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Int J Cardiol. 2018 Feb 15;253:161-166. doi: 10.1016/j.ijcard.2017.11.022. Epub 2017 Nov 12.

Longitudinal association among endothelial function, arterial stiffness and subclinical organ damage in hypertension.

Author information

1
Department of Cardiology, Tokyo Medical University, Tokyo, Japan. Electronic address: tomiyama@tokyo-med.ac.jp.
2
Cardiovascular Division, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan.
3
Department of Clinical Informatics, Jichi Medical University School of Medicine, Tochigi, Japan.
4
Department of Cardiology, Tokyo Medical University, Tokyo, Japan.
5
Department of Cardiovascular Physiology and Medicine, Hiroshima University Graduate School of Biomedical Science, Hiroshima, Japan.
6
Division of Biomedical Engineering, National Defense Medical College Research Institute, Saitama, Japan.
7
Cardiovascular Medicine, University of Leicester, Leicester, UK.
8
Department of Clinical Pharmacology and Therapeutics, University of the Ryukyu School of Medicine, Okinawa, Japan.
9
Department of Clinical Epidemiology and Systems, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
10
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Hokkaido, Japan.
11
Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
12
Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan.
13
Department of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan.
14
Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan.
15
Department of Medical Education and Population-based Medicine, Postgraduate School of Medicine, Wakayama Medical University, Wakayama, Japan.
16
Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
17
Department of General Medicine, Shimane University Faculty of Medicine, Izumo, Japan.
18
Department of Cardiovascular and Renal Medicine, Saga University, Saga, Japan.
19
Department of Cardiovascular Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
20
The Third Department of Internal Medicine, University of the Ryukyus, Okinawa, Japan.
21
Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
22
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.

Abstract

OBJECTIVES:

To examine the longitudinal mutual association between endothelial dysfunction and arterial stiffness, and also to determine which of the two variables was more closely associated with the progression of subclinical organ damage.

METHODS:

The brachial-ankle pulse wave velocity (baPWV), carotid intima-media thickness (CIMT), estimated glomerular filtration rate, microalbuminuria and flow-mediated vasodilatation of the brachial artery (FMD) were measured three times at 1.5-year intervals in 674 Japanese patients receiving antihypertensive treatment.

RESULTS:

The change of the baPWV during the study period was larger in the subjects with baseline FMD values in the lowest tertile as compared to those with baseline FMD values in the highest tertile. The change of the CIMT was smaller in the subjects with baseline baPWV values in the lowest tertile than in those with baseline baPWV values in the highest tertile. After the adjustment, the FMD value at the baseline was inversely associated with the baPWV at the end of the study period (beta=-0.07, p=0.01), although, the reverse association was not significant. The baPWV, but not the FMD value, at the baseline was associated with the CIMT (beta=0.06, p=0.04) measured at the end of the study period.

CONCLUSIONS:

In hypertension, endothelial dysfunction was associated with the progression of arterial stiffness, although the reverse association was not confirmed. The increased arterial stiffness rather than endothelial dysfunction may be more closely associated with the progression of atherosclerotic vascular damage, and the endothelial dysfunction-arterial stiffness-atherosclerosis continuum may be important in hypertension.

KEYWORDS:

Arterial stiffness; Atherosclerosis; Endothelial function; Hypertension; Renal function

PMID:
29174285
DOI:
10.1016/j.ijcard.2017.11.022
[Indexed for MEDLINE]
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