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Praveen Veerabhadrappa, Keith M Diaz, Deborah L Feairheller, Katie M Sturgeon, Sheara T Williamson, Deborah L Crabbe, Abul M Kashem, Michael D Brown, Endothelial-Dependent Flow-Mediated Dilation in African Americans With Masked-Hypertension, American Journal of Hypertension, Volume 24, Issue 10, October 2011, Pages 1102–1107, https://doi.org/10.1038/ajh.2011.103
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Office-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.
Fifty 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.
Subjects 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 (R2 = 0.160; P = 0.04).
Masked-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.
American Journal of Hypertension advance online publication 16 June 2011; doi:10.1038/ajh.2011.103
- hypertension
- tumor necrosis factors
- cardiovascular diseases
- inflammatory markers
- inflammation
- lack of exercise
- ambulatory blood pressure monitoring
- brachial artery
- cardiovascular system
- dilatation, pathologic
- endothelium
- fasting
- leukocyte count
- plasma
- c-reactive protein
- guidelines
- tumor necrosis
- african american
- hypertension, masked
- night time
- reactive hyperemia
- fluid flow
