Impaired endothelial function in hypertensive patients with target organ damage

To evaluate the correlation between endothelial dysfunction and multiple target organ damage (TOD), we measured endothelial function using high-resolution ultrasonography in hypertensive patients with or without TOD. Two hundred and eighty patients with hypertension were divided into four groups as follows: no TOD (Group I, n = 61); 1 TOD (Group II, n = 113); 2 TOD (Group III, n = 59); and >= 3 TOD ( Group IV, n = 47). Endothelial function was assessed by endothelium-dependent flow-mediated dilatation (FMD) and -independent vasodilation (after sublingual administration of nitroglycerin) of the brachial artery using high-resolution vascular ultrasound. We also assessed the intima-media thickness (IMT) of the common carotid, carotid to femoral pulse wave velocity (cf-PWV) and left ventricular mass index (LVMI). FMD was inversely associated with the number of affected organs. FMD was lower in the patient groups with >= 3 TOD (Group IV: 6.85 +/- 4.70% vs Group II: 10.00 +/- 6.15%, P<0.01), 2 TOD (Group III: 7.37 +/- 5.02% vs Group II, P<0.01) and 1 TOD as compared with patients with no TOD (Group I: 11.88 +/- 7.11% vs Group II, P<0.05). In univariate correlation analysis, there was a significant relationship between FMD and IMT, serum creatinine, LVMI and cf-PWV. In stepwise multivariate regression analysis, FMD still correlated with waist size (beta = -0.283, P<0.01), age (beta = -0.231, P<0.05) and IMT (beta = -0.197, P = 0.05). These findings suggested that reduced FMD was associated with the number of TOD and may be considered an indicator for evaluating TOD. Journal of Human Hypertension (2009) 23, 751-757; doi: 10.1038/jhh.2009.10; published online 5 March 2009