Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Elevated circulating endothelial microparticles and brachial–ankle pulse wave velocity in well-controlled hypertensive patients

Abstract

Vascular dysfunction in hypertensive condition is characterized by impaired endothelial function and reduced artery elasticity. Circulating endothelial microparticles (EMPs) and brachial–ankle pulse wave velocity (baPWV) are novel evaluation parameters for vascular function. However, their changes in patients with well-controlled blood pressure (BP) have not been fully acquired. To address this issue, circulating EMPs, defined as CD31+/CD42− MPs and baPWV were detected in 30 healthy subjects, 30 uncontrolled hypertensive (UCHT) patients and 23 well-controlled hypertensive (WCHT) patients. UCHT patients displayed elevated baPWV (P<0.01) and circulating EMPs (P<0.01) compared with healthy subjects. In WCHT patients, vascular damage represented by these two parameters constantly existed (P<0.01). Values of circulating EMPs were positively related to baPWV (P<0.01). Multivariate regression defined circulating EMPs as an independent contributor to the increase of baPWV value (P<0.05). Our study indicated that though BP was controlled, impaired endothelial function and arterial elasticity continued. The optimal therapy for patients with hypertension should include not only lowering BP but also improvement of vascular injury in parallel.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001; 37: 1236–1241.

    Article  CAS  PubMed  Google Scholar 

  2. Asmar RG, London GM, O’Rourke ME, Safar ME . Improvement in blood pressure, arterial stiffness and wave reflections with a very-low-dose perindopril/indapamide combination in hypertensive patient: a comparison with atenolol. Hypertension 2001; 38: 922–926.

    Article  CAS  PubMed  Google Scholar 

  3. Morgan T, Lauri J, Bertram D, Anderson A . Effect of different antihypertensive drug classes on central aortic pressure. Am J Hypertens 2004; 17: 118–123.

    Article  CAS  PubMed  Google Scholar 

  4. Pannier BM, Guerin AP, Marchais SJ, London GM . Different aortic reflection wave responses following long-term angiotensin-converting enzyme inhibition and beta-blocker in essential hypertension. Clin Exp Pharmacol Physiol 2001; 28: 1074–1077.

    Article  CAS  PubMed  Google Scholar 

  5. Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D et al. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation 2006; 113: 1213–1225.

    Article  CAS  PubMed  Google Scholar 

  6. Tropeano AI, Boutouyrie P, Pannier B, Joannides R, Balkestein E, Katsahian S et al. Brachial pressure-independent reduction in carotid stiffness after long-term angiotensin-converting enzyme inhibition in diabetic hypertensives. Hypertension 2006; 48: 80–86.

    Article  CAS  PubMed  Google Scholar 

  7. Brunner H, Cockcroft JR, Deanfield J, Donald A, Ferrannini E, Halcox J et al. Endothelial function and dysfunction. Part II: Association with cardiovascular risk factors and diseases. A statement by the Working Group on Endothelins and Endothelial Factors of the European Society of Hypertension. J Hypertens 2005; 23: 233–246.

    Article  CAS  PubMed  Google Scholar 

  8. Benetos A, Laurent S, Asmar RG, Lacolley P . Large artery stiffness in hypertension. J Hypertens Suppl 1997; 15: S89–S97.

    Article  CAS  PubMed  Google Scholar 

  9. Cohn JN, Duprez DA, Grandits GA . Arterial elasticity as part of a comprehensive assessment of cardiovascular risk and drug treatment. Hypertension 2005; 46: 217–220.

    Article  CAS  PubMed  Google Scholar 

  10. Boutouyrie P, Tropeano AI, Asmar R, Gautier I, Benetos A, Lacolley P et al. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: a longitudinal study. Hypertension 2002; 39: 10–15.

    Article  CAS  PubMed  Google Scholar 

  11. Tao J, Wang Y, Yang Z, Tu C, Xu MG, Wang JM . Circulating endothelial progenitor cell deficiency contributes to impaired arterial elasticity in persons of advancing age. J Hum Hypertens 2006; 20: 490–495.

