388 BRACHIAL FLOW-MEDIATED DILATION AS A PREDICTOR OF TARGET ORGAN DAMAGE IN ESSENTIAL HYPERTENSIVE PATIENTS

Abstract

Background: We found impaired brachial flow-mediated dilation (FMD) was associated with the number of target organ damage (TOD). The purpose of this study was to evaluate the predictive value of FMD for the progression of TOD in essential hypertension. Methods and results: Endothelium-dependent brachial FMD was measured in 280 adults (mean age 59 ± 10, men 58%) in 2007. At the third year examination (from May to December 2010), 204 patients were approached for participation in our study. Patients were divided into two groups as following: FMD>10 (normal FMD group) and FMD<10 (impaired FMD group). In patients with 0-1TOD(n = 124) in 2007, impaired FMD group(n = 65) led to thicker intima-media thickness(IMT) of common carotid artery (0.73 ± 0.15 vs 0.66 ± 0.09, P = 0.001), increased carotid to femoral pulse wave velocity (cf-PWV:14.6 ± 3.3 vs 13.2 ± 2.9, P = 0.012), decreased FMD (8.0 ± 3.9 vs 10.0 ± 4.0, P = 0.007) and increased urinary albumin creatinine ratio (lgUACR:0.35 ± 0.70 vs 0.12 ± 0.49, P = 0.035) than normal FMD group(n = 59) in 2010. Impaired FMD also led to increasing the number of TOD (1.91 ± 1.01 vs 1.36 ± 1.08,P = 0.004) in 2010. While in the patients with 2-4TOD (n = 75) in 2007, there was no difference in TOD progression between impaired and normal FMD groups in 2010. In addition, TOD number increasing was associated with higher pulse pressure (β = 0.274, P = 0.001), higher LDL-C (β = 0.274, P = 0.006) and worse FMD (β = −0.167, P = 0.048) in stepwise multivariate regression analysis. Conclusions: FMD is a predictor of future TOD progression in the early stage of essential hypertensive patients, but has little predictive value in the late stage of TOD.