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Diferencias étnicas en la actividad vasoconstrictora de la endotelina-1 endógena en pacientes hipertensos

Umberto Campia¹, Carmine Cardillo, Julio A Panza

¹National Heart, Lung, and Blood Institute, Bethesda, Md, USA.

|May 19, 2004

Resumen

Los pacientes negros hipertensivos exhiben una mayor actividad de la endotelina-1 (ET-1), lo que lleva a un aumento de la vasoconstricción. Esto sugiere un papel clave para ET-1 en la patogénesis de la hipertensión entre los individuos negros.

Área de la Ciencia:

Investigaciones Cardiovasculares Investigación Cardiovascular Investigaciones Cardiovasculares
Hipertensión Hipertensión Fisiopatología Fisiopatología
Disparidades Raciales en la Salud.

Sus antecedentes:

La patogénesis esencial de la hipertensión puede diferir entre las poblaciones negras y blancas.
Los pacientes negros a menudo presentan hipertensión sensible a la sal, baja en renina, potencialmente relacionada con una mayor actividad de endotelina-1 (ET-1).
Este estudio investigó las diferencias étnicas en la actividad vascular ET-1 en individuos normotensos e hipertensos.

Objetivo del estudio:

Para determinar si existen diferencias étnicas en la actividad de la endotelina-1 (ET-1) vascular.
Para evaluar el papel de ET-1 en el tono vascular de pacientes hipertensivos negros y blancos.

Principales métodos:

Las respuestas del flujo sanguíneo del antebrazo (FBF) a la infusión intra-arterial de un bloqueador del receptor ET(A) (BQ-123) se analizaron utilizando la pletismografía.
Los participantes incluyeron pacientes negros y blancos normotensos e hipertensos.
También se evaluaron las respuestas vasculares al ET-1 exógeno para evaluar la reactividad del músculo liso.

Principales resultados:

El bloqueo del receptor ET ((A) indujo una vasodilatación significativa en sujetos hipertensos, pero no en sujetos normotensos.
El efecto vasodilatador del bloqueo del receptor ET(A) fue significativamente mayor en pacientes negros hipertensivos en comparación con pacientes blancos hipertensivos.
La ET-1 exógena indujo una vasoconstricción similar tanto en pacientes hipertensivos negros como en blancos, lo que no indica diferencias en la reactividad del músculo liso.

Conclusiones:

Los individuos negros hipertensivos demuestran un tono vasoconstrictor mejorado dependiente de ET (A), probablemente debido al aumento de la producción de ET-1.
Esta mayor actividad de ET-1 puede contribuir a la patogénesis y complicaciones de la hipertensión en pacientes negros.

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