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ESANSİYEL HİPERTANSİYONLU HASTALARDA KARDİYOVASKÜLER RİSK FAKTÖRLERİNİN ENDOTEL DİSFONKSİYONUNA ETKİSİ: KESİTSEL VAKA KONTROLLÜ BİR ÇALIŞMA

CARDIOVASCULAR RISK FACTORS CAN AFFECT ENDOTHELIAL DYSFUNCTION IN ESSENTIAL HYPERTENSIVES: ACROSS SECTIONAL CASE-CONTROL STUDY

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2006

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: Endothelial dysfunction is now recognized as an early, perhaps initiating event in the pathogenesis of cardiovascular diseases. The purpose of the present study was to examine the influence of cardiac risk factors on endothelial function in essential hypertension (EH). Material and methods: Young 129 (53 males, mean age 45.0±6.4) mild hypertensive patients and same number of healthy controls were selected. All patients were under antihypertensive treatment for a mean duration of 44±63 months, and were at the targeted blood pressure. Major risk factors for cardiovascular diseases according to the National Cholesterol Education Program criteria and some other risk factors were evaluated. Seventy-eight EH patients and 78 age and sex matched control subjects were assessed for endothelial function using brachial artery ultrasound. Endothelium dependent (EDD) and independent (EID) vasodilation were evaluated. Results: Patients with EH were older with female dominance, had higher frequency of diabetes, obesity, higher cholesterol, triglycerides, and fibrinogen levels. EH patients had significantly impaired EDD (17.4±7.2% vs 20.7±5.8%, p=0.002) and EID (20.9±8.2% vs 24.4±6.8%, p=0.004) compared with controls. In multiple regression test only uric acid levels, presence of EH, and body mass index (BMI) were retained as significant for EDD. Only uric acid, hemoglobin levels, presence of EH, and BMI were significantly associated with EID. Conclusion: It was concluded that endothelial dysfunction was present in EH group despite optimal medical therapy. The factors analyzed in the study explain only a fraction of the variability in EDD but were intimately related to metabolic syndrome which may be one of the reasons why endothelial dysfunction was present in EH despite medical therapy.
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Abstract (Original Language): 
Amaç: Endotel disfonksiyonu, patogenezinde erken dönemde saptand›¤› kardiyovasküler hastal›klar› belki de bafllatan bir olayd›r. Bu çal›flman›n amac›, kardiyovasküler risk faktörlerinin esansiyel hipertansiyon (EH) hastalar›nda endotel fonksiyona etkisini de¤erlendirmekti. Gereç ve yöntem: Evre I 129 (53 erkek, ortalama yafl 45,0±6,4) hipertansif hasta ve ayn› say›da sa¤l›kl› kontrol çal›flmaya al›nd›. Hastalar ortalama 44±63 ayd›r tedavi alt›ndayd› ve hedef kan bas›nc›na ulafl›lm›flt›. Ulusal kolesterol e¤itim program› kriterlerine göre major risk faktörleri ve baz› di¤er risk faktörleri de¤erlendirildi. Brakiyel arter ultrasonografisi ile 78 yafl ve cinsiyeti efllefltirilmifl kontrol ve EH hastas›n›n endotel fonksiyonu incelendi. Endotele ba¤›ml› (EDD) ve endotelden ba¤›ms›z (EID) vazodilatasyon de¤erlendirildi. Bulgular: Hastalar daha yafll› idi, kad›n hastalar ço¤unluktayd›, hasta grubunda diabetes, obezite, yüksek kolesterol, trigliserid ve fibrinojen düzeyleri daha s›k idi. Hipertansiflerde EDD (%17,4±7,2 karfl›n %20,7±5,8, p=0,002) ve EID (%20,9 ± 8,2 karfl›n %24,4 ± 6,8, p=0,004) kontrol grubuna göre anlaml› olarak azalm›flt›.. Multipl regresyon analizinde EDD için ürik asit, EH varl›¤›, vücut kitle indeksi (VK‹), EID için ise ürik asit, hemoglobin düzeyi, EH varl›¤› ve VK‹ öngördürücü bulundu. Sonuç: Optimal t›bbi tedaviye ra¤men EH grubunda endotel disfonksiyonu saptand›. Çal›flmam›zda de¤erlendirilen faktörler EDD’ki de¤iflkenli¤in ancak küçük bir bölümünü aç›klayabildi, bu faktörlerin baz›lar› metabolik sendromun komponentleri idi. Bu durum EH'da optimal t›bbi tedaviye ra¤men süregelen endotel disfonksiyonun nedenlerinden birisi olabilir.
FULL TEXT (PDF): 
PDF icon arastirmax-esansiyel-hipertansiyonlu-hastalarda-kardiyovaskuler-risk-faktorlerinin-endotel-disfonksiyonuna-etkisi-kesitsel-vaka-kontrollu-bir-calisma.pdf
  • 4
98-101
  • English

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