2014, Number 4
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Rev cubana med 2014; 53 (4)
Endothelial dysfunction in newly diagnosed hypertensive patients
León ÁJL, Guerra IG, Yanes QMÁ, Calderín BRO, Gutiérrez RÁ
Language: Spanish
References: 20
Page: 417-429
PDF size: 240.05 Kb.
ABSTRACT
Introduction: atherosclerosis, endothelial dysfunction and hypertension are closely
related. Endothelium-dependent vasoreactivity is an equivalent of endothelial
dysfunction.
Objective: To evaluate the usefulness of baseline diameter of the brachial artery
measured by ultrasonographic techniques in the diagnosis of endothelial dysfunction and subclinical vascular lesion, its association with cardiovascular risk
factors, and overall cardiovascular risk.
Methods: Across-sectional analytical research was conducted in 60 newly
diagnosed hypertensive patients without target organ damage. They were
compared with 60 non-hypertensive subjects. Cardiovascular risk factors were
screened; these patients underwent several tests such as microalbuminuria, total
cholesterol, HDL cholesterol, triglycerides, non-HDL cholesterol, ultrasound
measurement of carotid intima-media thickness and basal diameter of the brachial
artery. The global cardiovascular risk was calculated.
Results: In the hypertensive group, males constituted 55 % of the total and in the
non-hypertensive group, females accounted for 78.3 %. Microalbuminuria was
present in 25 % of hypertensive subejcts by 13.3 % of patients without the
disease. Higher mean values of total cholesterol and non-HDL in hypertensive
subjects (4.6 mmol / L and 3.6 mmol / L, respectively) were found. The mean
intima-media thickness was 0.6 mm in hypertensive patients and 0.4 mm in non
hypertensive subjects. In hypertensive patients, the mean baseline brachial artery
diameter was 3.8 mm versus 3.5 mm in non-hypertensive subjects. In both study
groups, higher mean levels of baseline diameter of the brachial artery when there
were higher mean values of HDL-cholesterol.
Conclusions: There is a positive association for total cholesterol, HDL-cholesterol,
the carotid intima media thickness, microalbuminuria and global cardiovascular risk
in basal diameter of the brachial artery. The determination of basal diameter of the
brachial artery is concluded to show promising results as a marker of endothelial
dysfunction in hypertension.
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