Abnormalities of vascular function in resistant hypertension
Open accessAbstract
We aimed to evaluate markers of vascular dysfunction in patients with resistant hypertension (RH). A group of 144 patients (61 years, 42% women) with essential RH were divided in two groups based on ambulatory blood pressure monitoring (ABPM). True RH (72%) was considered when 24-h blood pressure (BP) was ≥ 130 and/or 80 mmHg. Otherwise, patients were classified as white coat RH (28%). Hyperemia-induced forearm vasodilation (HIFV), serum inflammatory biomarkers (hs-CRP, s-ICAM-1, s-VCAM-1, e-selectin, p-selectin and MCP-1) and large (C1) and small arterial (C2) compliance (HDI/Pulse Wave CR 2000) were determined in all individuals. In comparison with patients with white coat RH, and after adjustment for age, office systolic BP and diabetes status, those with true RH had a more impaired HIFV (201 ± 159 vs 436 ± 157%; p < 0.001), increased e-selectin (53.1 ± 29.8 vs 40.7 ± 23.5 ng/ml; p = 0.035), and MCP-1 (445 ± 120 vs 386 ± 126 ng/ml; p = 0.027). No significant differences were observed in arterial compliance. Maximal HIFV inversely correlated with urinary albumin excretion (Rho: - 0.278; p = 0.004) and with some inflammatory biomarkers (MCP-1: - 0.441; p < 0.001, e-selectin: - 0.468; p < 0.001 and p-selectin: - 0.329; p = 0.001). We conclude that true RH, diagnosed by ABPM, is associated with a more severe degree of vascular dysfunction, as measured by HIFV and serum biomarkers, whereas other types of vascular alterations, such as compliance, are not directly linked with the level of BP.
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Physiological aberrations in resistant hypertension include vascular disease/dysfunction as evidenced by high rates of peripheral and carotid artery atherosclerosis, impaired endothelial function, reduced arterial compliance, and raised systemic vascular resistance, all of which may be more pronounced in resistant hypertension compared with non-resistant hypertension.
“Physiological aberrations in RH include vascular disease/dysfunction as evidenced by high rates of peripheral39 and carotid artery atherosclerosis,42 impaired endothelial function,51,52 reduced arterial compliance, and raised systemic vascular resistance,40 all of which may be more pronounced in RH compared with non-RH.”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [51]
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- Authors
- de La Sierra, A., Larrousse, M., Oliveras, A., Armario, P., Hernández-Del Rey, R., Poch, E., & Roca-Cusachs, A.
- Affiliations
- Hospital de Mataró (ES)
- Hospital Del Mar (ES)
- Hospital Clínic de Barcelona (ES)
- Hospital de Sant Pau (ES)
- Venue
- Blood Pressure
- Publisher
- Informa UK Limited
- Published
- 2011-10-24
- Volume
- 21
- Issue
- 2
- Pages
- 104-109
- ISSN
- 0803-7051 (ISSN-L)
- 1651-1999
- OpenAlex
- W2107884445
- Cited by
- 21
- References
- 37
- Citations by year
- 2023: 3 · 2020: 1 · 2018: 1 · 2017: 5 · 2016: 2 · 2015: 1 · 2014: 1 · 2013: 5 · 2012: 2
- FWCI
- 1.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Blood Pressure (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Omron Healthcare
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- resistant hypertension, vascular dysfunction, white coat hypertension, arterial compliance, inflammatory markers, E-selectin, P-selectin, MCP-1, urinary albumin excretion, ambulatory blood pressure monitoring
- MeSH terms
- Adult, Aged, Blood Vessels, Compliance, Female, Forearm, Humans, Hypertension, Male, Middle Aged, Vasodilation, Blood Pressure Monitoring, Ambulatory
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