Tessier Elaine Alves Santos, Daltro Carla, Netto Eduardo Martins, Doria Glauco Moniz de Aragão, Peredo Andrea Jimena Gutierrez, Bulhões Fabio, Aras Roque, Harris Ryan A
Universidade Federal da Bahia, Salvador, BA - Brasil.
Augusta University - Laboratory of Integraative and Vascular Exercise Physiology - LIVEP, Augusta, Georgia - EUA.
Arq Bras Cardiol. 2025 Apr;122(5):e20240533. doi: 10.36660/abc.20240533.
High blood pressure (BP) values have traditionally been associated with the risk of ischemic heart disease, stroke, chronic kidney disease, and early mortality. The brachial artery FMD after cuff deflation has become the standard parameter for quantifying endothelial function, being a useful surrogate outcome due to its non-invasiveness, close correlation with coronary endothelial function, and association with the incidence of long-term coronary events.
To test hypotheses of correlation between the FMD and several blood parameters and to compare parameters between altered and non-altered FMD groups, and between hypertensive patients in the resistant hypertension groups (RHTN and non-RHTN).
Seventy-two volunteers from a referral hypertension outpatient clinic participated in this prospective cross-sectional study, in which several patient variables were compared between the altered FMD (n = 38) and non-altered FMD (n = 34) groups, and also between the RHTN (n = 49) and non-RHTN (n = 23) groups. The variables that would explain the FMD were also investigated in this study. Statistical analyses were performed using parametric methods when the assumptions were met, and non-parametric methods otherwise. The significance level adopted in the statistical analysis was 5%.
The results showed a significant positive correlation between the FMD and LDL (p = 0.204, p = 0.042) and between FMD and triglycerides (p = 0.247, p = 0.037). Glycated hemoglobin was higher in the RHTN group (p = 0.020), potassium was higher in the non-RHTN group (p = 0.029), and C-reactive protein was higher in the RHTN group (p = 0.04). For the other comparisons, no statistically significant differences were found.
LDL and triglycerides are FMD predictors, and the RHTN and non-RHTN groups differ in terms of the amount of potassium, protein C, and glycated hemoglobin. The altered and non-altered FMD groups differ only in terms of triglycerides.
传统上,高血压值与缺血性心脏病、中风、慢性肾病及早期死亡风险相关。袖带放气后的肱动脉血流介导的血管舒张功能(FMD)已成为量化内皮功能的标准参数,因其具有非侵入性、与冠状动脉内皮功能密切相关以及与长期冠状动脉事件发生率相关等特点,是一个有用的替代结局指标。
检验FMD与几种血液参数之间的相关性假设,并比较FMD改变组与未改变组之间以及难治性高血压组(RHTN和非RHTN)中高血压患者之间的参数。
来自一家高血压转诊门诊的72名志愿者参与了这项前瞻性横断面研究,比较了FMD改变组(n = 38)和FMD未改变组(n = 34)之间以及RHTN组(n = 49)和非RHTN组(n = 23)之间的几个患者变量。本研究还调查了解释FMD的变量。当满足假设时使用参数方法进行统计分析,否则使用非参数方法。统计分析采用的显著性水平为5%。
结果显示FMD与低密度脂蛋白(LDL)之间存在显著正相关(p = 0.204,p = 0.042),FMD与甘油三酯之间也存在显著正相关(p = 0.247,p = 0.037)。RHTN组糖化血红蛋白较高(p = 0.020),非RHTN组钾较高(p = 0.029),RHTN组C反应蛋白较高(p = 0.04)。对于其他比较,未发现统计学显著差异。
LDL和甘油三酯是FMD的预测指标,RHTN组和非RHTN组在钾、蛋白C和糖化血红蛋白含量方面存在差异。FMD改变组和未改变组仅在甘油三酯方面存在差异。