Lugo-Gavidia Leslie Marisol, Burger Dylan, Nolde Janis M, Carnagarin Revathy, Chan Justine, Bosio Erika, Matthews Vance B, Schlaich Markus P
Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit, Royal Perth Hospital Medical Research Foundation, The University of Western Australia, Perth, Australia.
Kidney Research Centre, The Ottawa Hospital Research Institute, Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Canada.
J Hypertens. 2022 Nov 1;40(11):2210-2218. doi: 10.1097/HJH.0000000000003248. Epub 2022 Aug 8.
Elevated nocturnal blood pressure (BP) is closely associated with increased risk of cardiovascular (CV) events. Circulating extracellular vesicles (EVs) have been proposed as a potential CV risk biomarker and shown to correlate with BP. The present study aimed to assess whether a reduction in BP is paralleled by respective changes in EVs.
Fifty-five hypertensive patients (age: 57.7 ± 14.1 years) were included in the study. EVs and BP were assessed at baseline and at 12 weeks follow-up. Interventions to lower BP included advice on life-style modification only or life-style advice combined with additional pharmacotherapy. EVs were evaluated by flow cytometry (CD41+/Annexin V+) and BP by unobserved automated office BP and ambulatory BP monitoring.
Nocturnal systolic BP correlated with EV levels at baseline ( P = 0.01). Multivariable regression models showed that changes in nocturnal systolic BP (adjusted R2 = 0.23; P = 0.01) and diastolic BP (adjusted R2 = 0.18; P = 0.02) were associated with respective changes in EV levels. Furthermore, intervention-induced improvement of systolic dipping was associated with a reduction in EVs in the univariate analysis (adjusted R2 = 0.06; P = 0.03). In contrast, systolic office, 24 h- and daytime-BP did not show significant associations with EVs. Patients whose medication was up-titrated at baseline showed a trend towards lower EV levels at follow-up (absolute change of -1.7 ± 1.3 EV/μl; P = 0.057).
Circulating platelet-derived EVs were positively associated with nocturnal BP and therapy-induced changes over a 12-week treatment period. EVs may provide an integrated measure of BP changes achieved with pharmacotherapy.
夜间血压升高与心血管（CV）事件风险增加密切相关。循环细胞外囊泡（EVs）已被提出作为一种潜在的心血管风险生物标志物，并显示与血压相关。本研究旨在评估血压降低是否与细胞外囊泡的相应变化平行。
55名高血压患者（年龄：57.7±14.1岁）纳入本研究。在基线和12周随访时评估细胞外囊泡和血压。降低血压的干预措施包括仅生活方式改变建议或生活方式建议联合额外药物治疗。通过流式细胞术（CD41+/膜联蛋白V+）评估细胞外囊泡，通过未观察到的自动诊室血压和动态血压监测评估血压。
夜间收缩压与基线时的细胞外囊泡水平相关（P = 0.01）。多变量回归模型显示，夜间收缩压变化（调整R2 = 0.23；P = 0.01）和舒张压变化（调整R2 = 0.18；P = 0.02）与细胞外囊泡水平的相应变化相关。此外，在单变量分析中，干预引起的收缩压谷峰比值改善与细胞外囊泡减少相关（调整R2 = 0.06；P = 0.03）。相比之下，诊室收缩压、24小时和日间血压与细胞外囊泡无显著关联。基线时药物剂量上调的患者在随访时细胞外囊泡水平有降低趋势（绝对变化为-1.7±1.3 EV/μl；P = 0.057）。
在12周治疗期内，循环血小板衍生的细胞外囊泡与夜间血压及治疗引起的变化呈正相关。细胞外囊泡可能提供药物治疗实现的血压变化的综合指标。
