Ricci Fabrizio, Larsson Anders, Ruge Toralph, Galanti Kristian, Hamrefors Viktor, Sutton Richard, Olshansky Brian, Fedorowski Artur, Johansson Madeleine
Department of Clinical Sciences, Lund University, Malmö, Sweden, Jan Waldenströms gata 35, 214 28 Malmö, Sweden.
Department of Neuroscience, Imaging and Clinical Sciences, 'G.d'Annunzio' University of Chieti-Pescara, Chieti, Italy.
Eur Heart J Open. 2024 Apr 10;4(3):oeae030. doi: 10.1093/ehjopen/oeae030. eCollection 2024 May.
The pathophysiology of orthostatic hypotension (OH), a common clinical condition, associated with adverse outcomes, is incompletely understood. We examined the relationship between OH and circulating endostatin, an endogenous angiogenesis inhibitor with antitumour effects proposed to be involved in blood pressure (BP) regulation.
We compared endostatin levels in 146 patients with OH and 150 controls. A commercial chemiluminescence sandwich immunoassay was used to measure circulating levels of endostatin. Linear and multivariate logistic regressions were conducted to test the association between endostatin and OH. Endostatin levels were significantly higher in OH patients (59 024 ± 2513 pg/mL) vs. controls (44 090 ± 1978pg/mL, < 0.001). A positive linear correlation existed between endostatin and the magnitude of systolic BP decline upon standing ( < 0.001). Using multivariate analysis, endostatin was associated with OH (adjusted odds ratio per 10% increase of endostatin in the whole study population = 1.264, 95% confidence interval 1.141-1.402), regardless of age, sex, prevalent cancer, and cardiovascular disease, as well as traditional cardiovascular risk factors.
Circulating endostatin is elevated in patients with OH and may serve as a potential clinical marker of increased cardiovascular risk in patients with OH. Our findings call for external validation. Further research is warranted to clarify the underlying pathophysiological mechanisms.
体位性低血压（OH）是一种常见的临床病症，与不良后果相关，其病理生理学尚未完全明确。我们研究了OH与循环内皮抑素之间的关系，内皮抑素是一种具有抗肿瘤作用的内源性血管生成抑制剂，据推测参与血压（BP）调节。
我们比较了146例OH患者和150例对照者的内皮抑素水平。采用商业化学发光夹心免疫分析法测定循环内皮抑素水平。进行线性和多变量逻辑回归以检验内皮抑素与OH之间的关联。OH患者的内皮抑素水平（59024±2513 pg/mL）显著高于对照组（44090±1978 pg/mL，<0.001）。内皮抑素与站立时收缩压下降幅度呈正线性相关（<0.001）。使用多变量分析，内皮抑素与OH相关（在整个研究人群中，内皮抑素每增加10%，调整后的优势比=1.264，95%置信区间1.141-1.402），不受年龄、性别、既往癌症和心血管疾病以及传统心血管危险因素的影响。
OH患者循环内皮抑素升高，可能作为OH患者心血管风险增加的潜在临床标志物。我们的研究结果需要外部验证。有必要进一步研究以阐明潜在的病理生理机制。
