Key result
Newly diagnosed adolescent essential hypertension is linked to lower microvascular endothelial function versus normotensives.
Why the study?
Endothelial dysfunction is a key pathomechanism in hypertension, but endothelial function evaluated by conventional and novel peripheral arterial tonometry indices had not been assessed in pediatric hypertensives.
Does peripheral arterial tonometry detect early microvascular endothelial dysfunction in adolescents with newly diagnosed essential hypertension compared to normotensives and white-coat hypertensives?
Cross-Sectional (n=100)
No
Does peripheral arterial tonometry detect early microvascular endothelial dysfunction in adolescents with newly diagnosed essential hypertension compared to normotensives and white-coat hypertensives?
The area under the curve of hyperemic response (AUC) using peripheral arterial tonometry is a sensitive biomarker for detecting early microvascular endothelial dysfunction in adolescents with essential hypertension.
Answers are grounded in this paper and cite their sources.
May support tonometry for early detection in hypertensive adolescents; hypothesis-generating and requires prospective validation before practice change.
Endothelial dysfunction represents one of the key pathomechanisms in many diseases, including hypertension. Peripheral arterial tonometry (PAT) evaluates the functional status of microvascular endothelium and offers a biomarker of early, potentially reversible, vascular damage. This study aimed to assess endothelial function using conventional and novel indices of PAT in pediatric hypertensives. As such, 100 adolescents with normal blood pressure, and essential and white-coat hypertension were examined using EndoPAT 2000. Conventional reactive hyperemia index (RHI) and novel indices of hyperemic response, including the area under the curve of hyperemic response (AUC), were evaluated. AUC was the only parameter sensitive to the effect of hypertension, with significantly lower values in essential hypertensives compared to normotensives and white-coat hypertensives (p = 0.024, p = 0.032, respectively). AUC was the only parameter significantly correlating with mean ambulatory monitored blood pressure (r = −0.231, p = 0.021). AUC showed a significant negative association with age (p = 0.039), but a significant positive association with pubertal status indexed by plasma levels of dehydroepiandrosterone (p = 0.027). This is the first study reporting early signs of microvascular endothelial dysfunction evaluated using PAT in adolescents with newly diagnosed essential hypertension. Detailed analysis of hyperemic response using overall magnitude indexed by AUC provided a more robust method compared to the conventional evaluation of RHI.
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Jurko et al. (2022) conducted a cross-sectional in Essential hypertension (n=100). Essential hypertension vs. Normal blood pressure and white-coat hypertension was evaluated on Log-transformed area under the curve (Ln AUC) of hyperemic response (p=0.024). Adolescents with newly diagnosed essential hypertension had significantly lower microvascular endothelial function, measured by the area under the curve of hyperemic response, compared to normotensives (p=0.024).
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