Persistent vascular dysfunction following an acute nonpharmacological reduction in blood pressure in hypertensive patients.
J Hypertens
; 40(6): 1115-1125, 2022 06 01.
Article
em En
| MEDLINE
| ID: mdl-35703879
ABSTRACT
BACKGROUND:
Vascular dysfunction, an independent risk factor for cardiovascular disease, often persists in patients with hypertension, despite improvements in blood pressure control induced by antihypertensive medications.METHODS:
As some of these medications may directly affect vascular function, this study sought to comprehensively examine the impact of reducing blood pressure, by a nonpharmacological approach (5âdays of sodium restriction), on vascular function in 22 hypertensive individuals (14 men/8 women, 50â±â10 years). Following a 2-week withdrawal of antihypertensive medications, two 5-day dietary phases, liberal sodium (liberal sodium, 200âmmol/day) followed by restricted sodium (restricted sodium, 10âmmol/day), were completed. Resting blood pressure was assessed and vascular function, at both the conduit and microvascular levels, was evaluated by brachial artery flow-mediated dilation (FMD), reactive hyperemia, progressive handgrip exercise, and passive leg movement (PLM).RESULTS:
Despite a sodium restriction-induced fall in blood pressure (liberal sodium 141â±â14/85â±â9; restricted sodium 124â±â12/79â±â9âmmHg, Pâ<â0.01 for both SBP and DBP), FMD (liberal sodium 4.6â±â1.8%; restricted sodium 5.1â±â2.1%, Pâ=â0.27), and reactive hyperemia (liberal sodium 548â±â201; restricted sodium 615â±â206âml, Pâ=â0.08) were not altered. Similarly, brachial artery vasodilation during handgrip exercise was not different between conditions (liberal sodium Δ0.36â±â0.19âmm; restricted sodium Δ0.42â±â0.18âmm, Pâ=â0.16). Lastly, PLM-induced changes in peak blood flow (liberal sodium 5.3â±â2.5; restricted sodium 5.8â±â3.6âml/min per mmHg, Pâ=â0.30) and the total vasodilatory response [liberal sodium 2 (0.9-2.5) vs. restricted sodium 1.7 (1.1-2.6) ml/min per mmHg; Pâ=â0.5] were also not different between conditions.CONCLUSION:
Thus vascular dysfunction, at both the conduit and microvascular levels, persists in patients with hypertension even when blood pressure is acutely reduced by a nonpharmacological approach.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Hiperemia
/
Hipertensão
Tipo de estudo:
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article