Abstract 4877: Circadian Variation of Blood Pressure is Correlated to Vascular Endothelial Function in Nondiabetic Essential Hypertensives

Background: Abnormal endothelium-dependent vascular relaxation in patients with essential hypertension has been described. We assessed the hypothesis that there was relationship between the circadian rhythm of blood pressure and endothelial function in patients with essential hypertension. Methods: Non-diabetic patients with either treated or untreated essential hypertension were evaluated if their office systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg. Serial studies including 24-hour ambulatory blood pressure monitoring, serum biomarkers, and brachial artery ultrasound were arranged. Results: Thirty-nine patients were enrolled into the study. They were subclassified by their nocturnal DBP fall (25 dippers, with nocturnal DBP fall ≥10%; and 14 non-dippers, with nocturnal DBP fall p =0.04) while the nitroglycerin-mediated dilation of brachial artery was similar between the two groups (14.3±5.5% vs. 13.7±6.0%, p =0.746). In all patients, sleep DBP (r=−0.379, p =0.017), nocturnal change of SBP (r=0.344, p =0.032) and DBP (r=0.420, p =0.008), and the use of calcium channel blockers (r=−0.394, p =0.013) were correlated to FMD. In multivariate analysis, only nocturnal change of DBP was the independent predictor for FMD ( β =0.175, p =0.008). Conclusions: In non-diabetic hypertensive patients, the dippers had better endothelial function than the non-dippers. Nocturnal change of DBP was the major predictor for endothelial function.

[1]  M. Yūksel,et al.  Diurnal Blood Pressure Abnormalities Are Related to Endothelial Dysfunction in Patients with Non-Complicated Type 1 Diabetes , 2008, Hypertension Research.

[2]  Piotr Ponikowski,et al.  2007 Guidelines for the management of arterial hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). , 2007, European heart journal.

[3]  H. Oflaz,et al.  Ambulatory Blood Pressure and Endothelial Dysfunction in Patients with Autosomal Dominant Polycystic Kidney Disease , 2007, Renal failure.

[4]  H. Leu,et al.  Comparison of endothelial vasodilator function, inflammatory markers, and N-terminal pro-brain natriuretic peptide in patients with or without chronotropic incompetence to exercise test , 2005, Heart.

[5]  J. Murabito,et al.  Clinical and genetic correlates of serum aldosterone in the community: the Framingham Heart Study. , 2005, American journal of hypertension.

[6]  F. Magrini,et al.  Cardiovascular target organ damage in essential hypertensives with or without reproducible nocturnal fall in blood pressure , 2004, Journal of hypertension.

[7]  K. Kario,et al.  Associations between nondipping of nocturnal blood pressure decrease and cardiovascular target organ damage in strictly selected community-dwelling normotensives. , 2003, American journal of hypertension.

[8]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, JAMA.

[9]  Yutaka Imai,et al.  European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement , 2003, Journal of hypertension.

[10]  K. Chayama,et al.  Circadian variation of blood pressure and endothelial function in patients with essential hypertension:a comparison of dippers and non-dippers. , 2002, Journal of the American College of Cardiology.

[11]  H. Ulmer,et al.  Association of wall thickness of the brachial artery measured with high-resolution ultrasound with risk factors and coronary artery disease. , 2002, The American journal of cardiology.

[12]  E. Benjamin,et al.  Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: a report of the International Brachial Artery Reactivity Task Force. , 2002, Journal of the American College of Cardiology.

[13]  P. Vallance,et al.  Cardiovascular risk factors as determinants of endothelium-dependent and endothelium-independent vascular reactivity in the general population. , 2001, Journal of the American College of Cardiology.

[14]  G. Lip,et al.  Abnormal haemorheology, endothelial function and thrombogenesis in relation to hypertension in acute (ictus < 12 h) stroke patients: the West Birmingham Stroke Project , 2001, Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis.

[15]  B. Conrad,et al.  Relationship Between Circadian Blood Pressure Patterns and Progression of Early Carotid Atherosclerosis: A 3-Year Follow-Up Study , 2000, Circulation.

[16]  A M Zeiher,et al.  Prognostic impact of coronary vasodilator dysfunction on adverse long-term outcome of coronary heart disease. , 2000, Circulation.

[17]  S. Higano,et al.  Long-term follow-up of patients with mild coronary artery disease and endothelial dysfunction. , 2000, Circulation.

[18]  P. Verdecchia,et al.  Prognostic value of ambulatory blood pressure : current evidence and clinical implications. , 2000, Hypertension.

[19]  A. Zeiher,et al.  A positive family history of premature coronary artery disease is associated with impaired endothelium-dependent coronary blood flow regulation. , 1999, Circulation.

[20]  Gianfranco Parati,et al.  Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. , 1999 .

[21]  J. Baguet,et al.  Clinical value of ambulatory blood pressure monitoring. , 1999, Journal of hypertension.

[22]  G Parati,et al.  Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. Systolic Hypertension in Europe Trial Investigators. , 1999, JAMA.

[23]  T. Ohkubo,et al.  Relation between nocturnal decline in blood pressure and mortality. The Ohasama Study. , 1997, American journal of hypertension.

[24]  J. Panza.  Endothelial Dysfunction in Essential Hypertension , 1997, Clinical cardiology.

[25]  A. Yeung,et al.  Close relation of endothelial function in the human coronary and peripheral circulations. , 1995, Journal of the American College of Cardiology.

[26]  D. Celermajer,et al.  Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. , 1994, Journal of the American College of Cardiology.

[27]  A. Quyyumi,et al.  Role of Endothelium‐Derived Nitric Oxide in the Abnormal Endothelium‐Dependent Vascular Relaxation of Patients With Essential Hypertension , 1993, Circulation.

[28]  A. Quyyumi,et al.  Abnormal endothelium-dependent vascular relaxation in patients with essential hypertension. , 1990, The New England journal of medicine.

[29]  R. Braman,et al.  Nanogram nitrite and nitrate determination in environmental and biological materials by vanadium (III) reduction with chemiluminescence detection. , 1989, Analytical chemistry.

[30]  S. Moncada,et al.  Nitric oxide release accounts for the biological activity of endothelium-derived relaxing factor , 1987, Nature.

[31]  J. Ménard,et al.  Direct immunometric assay of active renin in human plasma. , 1985, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.