Prognostic role of reversible endothelial dysfunction in hypertensive postmenopausal women.
By M. G. Modena, L. Bonetti, Francesca Coppi, F. Bursi, R. Rossi. Journal of the American College of Cardiology, 2002
616 citations recorded by the source corpus.
OBJECTIVES ; The aim of the present study was to assess whether optimized antihypertensive treatment is effective in modifying endothelial function and whether an improvement in flow-mediated vasodilation (FMD) in response to treatment, as an expression of reversible endothelial dysfunction, could predict a more favorable prognosis in a population of postmenopausal women. BACKGROUND Hypertensive postmenopausal women have been shown to have abnormal endothelium-dependent vascular function. However, FMD may change over time, according to antihypertensive treatment; the prognostic value of these changes has not been investigated. METHODS A total of 400 consecutive postmenopausal women with mild-to-moderate hypertension and impaired FMD underwent ultrasonography of the brachial artery at baseline and after six months, while optimal control of blood pressure was achieved using antihypertensive therapy. They were then followed up for a mean period of 67 months (range 57 to 78). Endothelial function was measured as FMD of the brachial artery, using high-resolution ultrasound. RESULTS After six months of treatment, FMD had not changed (< or = 10% relative to baseline) in 150 (37.5%) of 400 women (group 1), whereas it had significantly improved (>10% relative to baseline) in the remaining 250 women (62.5%) (group 2). During follow-up, we noticed 32 events (3.50 per 100 person-years) in group 1 and 15 events (0.51 per 100 person-years) in group 2 (p < 0.0001). CONCLUSIONS This study demonstrates that a significant improvement in endothelial function may be obtained after six months of antihypertensive therapy and clearly identifies patients who possibly have a more favorable prognosis.
Subfields: Cardiology and Cardiovascular Medicine, Endocrinology, Diabetes and Metabolism, Physiology
View Paper: https://www.semanticscholar.org/paper/d9eccd2d26a3994459ce4ad80caf4b258898b9d2
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Citations in the corpus
- The role of vascular biomarkers for primary and secondary prevention. A position paper from the European Society of Cardiology Working Group on peripheral circulation: Endorsed by the Association for Research into Arterial Structure and Physiology (ARTERY) Society. (2015, background): “In nonrandomized controlled studies, FMD improvement was associated with a reduction in events in hypertensive postmenopausal women [158], whereas persistent FMD impairment despite optimized therapy was associated with an increase in CV events [159,160].”
- 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. (2024, positive): “16 In post-menopausal women, oestrogen deficiency reduces the biological availability of NO. 17 In response to hypertensive stimuli, such as angiotensin II and high salt intake, T cells become pro-inflammatory and mediate endothelial dysfunction, infiltrating the brain, blood vessels, heart, and kid”
- The clinical implications of endothelial dysfunction. (2003, background): “(35) examined brachial artery FMD in post-menopausal women with newly diagnosed hypertension.”
- Effect of exercise training on endothelium‐derived nitric oxide function in humans (2004, background): “…Heitzer et al. 2001; Hollenberg et al. 2001) and peripheral (Neunteufl et al. 2000; Kuvin et al. 2001; Perticone et al. 2001b; Gokce et al. 2002a) vascular endothelial dysfunction predict cardiovascular events, and (vi) improvement in endothelial function improves prognosis (Modena et al. 2002).”
- Endothelial function in obstructive sleep apnea and response to treatment. (2004, background): “Some risk factor intervention or drug treatment have shown favorable effects on endothelial function, including smoking cessation, lipid lowering drugs, antioxidants, and antihypertensive drugs (14, 25, 37, 50 ).”
- Contemporary Reviews in Cardiovascular Medicine The Assessment of Endothelial Function From Research Into Clinical Practice (2012, positive): “Chez les femmes dont la fonction endothéliale (DDF) ne s’était pas améliorée (37,5 %), le taux d’événements cardiovasculaires a été près de 7 fois supérieur au terme d’une période moyenne de suivi de 67 mois.(151) Ces deux études apportent la démonstration convaincante de ce que les patients chez le”
- Expert consensus and evidence-based recommendations for the assessment of flow-mediated dilation in humans. (2019, positive): “37 Furthermore, persistent impairment in FMD after optimized risk reduction therapy represents an independent predictor of CV events in patients with coronary artery disease.”