Endothelial-dependent flow-mediated dilation in african americans with masked-hypertension

Praveen Veerabhadrappa, Keith M. Diaz, Deborah L. Feairheller, Kathleen Sturgeon, Sheara T. Williamson, Deborah L. Crabbe, Abul M. Kashem, Michael D. Brown

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

BackgroundOffice-blood pressure (BP) measurements alone overlook a significant number of individuals with masked-hypertension (office-BP: 120/80-139/89mmHg and 24-h ambulatory BP monitoring (ABPM) daytime 135/85mmHg or night-time 120/70mmHg). Diminished endothelial function contributes to the pathogenesis of hypertension. To better understand the pathophysiology involved in the increased cardiovascular (CV) disease risk associated with masked-hypertension, we estimated the occurrence, assessed the endothelial function, compared plasma levels of inflammatory markers, white blood cell count (WBC count), tumor necrosis factor-α (TNF-α), and high sensitivity C-reactive protein (hsCRP) and examined the possible relationship between endothelial function and inflammatory markers in apparently healthy prehypertensive (office-BP: 120/80-139/89mmHg) African Americans.MethodsFifty African Americans who were sedentary, nondiabetic, nonsmoking, devoid of CV disease were recruited. Office-BP was measured according to JNC-7 guidelines to identify prehypertensives in whom ABPM was then assessed. Fasting plasma samples were assayed for inflammatory markers. Brachial artery flow-mediated dilation (FMD) at rest and during reactive hyperemia was measured in a subset of prehypertensives.ResultsSubjects in the masked-hypertension sub-group had a higher hsCRP (P = 0.04) and diminished endothelial function (P = 0.03) compared to the true-prehypertensive sub-group (office-BP: 120/80-139/89mmHg and ABPM: daytime 135/85mmHg or night-time 120/70mmHg). Regression analysis showed that endothelial function was inversely related to hsCRP amongst the masked-hypertensive sub-group (R 2 = 0.160; P = 0.04).ConclusionsMasked- hypertension was identified in 58% of African Americans which suggests that a masking phenomenon may exist in a sub-group of prehypertensives who also seem to have a diminished endothelial function that could be mediated by an elevated subclinical inflammation leading to the increased CV disease.

Original languageEnglish (US)
Pages (from-to)1102-1107
Number of pages6
JournalAmerican journal of hypertension
Volume24
Issue number10
DOIs
StatePublished - Oct 1 2011

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Masked Hypertension
African Americans
Dilatation
Blood Pressure
C-Reactive Protein
Ambulatory Monitoring
Cardiovascular Diseases
Hypertension
Ambulatory Blood Pressure Monitoring
Brachial Artery
Hyperemia
Leukocyte Count
Fasting
Tumor Necrosis Factor-alpha
Regression Analysis
Guidelines
Inflammation

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Veerabhadrappa, Praveen ; Diaz, Keith M. ; Feairheller, Deborah L. ; Sturgeon, Kathleen ; Williamson, Sheara T. ; Crabbe, Deborah L. ; Kashem, Abul M. ; Brown, Michael D. / Endothelial-dependent flow-mediated dilation in african americans with masked-hypertension. In: American journal of hypertension. 2011 ; Vol. 24, No. 10. pp. 1102-1107.
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title = "Endothelial-dependent flow-mediated dilation in african americans with masked-hypertension",
abstract = "BackgroundOffice-blood pressure (BP) measurements alone overlook a significant number of individuals with masked-hypertension (office-BP: 120/80-139/89mmHg and 24-h ambulatory BP monitoring (ABPM) daytime 135/85mmHg or night-time 120/70mmHg). Diminished endothelial function contributes to the pathogenesis of hypertension. To better understand the pathophysiology involved in the increased cardiovascular (CV) disease risk associated with masked-hypertension, we estimated the occurrence, assessed the endothelial function, compared plasma levels of inflammatory markers, white blood cell count (WBC count), tumor necrosis factor-α (TNF-α), and high sensitivity C-reactive protein (hsCRP) and examined the possible relationship between endothelial function and inflammatory markers in apparently healthy prehypertensive (office-BP: 120/80-139/89mmHg) African Americans.MethodsFifty African Americans who were sedentary, nondiabetic, nonsmoking, devoid of CV disease were recruited. Office-BP was measured according to JNC-7 guidelines to identify prehypertensives in whom ABPM was then assessed. Fasting plasma samples were assayed for inflammatory markers. Brachial artery flow-mediated dilation (FMD) at rest and during reactive hyperemia was measured in a subset of prehypertensives.ResultsSubjects in the masked-hypertension sub-group had a higher hsCRP (P = 0.04) and diminished endothelial function (P = 0.03) compared to the true-prehypertensive sub-group (office-BP: 120/80-139/89mmHg and ABPM: daytime 135/85mmHg or night-time 120/70mmHg). Regression analysis showed that endothelial function was inversely related to hsCRP amongst the masked-hypertensive sub-group (R 2 = 0.160; P = 0.04).ConclusionsMasked- hypertension was identified in 58{\%} of African Americans which suggests that a masking phenomenon may exist in a sub-group of prehypertensives who also seem to have a diminished endothelial function that could be mediated by an elevated subclinical inflammation leading to the increased CV disease.",
author = "Praveen Veerabhadrappa and Diaz, {Keith M.} and Feairheller, {Deborah L.} and Kathleen Sturgeon and Williamson, {Sheara T.} and Crabbe, {Deborah L.} and Kashem, {Abul M.} and Brown, {Michael D.}",
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Endothelial-dependent flow-mediated dilation in african americans with masked-hypertension. / Veerabhadrappa, Praveen; Diaz, Keith M.; Feairheller, Deborah L.; Sturgeon, Kathleen; Williamson, Sheara T.; Crabbe, Deborah L.; Kashem, Abul M.; Brown, Michael D.

