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Correlations of ambulatory pulse pressure to large artery elasticity and vascular endothelial function in patients with primary hypertension / 中国组织工程研究
Article in Chinese | WPRIM | ID: wpr-407415
Responsible library: WPRO
ABSTRACT

BACKGROUND:

Ambulatory blood pressure monitoring can sensitively and objectively reflect blood pressure level, which is closely related to target organ damage and disease prognosis. In hypertension, vascular endothelial damage is the most common lesion to target organs. There is little known about how ambulatory pulse pressure correlates to large artery elasticity and vascular endothelial function.

OBJECTIVE:

To investigate changes of large artery elasticity and of vascular endothelial function in patients with primary hypertension using an automatic pulse wave velocity determinator and ultrasound techniques, and to analyze the correlation of ambulatory pulse pressure to large artery elasticity and vascular endothelial function.

DESIGN:

A non-randomized concurrent control clinical observation.

SETTING:

Diagnosis and Treatment Center for Coronary Heart Disease, the 305 Hospital of Chinese PLA.

PARTICIPANTS:

A total of 156 inpatients and/or outpatients, who were recently confirmed with primary hypertension, were recruited for this study between June 2005 and April 2007. Patients consisted of 114 males and 42 females. All patients averaged 56 ± 4 years of age (range 40-75). Inclusive criteria Corresponding to diagnostic standards for preventing and treating hypertension instituted in 2004 by Chinese scholars. Confirmed as primary hypertension within 1 month. Not receiving any blood pressure lowering, hypolipidemic or nitrate-like drug treatments. Written informed consents for laboratory measurements were obtained from all subjects. The study was approved by the hospital's Ethics Committee.

METHODS:

According to the mean pulse pressure over 24 hours, all patients were assigned into 3 groups Group A (mean pulse pressure < 40 mm Hg, n=92), group B (40 mm Hg ≤ mean pulse pressure < 60 mm Hg, n=39) and group C (mean pulse pressure > 60 mm Hg, n=25). In each group, daytime pulse pressure and night-time pulse pressure, as well as 24-hour mean pulse pressure were measured using a non-invasive portable ambulatory blood pressure monitor (ABPM-04, Meditech Inc, USA). Carotid-femoral and carotid-radial arterial pulse wave velocities were measured using an automatic pulse wave velocity determinator to evaluate large artery dilation. Blood flow mediated and nitroglycerin-dependent dilatation of the brachial artery was determined using a high-resolution ultrasound technique to evaluate vascular endothelial function. MAIN OUTCOME

MEASURES:

Correlations of ambulatory pulse pressure to large artery dilation and arterial endothelial function.

RESULTS:

All 156 patients were included in the final analysis. Correlation of ambulatory pulse pressure to large artery dilation Carotid-femoral arterial pulse wave velocity was significantly positively correlated to daytime pulse pressure, night-time pulse pressure and 24-hour mean pulse pressure, with coefficient of partial correlation being 0.310, 0.281 and 0.303, respectively, P < 0.01). There were no significant correlations of carotid-radial arterial pulse wave velocity to daytime pulse pressure, night-time pulse pressure or 24-hour pulse pressure (P > 0.05). Correlation of ambulatory pulse pressure to arterial endothelial function There was a linear relationship between ambulatory pulse pressure and blood flow-mediated blood vessel dilatation values. Linear correlation analysis was performed, taking ambulatory pulse pressure as an independent variable, and endothelial-dependent dilatation as a dependent variable. Results demonstrated that blood flow-mediated blood vessel dilatation was significantly negatively correlated to daytime pulse pressure, night-time pulse pressure and 24- hour mean pulse pressure (r = -0.684, -0.597, -0.668, P < 0.01). There was no correlation of ambulatory pulse pressure to non-endothelial-dependent blood vessel dilatation.

CONCLUSION:

Ambulatory pulse pressure increase is closely related to large artery elasticity decrease and injury to endothelial function in patients with primary hypertension.
Full text: Available Index: WPRIM (Western Pacific) Type of study: Controlled clinical trial / Practice guideline / Prognostic study Language: Chinese Journal: Chinese Journal of Tissue Engineering Research Year: 2008 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Type of study: Controlled clinical trial / Practice guideline / Prognostic study Language: Chinese Journal: Chinese Journal of Tissue Engineering Research Year: 2008 Type: Article