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Cited by 4,742Cardiovascular Health and Disease PreventionNitric Oxide and Endothelin EffectsCardiovascular Function and Risk Factors

Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis

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Celermajer, D.S., Sorensen, K.E., Gooch, V.M., Spiegelhalter, D.J., Miller, O.I., Sullivan, I.D., Lloyd, J.K., Deanfield, J.E.·1992·The Lancet
DOI 10.1016/0140-6736(92)93147-f
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Abstract

Endothelial dysfunction is an early event in experimental studies of atherogenesis, preceding formation of plaques. We have devised a non-invasive method for testing endothelial function, to find out whether abnormalities are present in symptom-free children and young adults at high risk of atherosclerosis. With high-resolution ultrasound, we measured the diameter of the superficial femoral and brachial arteries at rest, during reactive hyperaemia (with increased flow causing endothelium-dependent dilatation), and after sublingual glyceryl trinitrate (GTN; causing endothelium-independent dilatation) in 100 subjects--50 controls without vascular risk factors (aged 8-57 years), 20 cigarette smokers (aged 17-62 years), 10 children with familial hypercholesterolaemia (FH; aged 8-16 years), and 20 patients with established coronary artery disease (CAD). Adequate scans were obtained in all but 6 cases. Flow-mediated dilatation was observed in arteries from all control subjects. Dilatation was inversely related to baseline vessel diameter (r = -0.81, p < 0.0001); in arteries of 6.0 mm or less, mean dilatation was 10 (SE 2)%. In smokers, FH children, and adults with CAD, flow-mediated dilatation was much reduced or absent (p < 0.001 for comparison with each relevant control group). Dilatation in response to GTN was present in all groups. Endothelial dysfunction is present in children and adults with risk factors for atherosclerosis, such as smoking and hypercholesterolaemia, before anatomical evidence of plaque formation in the arteries studied. This may be an important early event in atherogenesis.

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  • Ingestion of beetroot juice (500 ml; 9 mmol nitrate) resulted in a diastolic BP reduction of 8 mmHg, an increase in onset of claudication pain and prolonged peak walking time in subjects with peripheral artery disease.

    “In the study by Kenjale et al. (89) the consumption of beetroot juice (500 ml; 9 mmol nitrate) resulted in a DBP reduction of 8 mmHg, an increase in the onset of claudication pain and prolonged peak walking time (89) .”

    From The effects of dietary nitrate on blood pressure and endothelial function: a review of human intervention studies (2013) · cites this paper as [89]

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Research works printed but not linked: 1

  1. Reneman RS, Van Merode T, Hick P, Muytjens MM, Hoeks APG. Age-related changes in carotid wall properties in man. Ultrasound Med Biol 1986; 12: 465-71.

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Authors
Celermajer, D. S., Sorensen, K. E., Gooch, V. M., Spiegelhalter, D. J., Miller, O. I., Sullivan, I. D., Lloyd, J. K., & Deanfield, J. E.
Affiliations
Great Ormond Street Hospital (GB)
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
1992-11
Volume
340
Issue
8828
Pages
1111-1115
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/0140-6736(92)93147-f
OpenAlex
W2063506869
Cited by
4,742
References
32
Citations by year
2026: 40 · 2025: 74 · 2024: 77 · 2023: 105 · 2022: 96 · 2021: 118 · 2020: 133 · 2019: 117 · 2018: 145 · 2017: 144 · 2016: 183 · 2015: 158 · 2014: 198 · 2013: 210 · 2012: 224
FWCI
23.49
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The Lancet (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
Hjerteforeningen
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
  • Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
Keywords
endothelial dysfunction, atherosclerosis, flow-mediated dilation, reactive hyperemia, nitroglycerin, superficial femoral artery, brachial artery, high-resolution ultrasound, familial hypercholesterolemia, smoking, coronary artery disease, children, atherogenesis, vascular risk factors
MeSH terms
Adolescent, Adult, Aged, Arteriosclerosis, Blood Flow Velocity, Brachial Artery, Child, Coronary Disease, Endothelium, Vascular, Female, Femoral Artery, Humans, Hyperlipoproteinemia Type II, Male, Middle Aged, Risk Factors, Smoking, Ultrasonography, Reproducibility of Results

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