Low-Density Lipoprotein Subfractions and Cardiovascular Risk in Hypertension: Relationship to Endothelial Dysfunction and Effects of Treatment

ABSTRACT—Although hypertensive patients are at particular risk of vascular complications, the possible contribution of an atherogenic lipoprotein profile and endothelial dysfunction to this risk is unclear. We investigated this by measuring LDL subfractions and flow-mediated dilation (FMD) (reflecti...

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Published in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 2003-03, Vol.41 (3), p.528-533
Main Authors: Felmeden, Dirk C, Spencer, Charles G.C, Blann, Andrew D, Beevers, D Gareth, Lip, Gregory Y.H
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cardiology. Vascular system
Cardiovascular Diseases - etiology
Cardiovascular Diseases - prevention & control
Coronary heart disease
Electrophoresis, Polyacrylamide Gel
Endothelium, Vascular - physiopathology
Female
Heart
Humans
Hypertension - blood
Hypertension - complications
Hypertension - physiopathology
Lipoproteins, LDL - blood
Lipoproteins, LDL - chemistry
Male
Medical sciences
Middle Aged
Risk Factors
Vasodilation
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Summary:ABSTRACT—Although hypertensive patients are at particular risk of vascular complications, the possible contribution of an atherogenic lipoprotein profile and endothelial dysfunction to this risk is unclear. We investigated this by measuring LDL subfractions and flow-mediated dilation (FMD) (reflecting endothelial dysfunction) in a cohort of high-risk hypertensive patients. We studied 84 hypertensive patients (74 men; mean age, 64 years; SD 8). Chylomicron-free LDL subfractions were analyzed by disc polyacrylamide gel electrophoresis, producing an LDL score, with higher scores being equivalent to a greater proportion of the more atherogenic LDL subfractions. High-resolution ultrasound was used to assess endothelium-dependent brachial artery FMD after reactive hyperemia after vessel occlusion. Baseline levels were compared with 61 age- and gender-matched healthy normotensive control subjects. Mean LDL score was higher and FMD impaired in hypertensive subjects compared with control subjects. These indexes were significantly improved after 6 months of cardiovascular risk factor management. LDL score correlated significantly with the 10-year Framingham coronary heart disease risk score, with a negative correlation with FMD (both P
ISSN:0194-911X
1524-4563
DOI:10.1161/01.HYP.0000056997.40992.41