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HDL cholesterol levels and endothelial glycocalyx integrity in treated hypertensive patients

Helen Triantafyllidi1, Dimitris Benas1, Stefanos Vlachos1

  • 12nd Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Attikon Hospital, Athens, Greece.

Journal of Clinical Hypertension (Greenwich, Conn.)
|October 14, 2018
PubMed

Insights

High HDL cholesterol (HDL-C) may protect the endothelial glycocalyx (EG) in older hypertensive patients. Moderate HDL-C levels (71-101 mg/dL) appear to support EG integrity and endothelial function, potentially reducing cardiovascular risk.

Area of Science:

  • Cardiovascular Science
  • Endocrinology
  • Vascular Biology

Background:

  • Endothelial dysfunction is a key indicator of target organ damage in hypertension.
  • The endothelial glycocalyx (EG) is crucial for vascular integrity, influencing permeability, inflammation, and elasticity, thus impacting cardiovascular disease risk.
  • High-density lipoprotein cholesterol (HDL-C) is typically considered cardioprotective, but its role in EG integrity in hypertensive individuals requires further investigation.

Purpose of the Study:

  • To investigate the association between elevated HDL-C levels and endothelial glycocalyx (EG) integrity in older hypertensive patients.
  • To determine if higher HDL-C levels are linked to better EG structure in this population.

Main Methods:

  • A study involving 120 treated hypertensive patients over 50 years old, divided into high (≥71 mg/dL) and low (<71 mg/dL) HDL-C groups.
  • Utilized Sideview Darkfield imaging (Microscan, Glycocheck) to measure the perfusion boundary region (PBR) of sublingual arterial microvessels as an index of EG thickness.
  • Employed multiple linear regression analysis to identify independent predictors of PBR 5-9.

Main Results:

  • A significantly decreased PBR 5-9 (indicating reduced EG thickness) was observed in the high HDL-C group (P=0.04).
  • HDL-C showed a moderate inverse relationship with PBR 5-9 across the entire study population (r=-0.22, P=0.01).
  • Body Mass Index (BMI) independently predicted PBR 5-9 (β=0.25, P=0.006), while HDL-C did not independently predict PBR in the regression model.

Conclusions:

  • In older hypertensive patients, HDL-C levels between 71 and 101 mg/dL may offer moderate protection to the endothelial glycocalyx (EG) and subsequent endothelial function.
  • Further research is needed to explore the role of extremely elevated HDL-C in cardiovascular risk assessment and its impact on the endothelial glycocalyx as a marker of target organ damage in essential hypertension.

Keywords:
arterial hypertensionendothelial glycocalyxextreme HDL-C

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