Perticone Francesco, Sciacqua Angela, Barlassina Cristina, Del Vecchio Lucia, Signorello Maria Chiara, Dal Fiume Chiara, Andreozzi Francesco, Sesti Giorgio, Cusi Daniele
Department of Experimental and Clinical Medicine, University Magna Graecia, Catanzaro, Italy.
J Hypertens. 2007 Nov;25(11):2234-9. doi: 10.1097/HJH.0b013e3282ef3a50.
Endothelium-dependent vasodilatation is impaired in essential hypertension. Besides traditional and emerging cardiovascular risk factors, genetic factors may also promote deleterious alterations of endothelial physiology. The aim of the present study was to investigate the relationship between the 460Trp allele of ADD1 and endothelium-dependent vasodilation in 110 never-treated hypertensive patients.
Forearm blood flow (FBF) was measured during intra-arterial infusion of acetylcholine (ACh) and sodium nitroprusside (SNP) at increasing doses. Analysis of endothelium-dependent and endothelium-independent vasodilation was tested according to ADD1 genotype.
The FBF values at the three incremental doses of ACh were 5.22 +/- 0.24 (+76%), 8.64 +/- 0.45 (+193%) and 14.74 +/- 0.71 (+395%) ml/100 ml of tissue per min for Gly460Gly and 4.63 +/- 0.20 (+51%), 6.84 +/- 0.36 (+123%) and 11.22 +/- 3.8 (+269%) ml/100 ml of tissue per min for 460Trp. Thus, ACh-stimulated FBF was significantly reduced in hypertensive subjects carrying the 460Trp allele of ADD1 (P < 0.001). SNP-stimulated FBF was not affected by ADD1.
The main finding in this study was that in essential hypertensives the 460Trp allele of ADD1 is strongly associated with an impaired endothelium-dependent vasodilation, a powerful predictor of cardiovascular risk.
原发性高血压患者存在内皮依赖性血管舒张功能受损。除了传统和新出现的心血管危险因素外,遗传因素也可能促使内皮生理功能发生有害改变。本研究旨在探讨110例未经治疗的高血压患者中ADD1基因460Trp等位基因与内皮依赖性血管舒张之间的关系。
在动脉内输注递增剂量的乙酰胆碱(ACh)和硝普钠(SNP)期间测量前臂血流量(FBF)。根据ADD1基因型对内皮依赖性和非内皮依赖性血管舒张进行分析。
对于Gly460Gly基因型,在ACh三个递增剂量下的FBF值分别为5.22±0.24(增加76%)、8.64±0.45(增加193%)和14.74±0.71(增加395%)ml/100 ml组织每分钟;对于460Trp基因型,分别为4.63±0.20(增加51%)、6.84±0.36(增加123%)和11.22±3.8(增加269%)ml/100 ml组织每分钟。因此,携带ADD1基因460Trp等位基因的高血压患者中,ACh刺激的FBF显著降低(P<0.001)。SNP刺激的FBF不受ADD1影响。
本研究的主要发现是,在原发性高血压患者中,ADD1基因的460Trp等位基因与内皮依赖性血管舒张功能受损密切相关,而内皮依赖性血管舒张功能受损是心血管风险的有力预测指标。