Age-related comparative evaluation of laboratory-functional parameters of vascular endothelial dysfunction in patients with arterial hypertension

Abstract

Aim. To conduct a comparative complex evaluation of the vasomotor and metabolic functions of the vascular endothelium in patients of different age groups with arterial hypertension. Methods. Examined were 98 young men and 60 elderly people with arterial hypertension of the I and II degree. The control group included 44 practically healthy young men and 45 elderly men. The endothelial function was assessed by Doppler measurements of brachial artery diameter at rest and during the test with reactive hyperemia and nitroglycerin, as well as by determining serum levels of the total amount of nitric oxide. Secondary stable products of lipid peroxidation were determined by the level of malondialdehyde. Antioxidant activity of blood was determined by evaluating the spontaneous chemiluminescence response. The diameter of the common carotid artery and the width of the intima/media complex was evaluated at rest using an ultrasound scanner. Results. Disturbance of the endothelium-dependent vasodilation in young and elderly patients with arterial hypertension of the I and II degree was accompanied by a significant decrease in production of endothelial nitric oxide. The expression of vascular endothelial dysfunction in patients of different ages with arterial hypertension of the I and II degree was in close correlation with the indicators of imbalance between the prooxidant activity and the antioxidant activity of blood, which manifested in an increase in the concentration of malondialdehyde in blood serum and in the decrease of the «antioxidant activity of blood/malondialdehyde content in blood serum» coefficient compared to groups of healthy individuals in response to pathological vasoconstriction. Conclusion. Arterial hypertension is accompanied by a progressive dysfunction of the vascular endothelium, which is more pronounced in the elderly due to reduced production of nitric oxide by the endothelium and due to the imbalance of the prooxidant-antioxidant system.