Endothelial Function and Common Carotid Artery Wall Thickening in Patients With Essential Hypertension
Why the study?
Is carotid wall intimal-medial thickening associated with reduced endothelium-dependent vasodilation in patients with essential hypertension?
Population
44 patients with essential hypertension who had never been treated and whose history of increased blood…
Design
Cross-sectional
Authors
Discussion
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Implication
May link endothelial dysfunction to early carotid changes in hypertension; hypothesis-generating and requires prospective validation.
Key Points
- The study aims to evaluate the relationship between vascular reactivity and carotid wall thickening in patients with essential hypertension.
- Measured intimal-medial thickening by B-mode ultrasound in 44 untreated patients with essential hypertension.
- Assessed forearm vascular response to acetylcholine and sodium nitroprusside using strain-gauge plethysmography.
- Calculated minimal forearm vascular resistances and left ventricular mass index via echocardiography.
- Significant inverse correlation between carotid wall thickening and vasodilation to acetylcholine (r=-0.58, P<0.001).
- Also significant inverse correlation between carotid wall thickening and age (r=-0.40, P<0.001).
- No correlation observed between forearm vascular responses to sodium nitroprusside and carotid intimal-medial thickening.
Structured PICO
Is carotid wall intimal-medial thickening associated with reduced endothelium-dependent vasodilation in patients with essential hypertension?
P
Population
44 patients with essential hypertension who had never been treated and whose history of increased blood pressure was no longer than 12 months (mean age 45.7+/-8.8 years; 31 men and 13 women).
I
Intervention
Assessment of forearm vascular response to intrabrachial infusion of acetylcholine (0.15, 0.45, 1.5, 4.5, and 15 microg/100 mL forearm tissue per minute) and sodium nitroprusside (1, 2, and 4 microg/100 mL forearm tissue per minute).
O
Outcome
Correlation between carotid wall intimal-medial thickening (by B-mode ultrasound) and forearm vascular response (vasodilation to acetylcholine and sodium nitroprusside).surrogate
In patients with early, untreated essential hypertension, carotid wall thickening is associated with reduced endothelium-dependent vasodilation, suggesting endothelial dysfunction is involved in early arterial structural alterations.
Limitations
- Comparison of different vascular districts (forearm microcirculation and carotid artery) does not allow for a conclusive interpretation
Cite This Study
Ghiadoni et al. (1998) studied this question.