Effects of Race and Hypertension on Flow-Mediated and Nitroglycerin-Mediated Dilation of the Brachial Artery

摘要: Black Americans have increased morbidity and mortality rates from cardiovascular disease, greater prevalence of hypertension, altered responses to vasodilator medications compared with those white Americans. Hypertension black race been linked impaired vascular function in the microcirculation. To examine these effects their interaction conduit vasculature, we examined vasomotor brachial artery by using high-resolution ultrasound 228 subjects (48% hypertensive, 54% black). Subjects had no history diabetes mellitus were matched for age gender. Flow-mediated dilation (8.5+/-5.3% versus 11.7+/-6.3%, P<0.001) nitroglycerin-mediated vasodilation (14.9+/-6.0 18.5+/-7.8, P=0.003) both hypertensive normotensive individuals. Multivariate analysis identified higher systolic blood pressure (P=0.003) larger baseline vessel (P<0.001) size as independent predictors lower flow-mediated dilation. Race did not significantly influence In contrast, blacks a response nitroglycerin whites (17.7+/-7.5% 15.0+/-6.2%, respectively; P=0.02). By multivariate analysis, (P=0.004), smaller (P=0.001), serum glucose (P=0.02), total cholesterol (P=0.04) Thus, hypertension is associated NO-mediated artery. Overall, dilation, but was an enhanced sublingual nitroglycerin. This later observation provides further evidence racial differences medical therapy that may be relevant treatment patients disease.