In: American journal of hypertension, Vol. 24, No. 10, 01.10.2011, p. 1102-1107.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Endothelial-dependent flow-mediated dilation in african americans with masked-hypertension

AU - Veerabhadrappa, Praveen

AU - Diaz, Keith M.

AU - Feairheller, Deborah L.

AU - Sturgeon, Kathleen

AU - Williamson, Sheara T.

AU - Crabbe, Deborah L.

AU - Kashem, Abul M.

AU - Brown, Michael D.

PY - 2011/10/1

Y1 - 2011/10/1

N2 - BackgroundOffice-blood pressure (BP) measurements alone overlook a significant number of individuals with masked-hypertension (office-BP: 120/80-139/89mmHg and 24-h ambulatory BP monitoring (ABPM) daytime 135/85mmHg or night-time 120/70mmHg). Diminished endothelial function contributes to the pathogenesis of hypertension. To better understand the pathophysiology involved in the increased cardiovascular (CV) disease risk associated with masked-hypertension, we estimated the occurrence, assessed the endothelial function, compared plasma levels of inflammatory markers, white blood cell count (WBC count), tumor necrosis factor-α (TNF-α), and high sensitivity C-reactive protein (hsCRP) and examined the possible relationship between endothelial function and inflammatory markers in apparently healthy prehypertensive (office-BP: 120/80-139/89mmHg) African Americans.MethodsFifty African Americans who were sedentary, nondiabetic, nonsmoking, devoid of CV disease were recruited. Office-BP was measured according to JNC-7 guidelines to identify prehypertensives in whom ABPM was then assessed. Fasting plasma samples were assayed for inflammatory markers. Brachial artery flow-mediated dilation (FMD) at rest and during reactive hyperemia was measured in a subset of prehypertensives.ResultsSubjects in the masked-hypertension sub-group had a higher hsCRP (P = 0.04) and diminished endothelial function (P = 0.03) compared to the true-prehypertensive sub-group (office-BP: 120/80-139/89mmHg and ABPM: daytime 135/85mmHg or night-time 120/70mmHg). Regression analysis showed that endothelial function was inversely related to hsCRP amongst the masked-hypertensive sub-group (R 2 = 0.160; P = 0.04).ConclusionsMasked- hypertension was identified in 58% of African Americans which suggests that a masking phenomenon may exist in a sub-group of prehypertensives who also seem to have a diminished endothelial function that could be mediated by an elevated subclinical inflammation leading to the increased CV disease.

AB - BackgroundOffice-blood pressure (BP) measurements alone overlook a significant number of individuals with masked-hypertension (office-BP: 120/80-139/89mmHg and 24-h ambulatory BP monitoring (ABPM) daytime 135/85mmHg or night-time 120/70mmHg). Diminished endothelial function contributes to the pathogenesis of hypertension. To better understand the pathophysiology involved in the increased cardiovascular (CV) disease risk associated with masked-hypertension, we estimated the occurrence, assessed the endothelial function, compared plasma levels of inflammatory markers, white blood cell count (WBC count), tumor necrosis factor-α (TNF-α), and high sensitivity C-reactive protein (hsCRP) and examined the possible relationship between endothelial function and inflammatory markers in apparently healthy prehypertensive (office-BP: 120/80-139/89mmHg) African Americans.MethodsFifty African Americans who were sedentary, nondiabetic, nonsmoking, devoid of CV disease were recruited. Office-BP was measured according to JNC-7 guidelines to identify prehypertensives in whom ABPM was then assessed. Fasting plasma samples were assayed for inflammatory markers. Brachial artery flow-mediated dilation (FMD) at rest and during reactive hyperemia was measured in a subset of prehypertensives.ResultsSubjects in the masked-hypertension sub-group had a higher hsCRP (P = 0.04) and diminished endothelial function (P = 0.03) compared to the true-prehypertensive sub-group (office-BP: 120/80-139/89mmHg and ABPM: daytime 135/85mmHg or night-time 120/70mmHg). Regression analysis showed that endothelial function was inversely related to hsCRP amongst the masked-hypertensive sub-group (R 2 = 0.160; P = 0.04).ConclusionsMasked- hypertension was identified in 58% of African Americans which suggests that a masking phenomenon may exist in a sub-group of prehypertensives who also seem to have a diminished endothelial function that could be mediated by an elevated subclinical inflammation leading to the increased CV disease.

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