The Relationship Between The Level Of Circulating EPCs CD34～+ Cells And Early Vascular Lesion In Patients With Hypertension

ObjectTo study the relationship between the level of circulating endothelial progenitor cells (EPCs) CD34~+ with the Framingham cardiovascular risk factors, endothelium-dependent vasodilation function (flow-mediated dialation, FMD), and carotid artery intima-media thickness (IMT) in patients with hypertension. To evaluate the relationship between the circulating EPCs and early vascular lesion in patients with hypertension. To evaluate whether the variations in the number of circulating EPCs CD34~+ could be presented as the cytological maker of early vascular lesion in patients with hypertension.Method62 patients with hypertension and 20 healthy people were collected. Hypertension group were stratified by cardiovascular risk factors according to Framingham risk factors Score, and were divided into low-risk group of 18 cases, mid-risk group of 14 cases, high-risk group of 17 cases and much-high-risk group of 13 cases. The level of peripheral circulating EPCs CD34~+, brachial artery FMD, carotid artery IMT were respectively measured. The relationships between the level of circulating EPCs CD34~+ and Framingham cardiovascular risk factors, brachial artery FMD, carotid artery IMT were analyzed.Result1). The level of peripheral circulating EPCs CD34~+ was significantly lower in hypertension groups than that in control group (P＜0.05), and CD34~+ cells were inversely correlated with cardiovascular risks.2). Brachial artery FMD was significantly lower and carotid artery IMT wassignificantly thicker in each hypertension groups than that was in control group (P＜0.01). The scores of FMD and IMT were inversely correlated with cardiovascular risks.3). The level of peripheral circulating EPCs CD34~+ was lower in low-risk hypertension group compared with control group, the difference was significant (P＜0.01). However, there were no significant differences in the scores of FMD and IMT between low-risk hypertension group with control group (P＞0.05).4). There was a negative correlation between the level of circulating EPCs CD34~+ with Framingham cardiovascular risk factors(r=-0.875, P＜0.01), a positive correlation with brachial artery FMD (r=0.859, P＜0.01) and a negative correlation with carotid artery IMT (r=-0.852, P＜0.01).ConclusionThe level of peripheral circulating EPCs CD34~+ cells were significantly reduced, following with the score of cardiovascular risk factors increased, with the parameters of arterial vascular function decreased, and with peripheral artherosclerosis found in study groups of hypertension patients. This study shows that some determinants of peripheral artery lesions had been found in hypertension patients with circulating EPCs CD34~+ decreased. The level of peripheral circulating EPCs CD34~+ were decreased and the determinant of endothelial function impaired was found, but there was no any other determinants of peripheral arterial dysfunction, and no any peripheral artherosclerosis vascular lesions demonstrated in tests in low cardiovascular risk hypertension patient group. In summary, this study demonstrats that the level of peripheral circulating EPCs CD34~+ cells is a cytological marker of peripheral arterial injury included pathological and functional changes, and the level of circulating EPCs is a predictor of early vascular lesion in patients with hypertension.