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Clinical Significance of Endothelial Dysfunction in Essential Hypertension

  • Pathogenesis of Hypertension (W Elliott, Section Editor)
  • Published:
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Abstract

The endothelium is recognized as a major determinant of vascular physiology and pathophysiology. Over the last few decades, a plethora of studies have implicated endothelial dysfunction in the progression of atherosclerosis and the subclinical target organ damage observed in essential hypertension. However, the clinical significance of diagnosing endothelial dysfunction in patients with essential hypertension remains under investigation. Although a number of vascular and non-vascular markers of endothelial dysfunction have been proposed, there is an ongoing quest for a marker in the clinical setting that is optimal, inexpensive, and reproducible. In addition, endothelial dysfunction emerges as a promising therapeutic target of agents that are readily available in clinical practice. In this context, a better understanding of its role in essential hypertension becomes of great importance. Here, we aim to investigate the clinical significance of endothelial dysfunction in essential hypertension by accumulating novel data on (a) early diagnosis using robust markers with prognostic value in cardiovascular risk prediction, (b) the association of endothelial dysfunction with subclinical vascular organ damage, and (c) potential therapeutic targets.

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Abbreviations

NO:

Nitric oxide

eNOS:

Endothelial nitric oxide synthase

CaM:

Calmodulin

BH4:

Tetrahydrobiopterin

ADMA:

Asymmetrical dimethylarginine

MPAs:

Monocyte-platelet aggregates

BP:

Blood pressure

EMPs:

Endothelial microparticles

EPCs:

Endothelial progenitor cells

QCA:

Quantitative coronary angiography

MRI:

Magnetic resonance imaging

PET:

Positron emission tomography

FBF:

Forearm blood flow

VOP:

Venous occlusion plethysmography

FMD:

Flow-mediated dilation

PAT:

Peripheral arterial tonometry

LDF:

Laser Doppler flowmetry

PWV:

Pulse wave velocity

RAS:

Renin-angiotensin system

ACEs:

Angiotensin-converting enzyme inhibitors

ARBs:

Angiotensin receptor blockers

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Conflict of Interest

Drs. Gkaliagkousi, Gavriilaki, Triantafyllou, and Douma declare that they have no conflicts of interest.

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Authors and Affiliations

  1. 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Ring Road Nea Eukarpia, 564 03, Thessaloniki, Greece

    Eugenia Gkaliagkousi, Eleni Gavriilaki, Areti Triantafyllou & Stella Douma

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  1. Eugenia Gkaliagkousi
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  2. Eleni Gavriilaki
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  3. Areti Triantafyllou
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  4. Stella Douma
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Correspondence to Eugenia Gkaliagkousi.

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This article is part of the Topical Collection on Pathogenesis of Hypertension

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Gkaliagkousi, E., Gavriilaki, E., Triantafyllou, A. et al. Clinical Significance of Endothelial Dysfunction in Essential Hypertension. Curr Hypertens Rep 17, 85 (2015). https://doi.org/10.1007/s11906-015-0596-3

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