Isolated systolic hypertension is characterized by increased aortic stiffness and endothelial dysfunction
Isolated systolic hypertension is characterized by increased aortic stiffness and endothelial dysfunction
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DOI：
10.1161/hypertensionaha.107.089391
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发表时间：
2007-07-01
期刊：
影响因子：
8.3
通讯作者：
Wilkinson, Ian B.
中科院分区：
文献类型：
--
作者：
Wallace, Sharon M. L.;Yasmin;Wilkinson, Ian B.
单纯的收缩期高血压与心血管风险增加有关。它被认为是大动脉硬化的结果，这是由血管系统中的结构成分决定的，也是由包括一氧化氮和内皮素-1在内的功能因素决定的。我们假设内皮功能障碍可能是单纯收缩期高血压患者动脉僵硬增加的原因。本研究的目的是调查这些患者和对照组血管内皮细胞功能和动脉僵硬之间的关系。我们研究了113名受试者：35名单纯收缩期高血压患者(平均年龄+/-6岁)、30名年龄匹配的对照组(65+/-5岁)和48名年轻对照组(37+/-9岁)。脉搏波速度(PWV)由颈动脉/股动脉连续记录得到。用血流介导的扩张法测定血管内皮功能。与年龄匹配的对照组比较，单纯收缩期高血压患者的主动脉PWV值升高(9.65±2.56m/S比8.26±0.85m/S；P=0.009)，血流介导的舒张率降低(2.67±1.64%比4.79±3.1%；P=0.03)。同样，老年对照组的主动脉PWV高于青年对照组(8.26±0.85m/S比7.09±1.01m/S，4.79±3.1%比6.94+/-2.7%，P=0.004)。总体而言，主动脉PWV与血流介导的扩张呈负相关(r=-0.30；P=0.001)，在调整混杂因素后仍显著(P=0.01)。单纯收缩期高血压患者与年龄匹配的对照组相比，主动脉PWV升高，内皮功能降低。我们的结果表明，内皮功能对单纯收缩期高血压患者和年龄增加的动脉僵硬有显着影响。
Isolated systolic hypertension is associated with increased cardiovascular risk. It is thought to result from large artery stiffening, which is determined by structural components within the vasculature but also by functional factors including NO and endothelin-1. We hypothesized that endothelial dysfunction would account for increased arterial stiffness in patients with isolated systolic hypertension. The aim of this study was to investigate the relationship between endothelial function and arterial stiffness in these patients along with control subjects. We studied 113 subjects: 35 patients with isolated systolic hypertension (mean age +/- SD: 68 +/- 6 years), 30 age-matched control subjects (65 +/- 5 years), and 48 young control subjects (37 +/- 9 years). Aortic pulse wave velocity (PWV) was derived by sequential carotid/femoral waveform recordings. Conduit artery endothelial function was determined by flow-mediated dilatation. Aortic PWV was higher (9.65 +/- 2.56 m/s versus 8.26 +/- 0.85 m/s; P = 0.009), and flow-mediated dilatation was lower (2.67 +/- 1.64% versus 4.79 +/- 3.1%; P = 0.03) in patients with isolated systolic hypertension compared with age-matched control subjects. Similarly, aortic PWV was also higher, and flow-mediated dilatation lower, in older versus young control subjects (8.26 +/- 0.85 m/s versus 7.09 +/- 1.01 m/s and 4.79 +/- 3.1% versus 6.94 +/- 2.7%; P = 0.004 for both). Overall, aortic PWV correlated inversely with flow-mediated dilatation (r = -0.3; P = 0.001), which remained significant after adjustment for confounding factors (P = 0.01). Patients with isolated systolic hypertension have higher aortic PWV and decreased endothelial function compared with age-matched control subjects. Our results suggest that endothelial function contributes significantly to increased arterial stiffness in patients with isolated systolic hypertension and with age.