Abstract
Objective: To evaluate arterial stiffness (AS) and lipids transfer to high density lipoprotein cholesterol (HDL-c) in ischemic stroke due to hypertensive emergency (IS-HE). Methods: Thirty and one patients with IS-HE, 33 individuals with ischemic stroke without hypertensive emergency (IS), 31 controlled hypertensive (CHT) and 33 normotensive (NT) individuals were studied. AS was assessed by analyzing the pulse wave velocity (PWV), augmentation index and central blood pressure. The lipids transfer to HDL-c was evaluated after incubation of the plasma with an artificial radiolabeled nanoparticle, used as a donor of esterified and non-esterified cholesterol. Cholesterol transfer was measured in the HDL-c fraction, after chemical precipitation of lipoproteins containing apolipoprotein B. Results: Systolic (SBP) and diastolic (DBP) blood pressure were significantly higher in the IS-HE compared to IS, CHT and NT groups (190/110 mmHg vs 140/87, 128/69 and 129/80 mmHg, respectively; p<0.05). Similarly, central SBP and DBP were higher in patients with IS-HE compared to IS, CHT and NT (147/101 mmHg vs 128/90, 118/71 and 120/83 mmHg, respectively; p<0.05). PWV was significantly higher in the groups IS-HE and IS, compared to NT group (9.7 and 10.6 vs 7.8 m/s, respectively; p<0.05). The esterified cholesterol transfer was reduced in the IS-HE and IS groups in relation to the CHT and NT groups (4.19 and 3.76 vs 4.5 and 4.75, respectively; p<0.05). The non-esterified cholesterol transfer was also markedly decreased in IS-HE e IS groups compared to CHT and NT groups (4.57 and 4.06 vs 5.47 and 5.71, respectively; p<0.05). A negative correlation was observed between non-esterified cholesterol transfer and PWV in the IS-HE group. Conclusion: This study provides evidence that high blood pressure levels are associated to arterial stiffness and a marked decrease in the lipids transfer to HDL-c in patients with ischemic stroke due to hypertensive emergency, which indicates that changes in the HDL-c fraction can contribute to atherogenesis in these patients. These considerations contribute to the concept that determining HDL-c functionality with dynamic assays can be relevant for predicting the cardiovascular disease risk.
Published Version
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