Key result
Refractory hypertension was associated with higher left ventricular mass index (138 vs 108 g/m2, p<0.001) and carotid thickness, but not with altered biochemical endothelial function markers.
Why the study?
Is there an association between biochemical endothelial markers and cardiovascular remodeling in refractory hypertensive patients?
Case-Control (n=40)
Is there an association between biochemical endothelial markers and cardiovascular remodeling in refractory hypertensive patients?
Absolute Event Rate: 138% vs 108%
p-value: p=<0.001
In patients with refractory hypertension, significant cardiovascular remodeling (increased LV mass and carotid thickness) is present but does not correlate with plasma levels of NO2/NO3, cGMP, or thromboxane B2.
Remodeling in refractory hypertension occurs without endothelial marker shifts; leaves open non-endothelial mechanisms and needs prospective confirmation.
BACKGROUND: Hypertension is the most important and well established risk factor for atherosclerosis. The vascular and cardiac remodeling present in refractory hypertensive patients are related to endothelial dysfunction, a key factor in early atherogenesis and cardiovascular disease. However the mechanistic relationship among biochemical endothelial function markers, cardiovascular remodeling, and refractory hypertension is unknown. METHODS: We evaluated the left ventricular mass and function, carotid thickness, and plasma nitrate/nitrite (NO2/NO3), cyclic 3'-5'-guanosine monophosphate (cGMP), and thromboxane B2 (TXB2) levels in refractory hypertensive (RH; n = 20) and healthy (CONTROL; n = 20) subjects 22-65 years old. Carotid thickness, left ventricular mass index (LVMI), and left ventricular fraction ejection (LVFE) were estimated by duplex scan ultrasound. Nitrates/nitrites were assayed using the Griess reaction, and plasma cGMP and thromboxane B2 were determined by enzymatic immunoassay (EIA). RESULTS: Left ventricular mass index was higher in the RH group (138 +/- 20 vs. 108 +/-17 g/m2, p < 0.001) but there was no significant difference in the ejection fraction (67 +/- 5% vs. 69 +/- 4%). Pulse pressure (61 +/- 9 mmHg vs. 46 +/- 10 mmHg) and carotid thickness (1.59 +/- 0.22m vs. 1.04 +/- 0.14mm) were significantly higher (p < 0.001) in RH patients whereas NO2/NO3, cGMP, and thromboxane B2 plasma concentrations were similar in bot groups. CONCLUSION: There was no association between cardiovascular remodeling and the particular biochemical markers of endothelial function we assessed in refractory hypertensive patients.
No takes yet. Share an insight, caveat, or question.
Cittadino et al. (2003) conducted a case-control in Refractory Arterial Hypertension (n=40). Refractory hypertension vs. Healthy subjects was evaluated on Left ventricular mass index (LVMI) (p=<0.001). Refractory hypertension was associated with higher left ventricular mass index (138 vs 108 g/m2, p<0.001) and carotid thickness, but not with altered biochemical endothelial function markers.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: