Endothelial vasomotor function and global arterial distensibility in ischaemic cerebrovascular diseases and arterial hypertension

Abstract

The study of endothelial vasomotor function (EVF) and global arterial distensibility (glAD) aimed at determining their role in the development and progression of cerebral disturbances in arterial hypertension (AH) was conducted. We investigated 292 patients with different clinical forms of hypertensive cerebrovascular diseases (CVD). EVF was assessed with the use of endothelium-dependent flow-mediated vasodilatation of the brachial artery, and glAD was calculated as stroke volume (by echocardiography)/pulse pressure ratio (ml/mm Hg). Reduced EVF was revealed in patients versus controls: 7.2% (5.9; 8.2) and 10.5% (10.0; 12.9), respectively (p<0.001). EVF values were similar in patients with both early and late progressive stages of CVD. glAD was inversely correlated with the grade and duration of AH, patient age, and presence of deformations or atherosclerotic lesions of brachiocephal arteries, and it was diminished only in hypertensive encephalopathy, stage II–III [1.34 ml/mm Hg (1.11; 1.56) and 1.33 ml/mm Hg (1.13; 1.73)]. Thus, endothelial dysfunction is the earliest abnormality of vascular functional properties in AH and may be regarded as a universal factor of cerebrovascular complications. Reduced glAD reflects the loss of arteasticity and may represent a predictor of progressive course of CVD.