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:

Endothelial function in normotensive and high-normal hypertensive subjects

Abstract

To evaluate the impact of a mild increment in blood pressure level on endothelial function, we evaluated 61 healthy volunteers (24 women, 37 men, and aged 35–50 years). All subjects underwent a blood chemistry panel to exclude any metabolic abnormalities and were submitted to a Doppler ultrasound of the brachial artery to assess endothelial function. We assessed the endothelial response to reactive hyperaemia and exogenous nitric oxide administration considering an increase in systolic blood pressure (SBP) at each 10-mm Hg interval. Our study population was divided as follows: SBP <115 mm Hg (SG1, n=13), SBP 115 mm Hg and <125 mm Hg (SG2, n=20), SBP 125 mm Hg and <135 mm Hg (SG3, n=13) and SBP 135 mm Hg and <140 mm Hg (SG4, n=15). We found a significant difference in flow-mediated dilation among SG2, SG3 and SG4, 16.2±5.6, 13.4±5.2 and 11.5±3.6%, P<0.05, respectively). After nitrate administration, we observed a nonsignificant decrease in brachial artery dilation among groups, P=0.217. Our data showed in a healthy normotensive population, without any risk factor for atherosclerotic disease that small increases in SBP but not in diastolic blood pressure may impair endothelial function even in subjects considered as high-normal, meaning that this population deserves more attention than usually ascribed to intervene and prevent complications, as endothelial dysfunction may represent an early change in those who develop hypertension later in life.

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

Access options

Buy this article

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. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL et al. The National High Blood Pressure Education Program Coordinating Committee on prevention, detection, evaluation, and treatment of high blood pressure. Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension 2003; 42: 1206–1252.

    Article  CAS  Google Scholar 

  2. Vasan RS, Larson MG, Evans JC, O' Donnell CJ, Levy D . High normal blood pressure and risk of cardiovascular disease: the Framingham Heart Study. Circulation 1999; 100: 1–34.

    Google Scholar 

  3. Celermajer DS, Sorensen KE, Gooch VM, Spiegelhalter DJ, Miller OI, Sullivan ID et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992; 340: 1111–1115.

    Article  CAS  Google Scholar 

  4. Iiyama K, Nagano M, Yo Y, Nagano N, Kamide K, Higaki J et al. Impaired endothelial function with essential hypertension assessed by ultrasonography. Hypertension 1996; 132: 779–782.

    CAS  Google Scholar 

  5. McVeigh GE, Brennan GM, Johnston GD, McDermott BJ, McGrath IT, Henry WR et al. Impaired endothelium-dependent and independent vasodilation in patients with type 2 (noninsulin-dependent) diabetes mellitus. Diabetologia 1992; 35: 771–776.

    CAS  PubMed  Google Scholar 

  6. Zizek B, Poredos P, Videcnik V . Endothelial dysfunction in hypertensive patients and in normotensive offspring of subjects with essential hypertension. Heart 2001; 85: 215–217.

    Article  CAS  Google Scholar 

  7. Pereira RBR, Ajzen SA, Plavnik FL, Christofalo DJM, Kohlmann1 NEB, Tavares A et al. Impact of cardiovascular risk factors on function and structure of vessels and heart. Hipertensão 2006; 9: 23–28.

    Google Scholar 

  8. Celermajer DS . Noninvasive detection of atherosclerosis. N Engl J Med 1998; 339: 2014–2015.

    Article  CAS  Google Scholar 

  9. Anderson TJ, Gerhard MD, Meredith IT, Charbonneau F, Delagrange D, Creager MA et al. Systemic nature of endothelial dysfunction in atherosclerosis. Am J Cardiol 1995; 75: 71B–74B.

    Article  CAS  Google Scholar 

  10. Cugini P, Baldoni F, De Rosa R, Pandolfi C, Colotto M, Buccarella PA et al. Higher blood pressure load (baric impact) in normotensives with endothelial dysfunction: a paraphysiological status of ‘pre-hypertension’. Clin Ter 2002; 153: 309–315.

    CAS  PubMed  Google Scholar 

  11. Qureshi AI, Suri MF, Kirmani JF, Divani AA, Mohammad Y . Is prehypertension a risk factor for cardiovascular disease. Stroke 2005; 36: 1859–1863.

    Article  Google Scholar 

  12. Cugini P, Baldoni F, De Rosa R, Pandolfi C, Colotto M, Leone G et al. The ambulatory monitoring documents a more elevated blood pressure regimen (pre-hypertension) in normotensives with endothelial dysfunction. Clin Ter 2002; 153: 167–175.

    CAS  PubMed  Google Scholar 

  13. Rundek T, Hundle R, Ratchford E, Ramas R, Sciacca R, Di Tullio MR et al. Endothelial dysfunction is associated with carotid plaque: a cross-sectional study from the population based Northern Manhattan Study. BMC Cardiovasc Disord 2006; 17: 6:35.

    Google Scholar 

  14. Witte DR, Westerink J, de Koning EJ, van der Graaf Y, Grobbee DE, Bots ML . Is the association between flow-mediated dilation and cardiovascular risk limited to low-risk populations? J Am Coll Cardiol 2005; 45: 1987–1993.

    Article  Google Scholar 

  15. Williams IL, Chowienczyk PJ, Wheatcroft SB, Patel AG, Sherwood RA, Momin A et al. Endothelial function and weight loss in obese humans. Obes Surg 2005; 15: 1055–1060.

    Article  Google Scholar 

  16. Chan SY, Mancini GB, Burns S, Johnson FF, Brozic AP, Kingsbury K et al. Dietary measures and exercise training contribute to improvement of endothelial function and atherosclerosis even in patients given intensive pharmacologic therapy. J Cardiopulm Rehabil 2006; 26 (5): 288–293.

    Article  Google Scholar 

  17. Pulerwitz T, Grahame-Clarke C, Rodriguez CJ, Miyake Y, Sciacca RR, Hirata K et al. Association of increased body mass index and impaired endothelial function among Hispanic women. Am J Cardiol 2006; 97 (1): 68–70.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to F L Plavnik.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Plavnik, F., Ajzen, S., Christofalo, D. et al. Endothelial function in normotensive and high-normal hypertensive subjects. J Hum Hypertens 21, 467–472 (2007). https://doi.org/10.1038/sj.jhh.1002164

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jhh.1002164

Keywords

This article is cited by

Search

Quick links