    Article  CAS  PubMed  Google Scholar 

  12. Sun B, Yuan Y, Zhang W, Che D . Effects of hypoxic endothelial cell conditioned medium on proliferation and collagen synthesis of smooth muscle cells and inhibitory effects of radix salviae miltiorrhizae. Chin Med J (Engl) 1995; 108: 855–888.

    CAS  Google Scholar 

  13. Liu DH, Wang Y, Liao XX, Xu MG, Wang JM, Yang Z et al. Increased brachial-ankle pulse wave velocity is associated with impaired endothelial function in patients with coronary artery disease. Chin Med J (Engl) 2006; 119: 1866–1870.

    Article  Google Scholar 

  14. Tao J, Liu DH, Wang LC, Wang JM, Wang Y, Yang Z et al. Arterial elasticity identified by pulse wave analysis and its relation to endothelial function in patients with coronary artery disease. J Hum Hypertens 2007; 21: 149–153.

    Article  CAS  PubMed  Google Scholar 

  15. Wang JM, Huang YJ, Wang Y, Xu MG, Wang LC, Wang SM et al. Increased circulating CD31+/CD42- microparticles are associated with impaired systemic artery elasticity in healthy subjects. Am J Hypertens 2007; 20: 957–964.

    Article  CAS  PubMed  Google Scholar 

  16. Ito N, Ohishi M, Takagi T, Terai M, Shiota A, Hayashi N et al. Clinical usefulness and limitations of brachial-ankle pulse wave velocity in the evaluation of cardiovascular complications in hypertensive patients. Hypertens Res 2006; 29: 989–995.

    Article  PubMed  Google Scholar 

  17. Yu WC, Chuang SY, Lin YP, Chen CH . Brachial-ankle vs carotid-femoral pulse wave velocity as a determinant of cardiovascular structure and function. J Hum Hypertens 2008; 22: 24–31.

    Article  PubMed  Google Scholar 

  18. Horstman LL, Jy W, Jimenez JJ, Ahn YS . Endothelial microparticles as markers of endothelial dysfunction. Front Biosci 2004; 9: 1118–1135.

    Article  CAS  PubMed  Google Scholar 

  19. Safar ME, Boudier HS . Vascular development, pulse pressure, and the mechanisms of hypertension. Hypertension 2005; 46: 205–209.

    Article  CAS  PubMed  Google Scholar 

  20. Preston RA, Jy W, Jimenez JJ, Mauro LM, Horstman LL, Valle M et al. Effects of severe hypertension on endothelial and platelet microparticles. Hypertension 2003; 41: 211–217.

    Article  CAS  PubMed  Google Scholar 

  21. Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K et al. Validity, reproducibility, and clinical significance of noninvasive brachial-ankle pulse wave velocity measurement. Hypertens Res 2002; 25: 359–364.

    Article  PubMed  Google Scholar 

  22. Darling RC, Raines JK, Brener BJ, Austen WG . Quantitative segmental pulse volume recorder: a clinical tool. Surgery 1972; 72: 873–877.

    CAS  PubMed  Google Scholar 

  23. Piccin A, Murphy WG, Smith OP . Circulating microparticles: pathophysiology and clinical implications. Blood Rev 2007; 21: 157–171.

    Article  CAS  PubMed  Google Scholar 

  24. Li Y, Staessen JA, Lu L, Li LH, Wang GL, Wang JG . Is isolated nocturnal hypertension a novel clinical entity? Findings from a Chinese population study. Hypertension 2007; 50: 333–339.

    Article  CAS  PubMed  Google Scholar 

  25. Boulanger CM, Amabile N, Tedgui A . Circulating microparticles: a potential prognostic marker for atherosclerotic vascular disease. Hypertension 2006; 48: 180–186.

