Clinical Study Of Endothelium-dependent Vasodilation In Hypertensive Patients With Left Ventricular Hypertrophy

Background Left ventricular hypertrophy(LVH) is an independent predictor of cardiovascular disease in hypertensive patients.There are different opinions on the relationship between LVH and endothelium dependent vasodilatation(EDV)in recent studies.Objective To investigate the change of EDV and the relationship between EDV and LVH in hypertensive patients. Methods 222 patients(both untreated and treated patients) with mild to moderate hypertension were divided into two groups according to LVMI:hypertensive patients with left ventricular hypertrophy(LVH, n=98), hypertensive patients without left ventricular hypertrophy (NLVH, n=124),and 40 normotensive patients served as controls . LVH was determined by echocardiography. Flow-mediated dilation (FMD) ,determined as the percentage change of brachial artery diameter during reactive hyperemia by use of high-resolution ultrasound, was used to reflect EDV.Results FMD was much lower in LVH patients [(5.7±2.1)%] than in NLVH [(6.9±2.0)%] and control patients [(10.8±1.9)%,(p<0.01)].There was no significant difference in FMD between LVH patients under antihypertensive treatment [(5.9±2.1)%] and those without treatment [(5.3±2.1)%,(P>0.05)].The level of FMD in NLVH patients under antihypertensive treatment ([7.2±1.9)%]was much higher than that without treatment [(6.3±2.2)% ,(P<0.05)].Correlation analysis showed that age and systolic blood pressure were negatively correlated with FMD both in LVH patients and NLVH patients(P<0.01).FMD was negatively correlated with LVMI in LVH patients (r=-0.276,P<0.01),while no significant correlatation was found in NLVH patients (r=-0.105,P=0.247).Conclusion EDV was obviously impaired in hypertensive patients with LVH. EDV may relate to the degree of LVH. Intensive treatment was suggested to improve EDV in hypertensive patients with LVH.