Microcirculation and biomarkers in patients with resistant or mild-to-moderate hypertension: a cross-sectional study
Microcirculation and biomarkers in patients with resistant or mild-to-moderate hypertension: a cross-sectional study
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DOI：
10.1038/s41440-018-0043-3
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发表时间：
2018-07-01
影响因子：
5.4
通讯作者：
Bouskela, Eliete
中科院分区：
文献类型：
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作者：
Junqueira, Camillo L. C.;Magalhaes, Maria Eliane C.;Bouskela, Eliete
微循环影响外周血管阻力，因此有助于动脉血压。本研究的目的是探讨耐药患者血清炎症标志物与甲襞视频毛细血管镜检查（NVC）观察到的微循环参数之间的相关性（RH，58 [50-63]岁，n = 25）或轻度至中度高血压（MMH，56 [47-64]岁，n = 25）与正常血压患者（对照组（CG），33 [27-52]岁，n = 25）相比。通过实验室分析获得C反应蛋白（CRP）、内皮素、脂联素、I-CAM和V-CAM水平。通过NVC测定功能性毛细血管密度（FCD;单位组织面积内具有流动红细胞的毛细血管的数量）、毛细血管直径、反应性充血反应期间的最大红细胞流速（RBCVmax）/手指根部动脉闭塞1 min后的RBCV基线以及达到RBCVmax的时间。还对未服用他汀类药物、血压控制/未控制的高血压患者进行了亚组分析。与MMH和CG患者相比，RH组的RBCV和RBCVmax值较低，TRBCVmax较长，血压不受控制的患者的值更差。三组间FCD和直径无显著差异，RH和MMH组CRP值较高。在两个高血压组中，仅在未服用他汀类药物的患者中观察到内皮素增加。重度高血压和血压水平不受控制的患者表现出更明显的微血管功能障碍，以及更高的CRP和内皮素血清值（未接受他汀类药物治疗），表明使用他汀类药物可减少内皮素释放。
Microcirculation influences peripheral vascular resistance and therefore contributes to arterial blood pressure. The aim of this study was to investigate the correlation between serum markers of inflammation and microcirculatory parameters observed by nailfold videocapillaroscopy (NVC) in patients with resistant (RH, 58 [50-63] years, n = 25) or mild-to-moderate hypertension (MMH, 56 [47-64] years, n = 25) compared to normotensive patients (control group (CG), 33 [27-52] years, n = 25). C-reactive protein (CRP), endothelin, adiponectin, I-CAM and V-CAM levels were obtained by laboratory analysis. Functional capillary density (FCD; the number of capillaries with flowing red blood cells by unit tissue area), capillary diameters, maximum red blood cell velocity (RBCVmax) during the reactive hyperemia response/RBCVbaseline after 1 min of arterial occlusion at the finger base and time to reach RBCVmax were determined by NVC. A sub-analysis was also conducted on hypertensive patients not taking statins, with controlled/uncontrolled blood pressure. The RH group showed lower RBCV and RBCVmax values and longer TRBCVmax compared to MMH and CG patients, with worse values in those with uncontrolled blood pressure. FCD and diameters showed no significant differences among the three groups, with higher CRP values in the RH and MMH groups. An increase in endothelin was observed only in patients not taking statins in both hypertensive groups. Patients with severe hypertension and uncontrolled blood pressure levels presented more pronounced microvascular dysfunction, as well as higher serum values for CRP and endothelin (without statin treatment), suggesting that the use of statins decreases endothelin release.