4.2 Article

Left ventricular mass is related to endothelium-dependent vasodilation in the forearm, but not in the brachial artery, in elderly subjects: the Prospective Investigation of the Vasculature in Uppsala Seniors study

Journal

JOURNAL OF HUMAN HYPERTENSION
Volume 22, Issue 11, Pages 767-773

Publisher

NATURE PUBLISHING GROUP
DOI: 10.1038/jhh.2008.61

Keywords

endothelium; vasodilation; blood pressure; left ventricular hypertrophy

Funding

  1. Uppsala University
  2. Thureus foundation
  3. AstraZeneca R D Sweden

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Left ventricular hypertrophy (LVH) is a powerful cardiovascular risk factor and has previously been related to endothelium-dependent vasodilation (EDV) in hypertensive patients. In the Prospective Investigation of the Vasculature in Uppsala Seniors study, different techniques to evaluate EDV in different types of vessels were applied and were related to left ventricular mass index (LVMI) in the general population. In 1016 subjects aged 70 years, EDV was evaluated by the invasive forearm technique with acetylcholine given in the brachial artery, the brachial artery ultrasound technique with measurement of flow-mediated dilatation (FMD) and the pulse wave analysis method with beta-2-agonist (terbutaline) provocation. LVMI was determined by echocardiography. LVMI was related to both EDV and the pulse wave-based technique (both r = -0.14, P < 0.0001) in univariate analysis. LVMI was also weakly related to FMD (r = -0.07, P = 0.046). However, in multiple regression analysis adjusted for gender, systolic and diastolic blood pressure and use of antihypertensive medication, only EDV was associated with LVMI (P = 0.016). EDV was mainly reduced in those with left ventricular concentric hypertrophy (P = 0.0012). In conclusion, in a population-based sample of elderly subjects, EDV, but not FMD, was inversely correlated with LVM independent of blood pressure, suggesting that EDV in resistance arteries is of more importance for LVH than endothelial vasodilatory function in conduit arteries in the elderly.

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