Skip to main content

Advertisement

Log in

Effect of interaction between left ventricular dysfunction and endothelial function in hypertension

  • Published:
Current Hypertension Reports Aims and scope Submit manuscript

Abstract

Hypertension, one of the most important risk factors for cardiovascular diseases, is associated with both left ventricular hypertrophy and endothelial dysfunction. Both have been recently recognized as independent predictors of clinical events in different groups of patients. In fact, a dysfunctioning endothelium loses its antiatherosclerotic and antithrombotic action, and, therefore, promotes the atherosclerotic process. Similarly, cardiac hypertrophy is recognized as a powerful and independent risk factor for cardiovascular morbidity and mortality because it predisposes to arrhythmias and maximizes the consequences of acute myocardial ischemia. Recently, an evident interaction has been demonstrated between endothelial dysfunction and left ventricular mass. In particular, the coexistence of both left ventricular hypertrophy and endothelial dysfunction almost doubles the risk for future vascular events in hypertensives. Thus, in hypertensive patients, it is clinically useful to choose an aggressive therapeutic strategy—to reduce left ventricular mass and to improve endothelial function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. McMahon S, Peto R, Cutler J, et al.: Blood pressure, stroke, and coronary heart disease. Part 1. Prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet 1990, 335:765–774.

    Article  Google Scholar 

  2. Casale PN, Devereux RB, Millner N, et al.: Value of echocardiographic measurement of left ventricular mass in predicting cardiovascular morbid events in hypertensive men. Ann Intern Med 1986, 105:173–178.

    PubMed  CAS  Google Scholar 

  3. Koren MJ, Devereux RB, Casale PN, et al.: Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension. Ann Intern Med 1991, 114:345–352.

    PubMed  CAS  Google Scholar 

  4. Panza JA, Quyyumi AA, Brush JE, Epstein SE: Abnormal endothelium-dependent vascular relaxation in patients with essential hypertension. N Engl J Med 1990, 323:22–27.

    Article  PubMed  CAS  Google Scholar 

  5. Vane JR, Auggard EE, Botting RM: Regulatory functions of the vascular endothelium. N Engl J Med 1990, 323:27–36.

    Article  PubMed  CAS  Google Scholar 

  6. Ross R: Atherosclerosis: an inflammatory disease. N Engl J Med 1999, 340:115–126.

    Article  PubMed  CAS  Google Scholar 

  7. Palmer RMJ, Ferrige AG, Moncada S: Nitric oxide release accounts for the biological activity of endotheliumderived relaxing factor. Nature 1987, 327:524–526.

    Article  PubMed  CAS  Google Scholar 

  8. Furchgott RF, Zawadzki JV: The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine. Nature 1980, 288:373–376.

    Article  PubMed  CAS  Google Scholar 

  9. Lüscher TF, Vanhoutte PM: The Endothelium: Modulator of Cardiovascular Function. Boca Raton, FL: CRC Press; 1990.

    Google Scholar 

  10. MacAllister RJ, Fickling SA, Whitley GS, Vallance P: Metabolism of methylarginines by human vasculature: implications for the regulation of nitric oxide synthesis. Br J Pharmacol 1994, 112:43–48.

    PubMed  CAS  Google Scholar 

  11. Vallance P, Leone A, Calver A, et al.: Accumulation of an endogenous inhibitor of nitric oxide synthesis in chronic renal failure. Lancet 1992, 339:572–575.

    Article  PubMed  CAS  Google Scholar 

  12. Cooke JP, Dzan VJ: Derangements of the nitric oxide synthase pathway, L-arginine, and cardiovascular diseases. Circulation 1997, 96:379–382.

    PubMed  CAS  Google Scholar 

  13. Perticone F, Sciacqua A, Maio R, et al.: Asymmetric dimethylarginine, L-Arginine, and endothelial dysfunction in essential hypertension. J Am Coll Cardiol 2005, 46:518–523.

    Article  PubMed  CAS  Google Scholar 

  14. Treasure CB, Klein JL, Weintraub WS, et al.: Beneficial effects of cholesterol-lowering therapy on the coronary endothelium in patients wit coronary artery disease. N Engl J Med 1995, 332:481–487.

    Article  PubMed  CAS  Google Scholar 

  15. Schächinger V, Britten MB, Zeiher AM: Prognostic impact of coronary vasodilator dysfunction on adverse longterm outcome of coronary heart disease. Circulation 2000, 101:1899–1906.

