CARDIOVASCULAR RISK FACTORS CAN AFFECT ENDOTHELIAL DYSFUNCTION IN ESSENTIAL HYPERTENSIVES: ACROSS SECTIONAL CASE-CONTROL STUDY

Abstract

Objective: Endothelial dysfunction is now recognized as an early, perhaps initiating event in the pathogenesis of cardiovascular diseases. The purpose of the present study was to examine the influence of cardiac risk factors on endothelial function in essential hypertension (EH). Material and methods: Young 129 (53 males, mean age 45.0±6.4) mild hypertensive patients and same number of healthy controls were selected. All patients were under antihypertensive treatment for a mean duration of 44±63 months, and were at the targeted blood pressure. Major risk factors for cardiovascular diseases according to the National Cholesterol Education Program criteria and some other risk factors were evaluated. Seventy-eight EH patients and 78 age and sex matched control subjects were assessed for endothelial function using brachial artery ultrasound. Endothelium dependent (EDD) and independent (EID) vasodilation were evaluated. Results: Patients with EH were older with female dominance, had higher frequency of diabetes, obesity, higher cholesterol, triglycerides, and fibrinogen levels. EH patients had significantly impaired EDD (17.4±7.2% vs 20.7±5.8%, p=0.002) and EID (20.9±8.2% vs 24.4±6.8%, p=0.004) compared with controls. In multiple regression test only uric acid levels, presence of EH, and body mass index (BMI) were retained as significant for EDD. Only uric acid, hemoglobin levels, presence of EH, and BMI were significantly associated with EID. Conclusion: It was concluded that endothelial dysfunction was present in EH group despite optimal medical therapy. The factors analyzed in the study explain only a fraction of the variability in EDD but were intimately related to metabolic syndrome which may be one of the reasons why endothelial dysfunction was present in EH despite medical therapy.