Endothelial function in children with white-coat hypertension
Endothelial function in children with white-coat hypertension
复制标题
DOI：
10.1007/s00380-017-1107-z
复制
发表时间：
2018-06-01
影响因子：
1.5
通讯作者：
Tonhajzerova, Ingrid
中科院分区：
文献类型：
--
作者：
Jurko, Alexander;Jurko, Tomas;Tonhajzerova, Ingrid
多项研究表明原发性高血压患者存在内皮功能障碍。然而，尚未研究白大衣高血压儿童是否存在内皮功能障碍。我们使用基于血流介导扩张（FMD）评估的新方法评估了白大衣高血压和原发性高血压儿童的内皮功能。研究涉及 106 名儿童：30 名白大衣高血压患者（年龄 16.3 +/- 1.3 岁，平均值 +/- SD）、30 名原发性高血压患者（年龄 16.4 +/- 1.3 岁）和 46 名健康对照者（年龄 16.2 +/- 1.4 岁）。在方案期间使用 Prosound F75 Aloka 系统对右肱动脉进行超声扫描：基线（1 分钟）、前臂缺血（5 分钟）和闭塞后阶段（3 分钟）。 FMD (%) 表示为动脉直径从基线到最大闭塞后值的变化，值 < 5% 被认为是 FMD 不足。我们发现，与对照组相比，原发性高血压和白大衣高血压的 FMD 均显着降低（两者均 p < 0.05），但高血压组之间没有显着差异。两个高血压组均发现 FMD 缺陷，但对照组未发现。与对照组相比，原发性高血压和白大衣高血压患者的 FMD 缺陷发生率均显着较高（两者均 p < 0.01），但高血压组之间没有显着差异。我们对白大衣高血压儿科患者 FMD 受损表明的内皮功能障碍的发现可能有助于阐明心血管风险增加的机制，这可能与原发性高血压相似。因此，白大衣高血压不应被视为良性现象。
Several studies have demonstrated endothelial dysfunction in patients with essential hypertension. However, the presence of endothelial dysfunction in children with white-coat hypertension has not been studied. We evaluated the endothelial function in children with white-coat hypertension and essential hypertension using a novel method based on the assessment of flow-mediated dilation (FMD). Study involved 106 children: 30 white-coat hypertensives (age 16.3 +/- 1.3 years, mean +/- SD), 30 essential hypertensives (age 16.4 +/- 1.3 years), and 46 healthy controls (age 16.2 +/- 1.4 years). Ultrasound scans of the right brachial artery were performed using Prosound F75 Aloka system during protocol: baseline (1 min), forearm ischemia (5 min), and post-occlusion phase (3 min). FMD (%) was expressed as a change of the arterial diameter from baseline to maximum post-occlusion value and the values < 5% were considered as deficient FMD. We found significantly lower FMD in both essential and white-coat hypertension compared to control group (p < 0.05 for both) with no significant difference between the hypertensive groups. Deficient FMD was found in both hypertensive groups, but not in the control group. The occurence of deficient FMD was significantly higher in both essential and white-coat hypertensives compared to controls (p < 0.01 for both) with no significant difference between the hypertensive groups. Our findings of endothelial dysfunction indicated by impaired FMD in pediatric patients with white-coat hypertension could help to elucidate the mechanisms of the increased cardiovascular risk that could be similar as found in essential hypertension; therefore, white-coat hypertension should not be considered a benign phenomenon.