Enhanced Vascular Activity of Endogenous Endothelin-1 in Obese Hypertensive Patients
作者:
Carmine Cardillo,
Umberto Campia,
Micaela Iantorno,
Julio Panza,
期刊:
Hypertension: Journal of The American Heart Association
(OVID Available online 2004)
卷期:
Volume 43,
issue 1
页码: 36-40
ISSN:0194-911X
年代: 2004
出版商: OVID
关键词: endothelin;hypertension, obesity;vasculature;atherosclerosis
数据来源: OVID
摘要:
Abstract—Hypertensive patients have increased endothelin-1–dependent vasoconstrictor tone. This abnormality, however, might not be uniformly present in all forms of hypertension, as suggested by experimental studies showing that endothelin-1 activity is enhanced predominantly in low-renin, high-volume models and in insulin-resistant states. Because hypertension in obesity is commonly associated with both expanded plasma volume and insulin resistance, this study sought to determine whether increased body mass index (BMI) in hypertensive patients relates to activation of the endothelin-1 system. Forearm blood flow (FBF) responses (plethysmography) to intra-arterial infusion of an ETAreceptor blocker (BQ-123) were analyzed in hypertensive patients and normotensive control subjects according to BMI. The vasodilator response to BQ-123 was significantly higher in hypertensive patients than in control subjects (P<0.001). During BQ-123, a significant increase in FBF from baseline was observed in obese (BMI ≥30 kg/m2;P<0.001) and overweight (BMI, 27 to 29.9 kg/m2;P=0.04) but not in lean (BMI <27 kg/m2;P=0.83) hypertensive patients. In contrast, no significant change in FBF was observed during BQ-123 either in obese (P=0.53), overweight (P=0.76), or lean (P=0.93) normotensive subjects. Moreover, a significant correlation between BMI and the vasodilator response to ETAblockade was observed in hypertensive subjects (R=0.53;P=0.005) but not in control subjects (R=0.11;P=0.58). In human hypertension, increased BMI is associated with enhanced ETA-dependent vasoconstrictor activity, suggesting that this abnormality may play a role in the pathophysiology of obesity-related hypertension and that targeting the endothelin-1 system may be useful in the treatment of these patients.
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