    PubMed  Google Scholar 

  16. Perticone F, Ceravolo R, Pujia A, et al.: Prognostic significance of endothelial dysfunction in hypertensive patients. Circulation 2001, 104:191–196. Forearm endothelial dysfunction predicts long-term atherosclerotic disease progression and cardiovascular event rates in hypertensive patients.

    PubMed  CAS  Google Scholar 

  17. Lerman A, Zeiher AM: Endothelial function and cardiac events. Circulation 2005, 111:363–368.

    Article  PubMed  Google Scholar 

  18. Levy D, Garrison RJ, Savage DD, Simon AC: Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. N Engl J Med 1990, 322:1561–1566.

    Article  PubMed  CAS  Google Scholar 

  19. Verdecchia P, Porcellati C, Schillaci G, et al.: Ambulatory blood pressure: an independent predictor of prognosis in essential hypertension. Hypertension 1994, 24:793–801.

    PubMed  CAS  Google Scholar 

  20. Hammond IW, Devereux RB, Alderman MH, et al.: The prevalence and correlates of echocardiographic left ventricular hypertrophy among employed patients with uncomplicated hypertension. J Am Coll Cardiol 1986, 7:639–650.

    Article  PubMed  CAS  Google Scholar 

  21. Abergel E, Tase M, Bohlender J, et al.: Which definition for echocardiographic left ventricular hypertrophy? Am J Cardiol 1995, 75:498–502.

    Article  PubMed  CAS  Google Scholar 

  22. Girerd X, Laurent S, Pannier B, et al.: Arterial distensibility and left ventricular hypertrophy in patients with sustained essential hypertension. Am Heart J 1991, 22:1210–1214.

    Article  Google Scholar 

  23. Verdecchia P, Schillaci G, Borgioni C, et al.: Prognostic value of left ventricular mass and geometry in systemic hypertension with left ventricular hypertrophy. Am J Cardiol 1996, 78:197–202.

    Article  PubMed  CAS  Google Scholar 

  24. de Simone G, Greco R, Mureddu GF, et al.: Relation of left ventricular diastolic properties to systolic function in arterial hypertension. Circulation 2000, 101:152–157.

    PubMed  Google Scholar 

  25. Ganau A, Devereux RB, Pickering TG, et al.: Relation of left ventricular hemodynamic load and contractile performance to left ventricular mass in hypertension. Circulation 1990, 81:25–36.

    PubMed  CAS  Google Scholar 

  26. Schmieder RE, Messerli FH, Garavaglia GE, et al.: Dietary salt intake: a determinant of cardiac involvement in essential hypertension. Circulation 1988, 78:951–956.

    PubMed  CAS  Google Scholar 

  27. Perticone F, Ceravolo R, Cosco C, et al.: Deletion polymorphism of angiotensin-converting enzyme gene and left ventricular hypertrophy in southern Italian patients. J Am Coll Cardiol 1997, 29:365–369.

    Article  PubMed  CAS  Google Scholar 

  28. Reaven GM, Lithell H, Landsberg L: Hypertension and associated metabolic abnormalities. The role of insulin resistance and the sympathoadrenal system. N Engl J Med 1996, 334:374–381.

    Article  PubMed  CAS  Google Scholar 

  29. Colao A, Marzullo P, Di Somma C, Lombardi G.: Growth hormone and the heart. Clin Endocrinol 2001, 54:137–154.

    Article  CAS  Google Scholar 

  30. Ceravolo R, Maio R, Cuda G, et al.: Relation of fasting insulin related to insertion/deletion polymorphism of angiotensin-converting enzyme-gene and cardiac mass in never-treated patients with systemic hypertension. Am J Cardiol 2003, 92:1234–1237.

    Article  PubMed  CAS  Google Scholar 

  31. Schelling P, Fischer H, Ganten D: Angiotensin and cell growth: a link to cardiovascular hypertrophy? J Hypertens 1991, 9:3–15.

    PubMed  CAS  Google Scholar 

  32. Devereux RB, Roman MJ: Hypertensive cardiac hypertrophy: pathophysiologic and clinical characteristics. In Hypertension: Pathophysiology, Diagnosis and Management, edn 2. Edited by Laragh JH, Brenner BM. New York, NY: Raven Press; 1995:409–432.

