Brachial flow-mediated dilation predicts subclinical target organ damage progression in essential hypertensive patients: a 3-year follow-up study.

Abstract

OBJECTIVES:

We found impaired brachial flow-mediated dilation (FMD) was associated with the number of target organ damage (TOD) in 2007. The present study investigated whether FMD predicted TOD progression in essential hypertension.

METHODS AND RESULTS:

Endothelium-dependent FMD was measured in 280 adults in 2007. At the third year of examination, 199 patients (mean age 62.5 ± 9.5, men 59.3%) were approached for participation in our study. Patients were divided into two groups: normal FMD group (FMD ≥10) and impaired FMD group (FMD <10). In patients with 0-1 TOD at baseline, impaired FMD group (n = 65) led to thicker intima-media thickness (P = 0.02), increased carotid-to-femoral pulse wave velocity (P = 0.03), increased urinary albumin/creatinine ratio (P = 0.04) and increased TOD number (P = 0.02), as compared with the normal FMD group (n = 59) at the end of the follow-up, even after adjusting for age and sex, whereas the relationship did not exist in 2-4 TOD group at baseline. TOD number increase was associated with the prevalence of diabetes mellitus (β = 0.180, P = 0.035), blood pressure control (β = -0.277, P = 0.001), low-density lipoprotein cholesterol (β = 0.234, P = 0.006) and baseline FMD (β = -0.168, P = 0.043) in stepwise multivariate regression analysis. FMD remained a significant predictor of TOD number increase in multiple logistic regression analysis after adjustment for several known risk factors (relative risk 0.92, 95% confidence interval 0.85-0.99, P = 0.042, for each 1% increase in FMD).

CONCLUSION:

FMD is a predictor of future TOD progression in low-risk essential hypertensive patients, but has little predictive value in the late stage of TOD.

• Authors: Yan Yang, Jian-zhong Xu, Yan Wang, Xiao-feng Tang, Ping-jin Gao
• Journal: Journal of hypertension (J Hypertens) Vol. 32 Issue 12 Pg. 2393-400; discussion 2400 (Dec 2014) ISSN: 1473-5598 [Electronic] Netherlands
• PMID: 25188368 (Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Blood Flow Velocity
• Blood Pressure
• Blood Pressure Determination (methods)
• Brachial Artery (physiopathology)
• Disease Progression
• Essential Hypertension
• Female
• Follow-Up Studies
• Humans
• Hypertension (physiopathology)
• Male
• Middle Aged
• Predictive Value of Tests
• Pulse Wave Analysis
• Regional Blood Flow
• Risk Factors
• Severity of Illness Index