Patil Sumangala M, Khodnapur Jyoti P, Das Kusal K, Podder Amrit
Physiology, Shri B M Patil Medical College, Hospital and Research Centre, Vijayapur, IND.
Physiology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, IND.
Cureus. 2024 Jun 15;16(6):e62416. doi: 10.7759/cureus.62416. eCollection 2024 Jun.
Background and objective While hypertension (HTN) is a major health-related threat globally, it is often an under-reported clinical condition as most of the stage I hypertensive patients do not present with any symptoms. The relationship between endogenous oxygen-sensing protein [erythropoietin (EPO) and vascular endothelial growth factor (VEGF)] levels and vascular stress in hypertensive patients is not fully understood as the mechanistic pathway by which these oxygen-sensing proteins alter the vascular physiology and cause hypertension is still a matter of debate. In light of this, we explored the role of these two proteins in the development of vascular stress including increased pulse wave velocity (PWV). We aimed to examine the correlation between oxygen-sensing proteins and vascular stress markers including PWV in hypertensive patients. Materials and methods We conducted a cross-sectional study involving age-matched participants classified into three groups (group 1: normotensive persons, n=36; group 2: stage I hypertensive patients, n=36; and group 3, stage II hypertensive patients, n=36). Adiposity-related parameters such as waist circumference (WC), hip circumference (HC), BMI, and waist-hip ratio (WHR) were measured. BP was recorded manually in resting posture by using a sphygmomanometer. PWV, which predicts the progression of BP and the development of HTN, was recorded using a periscope, which works based on the oscillometric method. Vascular stress-induced oxidative stress parameters [serum malondialdehyde (MDA) and serum nitric oxide (NO)] were also estimated by using a UV spectrophotometer. Quantitative estimations of oxygen-sensing proteins (serum EPO and serum VEGF) were done by using the ELISA kit method. The results were expressed as mean ± standard deviation (SD). The correlation between the variables was done using Spearman's correlation. A p-value <0.05 was considered statistically significant. Results Adiposity indices and vascular stiffness parameters were found to be significantly (p <0.05) increased in group 2 and group 3 compared to group 1. The levels of serum MDA were found to be significantly (p<0.05) increased in group 2 and group 3 than group 1, whereas the levels of serum NO were significantly (p<0.05) decreased in group 3 and group 2 than group 1. A significant (p<0.05) positive correlation was observed between the PWV and EPO (r=0.492) while a significant (p<0.05) negative correlation was observed between PWV and VEGF (r=-0.406) among the study population. Conclusion The results are indicative of the influence of vascular stress in stage I and II hypertensive patients. Furthermore, the relationship between oxygen-sensing proteins and vascular stress in hypertensive patients has also been established.
尽管高血压（HTN）是全球主要的健康相关威胁，但它常常是一种报告不足的临床病症，因为大多数I期高血压患者没有任何症状。内源性氧感应蛋白[促红细胞生成素（EPO）和血管内皮生长因子（VEGF）]水平与高血压患者血管应激之间的关系尚未完全明确，因为这些氧感应蛋白改变血管生理并导致高血压的机制途径仍存在争议。鉴于此，我们探讨了这两种蛋白在包括脉搏波速度（PWV）增加在内的血管应激发展中的作用。我们旨在研究高血压患者中氧感应蛋白与包括PWV在内的血管应激标志物之间的相关性。
我们进行了一项横断面研究，纳入年龄匹配的参与者，分为三组（第1组：血压正常者，n = 36；第2组：I期高血压患者，n = 36；第3组：II期高血压患者，n = 36）。测量了与肥胖相关的参数，如腰围（WC）、臀围（HC）、体重指数（BMI）和腰臀比（WHR）。使用血压计以静息姿势手动记录血压。使用基于示波法的潜望镜记录PWV，PWV可预测血压进展和高血压的发生。还使用紫外分光光度计估计血管应激诱导的氧化应激参数[血清丙二醛（MDA）和血清一氧化氮（NO）]。通过酶联免疫吸附测定试剂盒法对氧感应蛋白（血清EPO和血清VEGF）进行定量估计。结果以平均值±标准差（SD）表示。变量之间的相关性采用Spearman相关性分析。p值<0.05被认为具有统计学意义。
与第1组相比，第2组和第3组的肥胖指数和血管硬度参数显著（p <0.05）升高。第2组和第3组的血清MDA水平显著（p<0.05）高于第1组，而第3组和第2组的血清NO水平显著（p<0.05）低于第1组。在研究人群中，观察到PWV与EPO之间存在显著（p<0.05）正相关（r = 0.492），而PWV与VEGF之间存在显著（p<0.05）负相关（r = -0.406）。
结果表明血管应激对I期和II期高血压患者有影响。此外，还建立了高血压患者中氧感应蛋白与血管应激之间的关系。
