Bharani Anil, Jain Neeraj, Jain Ashok, Deedwania Prakash
Division of Cardiology, Department of Medicine, MGM Medical College and Maharaja Yeshwant Rao Hospital, Indore, Madhya Pradesh, India.
Indian Heart J. 2011 May-Jun;63(3):255-8.
Impaired endothelium-dependent vasodilation has been demonstrated in asymptomatic normotensive offspring of hypertensive parents in Caucasians and Chinese population. The study was designed to determine whether impaired endothelium-dependent vasodilation is present in Indian normotensive offspring with hypertensive parents.
We conducted this study in non smoker, healthy, young volunteers with a positive (n = 45) or a negative parental history (n = 30) of essential hypertension in a case-control, blinded design. The subjects underwent a thorough clinical and routine laboratory evaluation. A high resolution ultrasound was used to assess endothelium-dependent brachial artery flow-mediated dilation by a single observer blinded to the family histories. The brachial artery diameters at baseline and after occlusion release, flow mediated dilatation %, brachial intima-media thickness/lumen diameter were obtained and compared between the two groups using student's t-test. There was no significant difference between the two groups in age, sex, body mass index, blood pressure and total cholesterol levels. However, there was a statistically significant impairment of flow mediated dilatation amongst subjects with parental history of hypertension compared to controls (6.87 SD 8.14 % vs 11.31 SD 5.17%, p < 0.01). Multiple regression analysis revealed no association of FMD with age, blood pressure, BMI or total cholesterol in those with or without parental hypertension.
Our study demonstrated impaired brachial artery flow mediated dilatation amongst normotensive offspring with parental hypertension compared to controls. This suggests that endothelial dysfunction possibly precedes clinical hypertension and might have a role in the pathogenesis of essential hypertension.
在高加索人和中国人群中,已证实高血压患者的无症状血压正常后代存在内皮依赖性血管舒张功能受损。本研究旨在确定有高血压父母的印度血压正常后代是否存在内皮依赖性血管舒张功能受损。
我们采用病例对照、双盲设计,对无吸烟史、健康的年轻志愿者进行了研究,其中有原发性高血压家族史阳性者(n = 45),无家族史者(n = 30)。受试者接受了全面的临床和常规实验室评估。由一名对家族史不知情的观察者使用高分辨率超声评估内皮依赖性肱动脉血流介导的舒张功能。获取两组受试者的基线和阻断释放后的肱动脉直径、血流介导的舒张百分比、肱动脉内膜中层厚度/管腔直径,并使用学生t检验进行比较。两组在年龄、性别、体重指数、血压和总胆固醇水平方面无显著差异。然而,与对照组相比,有高血压家族史的受试者中血流介导的舒张功能存在统计学上的显著受损(6.87±8.14% 对 11.31±5.17%,p < 0.01)。多元回归分析显示,无论有无父母高血压,血流介导的舒张功能与年龄、血压、体重指数或总胆固醇均无关联。
我们的研究表明,与对照组相比,有父母高血压的血压正常后代的肱动脉血流介导的舒张功能受损。这表明内皮功能障碍可能先于临床高血压出现,并且可能在原发性高血压的发病机制中起作用。