifactorial treatment on vascular progenitor cells in hypertensive patients
Charbel Maroun-Eid1, Adriana Ortega-Hernández2,3, Javier Modrego2
1Unit of Hypertension, Área de Prevención Cardiovascular, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
Insights
Intensive multifactorial treatment in hypertensive patients improved cardiovascular risk and increased circulating endothelial progenitor cells (EPCs), suggesting EPCs as a potential therapeutic target for managing hypertension-related complications.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Cell Biology
Background:
- Hypertension frequently co-occurs with dyslipidemia, diabetes, and obesity, increasing cardiovascular risk.
- Endothelial dysfunction is linked to cardiovascular risk factors and adverse outcomes.
- Target-organ damage control is crucial for hypertensive patients, even with controlled risk factors.
Purpose of the Study:
- To investigate the impact of intensive multifactorial treatment on circulating vascular progenitor cells in high-risk hypertensive patients.
- To assess changes in endothelial (CD34+/KDR+, CD34+/VE-cadherin+) and smooth muscle (CD14+/endoglin+) progenitor cells.
- To determine the effect on vascular endothelial growth factor (VEGF) plasma concentration.
Main Methods:
- 108 high-risk hypertensive patients underwent 12 months of intensive multifactorial treatment (pharmacologic and dietary).
- Circulating progenitor cells were quantified using flow cytometry.
- Plasma VEGF levels were measured via ELISA.
Main Results:
- Intensive treatment significantly reduced body mass index, blood pressure, and key biochemical parameters.
- Circulating CD34+/VE-cadherin+ cells significantly increased post-treatment.
- Plasma VEGF concentration significantly decreased, while CD34+/KDR+ and CD14+/endoglin+ levels showed no significant change.
Conclusions:
- Intensive multifactorial treatment improves cardiovascular risk factors and enhances circulating endothelial progenitor cells in hypertensive patients.
- Increased CD34+/VE-cadherin+ cells suggest a potential benefit of intensive therapy on vascular repair mechanisms.
- Circulating progenitor cells may represent a viable therapeutic target for managing cardiovascular complications in hypertension.
Background:
Most hypertensive patients, despite a proper control of their cardiovascular risk factors, have cardiovascular complications, evidencing the importance of controlling and/or reversing target-organ damage. In this sense, endothelial dysfunction has been associated with the presence of cardiovascular risk factors and related cardiovascular outcomes. Since hypertension often clusters with other risk factors such as dyslipemia, diabetes and obesity, in this study we have investigated the effect of intensive multifactorial treatment on circulating vascular progenitor cell levels on high-risk hypertensive patients.
Design:
We included108 hypertensive patients receiving intensive multifactorial pharmacologic treatment and dietary recommendations targeting blood pressure, dyslipemia, hyperglycemia and weight for 12 months. After the treatment period, blood samples were collected and circulating levels of endothelial (CD34+/KDR+, CD34+/VE-cadherin+) and smooth muscle (CD14+/endoglin+) progenitor cells were identified by flow cytometry. Additionally, plasma concentration of vascular endothelial growth factor (VEGF) was determined by ELISA.
Results:
Most hypertensive patients (61±12 years, 47% men) showed cardiovascular parameters within normal ranges at baseline. Moreover, body mass index and the majority of the biochemical parameters (systolic and diastolic blood pressure, fasting glucose, total cholesterol, HDL-c, LDL-c, creatinine and hs-CRP) significantly decreased overtime. After 12 months of intensive treatment, CD34+/KDR+ and CD14+/endoglin+ levels did not change, but CD34+/VE-cadherin+ cells increased significantly at month 12 [0.9(0.05-0.14)% vs 0.05(0.02-0.09)% P<0.05]. However, VEGF plasma concentration decreased significantly overtime [89.1(53.9-218.7) vs [66.2(47.5-104.6) pg/mL, P<0.05].
Conclusions:
Long-term intensive treatment in hypertensive patients further improves cardiovascular risk and increases circulating EPCs, suggesting that these cells could be a therapeutic target.
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