Gender differences in the risk factors for endothelial dysfunction in Chinese hypertensive patients: homocysteine is an independent risk factor in females.

Cheng Cao,Jianxin Hu,Yifei Dong,Xiaoshu Cheng,Hai Su,Qinghua Wu,Xiao Huang,Rui Zhan,Ping Li,Tao Wu,Qiang Peng,Liang Lei,Zhanjun Jia

doi:10.1371/journal.pone.0118686

Abstract

ObjectivesEndothelial dysfunction plays a key role in the pathogenesis of cardiovascular disease. However, the gender-related differences in risk factors for endothelial dysfunction are controversial. We investigated the gender differences in the risk factor profiles for endothelial dysfunction in Chinese hypertensive patients.MethodsVascular endothelial functions in 213 hypertensive patients were measured by digital reactive hyperemia peripheral arterial tonometry (RH-PAT). Peripheral blood samples were collected, and the self-reported smoking and alcohol consumption status, age, body mass index, heart rate, blood pressure and drug administrations were recorded.ResultsRH-PAT indexes were attenuated in both male and female hypertensive patients [1.60 (1.38-2.02) vs. 1.63 (1.44-1.98)]. Multivariate logistic regression analysis identified plasma creatinine (p < 0.001), total cholesterol (p = 0.001), homocysteine (p = 0.002) and smoking (p < 0.001) as the independent factors correlated with gender (male). Multivariate linear regression analysis further identified homocysteine as the factor that is significantly and independently correlated with the decrease in the RH-PAT indexes in female patients (odds ratio: -0.166, 95% confidence interval: -0.292 to -0.040, p = 0.01). However, none of these four factors were correlated with the RH-PAT indexes in male patients.ConclusionsThere are gender-related differences in the risk factors for endothelial dysfunction in Chinese hypertensive patients. Homocysteine is an independent factor for endothelial dysfunction in female hypertensive patients.

Highlights

The vascular endothelium plays a vital role in regulating the cardiovascular system and maintaining vascular health [1]
Multivariate logistic regression analysis identified plasma creatinine (p < 0.001), total cholesterol (p = 0.001), homocysteine (p = 0.002) and smoking (p < 0.001) as the independent factors correlated with gender
Multivariate linear regression analysis further identified homocysteine as the factor that is significantly and independently correlated with the decrease in the reactive hyperemia peripheral arterial tonometry (RH-PAT) indexes in female patients

Summary

Introduction

The vascular endothelium plays a vital role in regulating the cardiovascular system and maintaining vascular health [1]. Gender differences in the burden of CVD influence the relationship between endothelial dysfunction and the adverse outcomes of CVD. They provide evidence for the importance of gender-based CVD prevention [5]. Novel biomarkers representing new risk factors, such as homocysteine (Hcy), correlate with endothelial dysfunction in humans [10]. The impact of these new risk factors on vascular disease seem to vary by gender, race and ethnicity [11, 12]. The influence of risk factor profiles on endothelial function, especially gender-related differences in endothelial dysfunction, remains to be identified. The aims of this study were to investigate the relationship between vascular risk factors and endothelial function in male and female Chinese hypertensive patients

Objectives

Results

Conclusion