    Article  CAS  PubMed  Google Scholar 

  26. Blacher J, Safar ME . Large-artery stiffness, hypertension and cardiovascular risk in older patients. Nat Clin Pract Cardiovasc Med 2005; 2: 450–455.

    Article  PubMed  Google Scholar 

  27. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25: 1105–1187.

    Article  CAS  PubMed  Google Scholar 

  28. Celermajer DS, Sorensen KE, Bull C, Robinson J, Deanfield JE . Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. J Am Coll Cardiol 1994; 24: 1468–1474.

    Article  CAS  PubMed  Google Scholar 

  29. Cattan V, Kakou A, Louis H, Lacolley P . Pathophysiology, genetic, and therapy of arterial stiffness. Biomed Mater Eng 2006; 16: S155–S161.

    CAS  PubMed  Google Scholar 

  30. Davignon J, Ganz P . Role of endothelial dysfunction in atherosclerosis. Circulation 2004; 109: III27–III32.

    PubMed  Google Scholar 

  31. Schillaci G, Pirro M, Gemelli F, Pasqualini L, Vaudo G, Marchesi S et al. Increased C-reactive protein concentrations in never-treated hypertension: the role of systolic and pulse pressures. J Hypertens 2003; 21: 1841–1846.

    Article  CAS  PubMed  Google Scholar 

  32. Boos CJ, Lip GY . Elevated high-sensitive C-reactive protein, large arterial stiffness and atherosclerosis: a relationship between inflammation and hypertension? J Hum Hypertens 2005; 19: 511–513.

    Article  CAS  PubMed  Google Scholar 

  33. Wang JM, Wang Y, Huang JY, Yang Z, Chen L, Wang LC et al. C-reactive protein-induced endothelial microparticle generation in HUVECs is related to BH4-dependent NO formation. J Vasc Res 2007; 44: 241–248.

    Article  CAS  PubMed  Google Scholar 

  34. Jimenez JJ, Jy W, Mauro LM, Horstman LL, Bidot CJ, Ahn YS . Endothelial microparticles (EMP) as vascular disease markers. Adv Clin Chem 2005; 39: 131–157.

    Article  PubMed  Google Scholar 

  35. Cohn JN . Arterial stiffness, vascular disease, and risk of cardiovascular events. Circulation 2006; 113: 601–603.

    Article  PubMed  Google Scholar 

  36. Hirata K, Vlachopoulos C, Adji A, O’Rourke MF . Benefits from angiotensin-converting enzyme inhibitor ‘beyond blood pressure lowering’: beyond blood pressure or beyond the brachial artery? J Hypertens 2005; 23: 551–556.

    Article  CAS  PubMed  Google Scholar 

  37. Pirro M, Schillaci G, Paltriccia R, Bagaglia F, Menecali C, Mannarino MR et al. Increased ratio of CD31+/CD42- microparticles to endothelial progenitors as a novel marker of atherosclerosis in hypercholesterolemia. Arterioscler Thromb Vasc Biol 2006; 26: 2530–2535.

    Article  CAS  PubMed  Google Scholar 

  38. Tomiyama H, Koji Y, Yambe M, Shiina K, Motobe K, Yamada J et al. Brachial-ankle pulse wave velocity is a simple and independent predictor of prognosis in patients with acute coronary syndrome. Circ J 2005; 69: 815–822.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was financially supported by the Grants from Natural Scientific Foundation of China (30770895 and u0732002), The National High-tech Research and Development Programme of China (No.2006AA02A406) and Guangzhou Scientific Project Foundation (2007Z3-E0241).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J Tao.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wang, JM., Su, C., Wang, Y. et al. Elevated circulating endothelial microparticles and brachial–ankle pulse wave velocity in well-controlled hypertensive patients. J Hum Hypertens 23, 307–315 (2009). https://doi.org/10.1038/jhh.2008.137

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2008.137

Keywords

This article is cited by

Search

Quick links