Endothelial Function Is Impaired in Patients Receiving Antihypertensive Drug Treatment Regardless of Blood Pressure Level: FMD-J Study (Flow-Mediated Dilation Japan).
Hypertension is associated with endothelial dysfunction. Blood pressure significantly correlates with endothelial function in antihypertensive drug-naive subjects. The purpose of this study was to determine whether treatment status affects the relationship between blood pressure and endothelial function. We measured flow-mediated vasodilation (FMD) in 2297 subjects, including 1822 antihypertensive drug-naive subjects and 475 treated hypertensive patients. FMD significantly decreased in relation to increase in systolic blood pressure (8.2±3.1% in subjects with systolic blood pressure of <120 mm Hg, 7.5±2.8% for 120-129 mm Hg, 7.1±2.8% for 130-139 mm Hg, and 6.7±2.6% for ≥140 mm Hg; P<0.001). Systolic blood pressure was independently associated with FMD in untreated subjects. In contrast, there was no significant relationship between systolic blood pressure and FMD in treated hypertensive patients (4.6±3.1% in treated hypertensives with systolic blood pressure of <120 mm Hg, 4.8±2.7% for 120-129 mm Hg, 4.9±2.8% for 130-139 mm Hg, and 4.5±2.3% for ≥140 mm Hg; P=0.77). Propensity score matching analysis revealed that the prevalence of endothelial dysfunction defined as FMD of less than the division point for the lowest tertile, and the middle tertile of FMD was significantly higher in treated hypertensive patients than in untreated subjects in all systolic blood pressure categories. Endothelial function assessed by FMD was impaired regardless of the level of blood pressure achieved by antihypertensive drug treatment in hypertensive patients.
['Maruhashi|Tatsuya|T|', 'Soga|Junko|J|', 'Fujimura|Noritaka|N|', 'Idei|Naomi|N|', 'Mikami|Shinsuke|S|', 'Iwamoto|Yumiko|Y|', 'Iwamoto|Akimichi|A|', 'Kajikawa|Masato|M|', 'Matsumoto|Takeshi|T|', 'Oda|Nozomu|N|', 'Kishimoto|Shinji|S|', 'Matsui|Shogo|S|', 'Hashimoto|Haruki|H|', 'Aibara|Yoshiki|Y|', 'Yusoff|Farina Binti Mohamad|FBM|', 'Hidaka|Takayuki|T|', 'Kihara|Yasuki|Y|', 'Chayama|Kazuaki|K|', 'Noma|Kensuke|K|', 'Nakashima|Ayumu|A|', 'Goto|Chikara|C|', 'Tomiyama|Hirofumi|H|', 'Takase|Bonpei|B|', 'Kohro|Takahide|T|', 'Suzuki|Toru|T|', 'Ishizu|Tomoko|T|', 'Ueda|Shinichiro|S|', 'Yamazaki|Tsutomu|T|', 'Furumoto|Tomoo|T|', 'Kario|Kazuomi|K|', 'Inoue|Teruo|T|', 'Koba|Shinji|S|', 'Watanabe|Kentaro|K|', 'Takemoto|Yasuhiko|Y|', 'Hano|Takuzo|T|', 'Sata|Masataka|M|', 'Ishibashi|Yutaka|Y|', 'Node|Koichi|K|', 'Maemura|Koji|K|', 'Ohya|Yusuke|Y|', 'Furukawa|Taiji|T|', 'Ito|Hiroshi|H|', 'Ikeda|Hisao|H|', 'Yamashina|Akira|A|', 'Higashi|Yukihito|Y|']
D000328:Adult D000368:Aged D000959:Antihypertensive Agents D001794:Blood Pressure D001795:Blood Pressure Determination D004730:Endothelium, Vascular D005260:Female D006801:Humans D006973:Hypertension D007564:Japan D008297:Male D054539:Medication Therapy Management D008875:Middle Aged D014664:Vasodilation
blood pressure hypertension vasodilation antihypertensive agents blood pressure determination