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[Coronary endothelial dysfunction in hypertension]

I Antony1, A Nitenberg

  • 1Service de physiologie et d'explorations fonctionnelles, INSERM U 426, hôpital, Louis-Mourier, Colombes.

Archives Des Maladies Du Coeur Et Des Vaisseaux
|March 27, 1998
PubMed
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Hypertension impairs coronary artery response to physiological stimuli, causing vasoconstriction instead of dilation in some patients. Angiotensin converting enzyme inhibitors can restore normal vasomotion, suggesting a potential treatment pathway for endothelial dysfunction.

Area of Science:

  • Cardiovascular Physiology
  • Endothelial Function Research
  • Hypertension Studies

Background:

  • Endothelial dysfunction is implicated in hypertension, affecting coronary artery responses.
  • Previous studies show acetylcholine causes vasoconstriction in hypertensive subjects, indicating impaired endothelial function.

Purpose of the Study:

  • To investigate coronary artery responses to physiological stimuli in hypertensive patients with normal coronary arteries.
  • To assess the impact of sympathetic stimulation and increased blood flow on coronary vasomotion.
  • To evaluate the potential of angiotensin converting enzyme inhibitors in restoring normal coronary vasomotion.

Main Methods:

  • Analyzed coronary artery responses to cold pressor test and increased flow velocity in 26 hypertensive and 10 control subjects.

Related Experiment Videos

  • Utilized intracoronary papaverine and isosorbide dinitrate injections to assess vasodilation.
  • Administered perindoprilat (angiotensin converting enzyme inhibitor) to hypertensive patients to observe effects on vasodilation.

    • Main Results:

    • Hypertensive subjects showed coronary vasoconstriction during sympathetic stimulation and increased flow, unlike controls who exhibited vasodilation.
    • Papaverine induced proximal dilation in controls but was ineffective in hypertensives.
    • Isosorbide dinitrate caused comparable dilation in both groups.
    • Perindoprilat restored the vasodilatory response to physiological stimuli in hypertensive patients.

    Conclusions:

    • Hypertensive individuals with normal coronary arteries exhibit altered coronary responses to physiological stimuli.
    • Endothelial dysfunction in hypertension affects endothelium-dependent vasodilation.
    • Angiotensin converting enzyme inhibitors may normalize coronary vasomotion in hypertensive patients.