    Google Scholar 

  33. Dandona P, Aljada A, Chaudhuri A, et al.: Metabolic syndrome: a comprehensive perspective based on interactions between obesity, diabetes, and inflammation. Circulation 2005, 11:1448–1454.

    Article  Google Scholar 

  34. Lorell BH, Carabello BA: Left ventricular hypertrophy: pathogenesis, detection, and prognosis. Circulation 2000, 102:470–479.

    PubMed  CAS  Google Scholar 

  35. Vasan RS, Larson MG, Levy D, et al.: Distribution and categorization of echocardiographic measurements in relation to reference limits: the Framingham Heart Study: formulation of a height- and sex-specific classification and its prospective validation. Circulation 1997, 96:1863–1873.

    PubMed  CAS  Google Scholar 

  36. Messerli FH, Ventura HO, Elizardi DJ, et al.: Hypertension and sudden death: increased ventricular ectopic activity in left ventricular hypertrophy. Am J Med 1984, 77:18–22.

    Article  PubMed  CAS  Google Scholar 

  37. Haider AW, Larson MG, Benjamin EJ, Levy D: Increased left ventricular mass and hypertrophy are associated with increased risk for sudden death. J Am Coll Cardiol 1998, 32:1454–1459.

    Article  PubMed  CAS  Google Scholar 

  38. Schillaci G, Verdecchia P, Porcellati C, et al.: Continuous relation between left ventricular mass and cardiovascular risk in essential hypertension. Hypertension 2000, 35:580–586.

    PubMed  CAS  Google Scholar 

  39. Kannel WB, Gordon T, Castelli WP, Margolis JR: Electrocardiographic left ventricular hypertrophy and risk of coronary artery disease: the Framingham Study. Ann Intern Med 1970, 72:813–822.

    PubMed  CAS  Google Scholar 

  40. Perticone F, Maio R, Ceravolo R, et al.: Relationship between left ventricular mass and endothelium-dependent vasodilation in never-treated hypertensive patient. Circulation 1999, 99:1991–1996.

    PubMed  CAS  Google Scholar 

  41. Silacci P, Desgeorges A, Mazzolai L, et al.: Flow pulsatility is a critical determinant of oxidative stress in endothelial cells. Hypertension 2001, 38:1162–1166.

    PubMed  CAS  Google Scholar 

  42. Miller JA, Lever AF: Implications of pulse pressure as a predictor of cardiac risk in patients with hypertension. Hypertension 2000, 36:907–911.

    Google Scholar 

  43. Ceravolo R, Maio R, Pujia A, et al.: Pulse pressure and endothelial dysfunction in never treated hypertensive patients. J Am Coll Cardiol 2003, 41:1753–1758.

    Article  PubMed  CAS  Google Scholar 

  44. Widlansky ME, Gokce N, Keaney JF Jr, Vita JA: The clinical implications of endothelial dysfunction. J Am Coll Cardiol 2003, 42:1149–1160. The detection of endothelial dysfunction provides important diagnostic and prognostic information in patients who are at risk for vascular disease.

    Article  PubMed  CAS  Google Scholar 

  45. Modena MG, Bonetti L, Coppi F, et al.: Prognostic role of reversible endothelial dysfunction in hypertensive postmenopausal women. J Am Coll Cardiol 2002, 40:505–510.

    Article  PubMed  Google Scholar 

  46. Schindler TH, Hornig B, Buser PT, et al.: Prognostic value of abnormal vasoreactivity of epicardial coronary arteries to sympathetic stimulation in patients with normal coronary angiograms. Arterioscler Thromb Vasc Biol 2003, 23:495–501.

    Article  PubMed  CAS  Google Scholar 

  47. Sciacqua A, Scozzafava A, Pujia A, et al.: Interaction between vascular dysfunction and cardiac mass increases the risk of cardiovascular outcomes in essential hypertension. Eur Heart J 2005, 26:921–927. Endothelial dysfunction and LVH are independent predictors of cardiovascular events, but their coexistence doubles this risk in hypertensive patients.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Francesco Perticone MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sciacqua, A., Borrello, F., Vatrano, M. et al. Effect of interaction between left ventricular dysfunction and endothelial function in hypertension. Current Science Inc 8, 212–218 (2006). https://doi.org/10.1007/s11906-006-0053-4

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11906-006-0053-4

Keywords

Navigation