HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (10) Citing Articles via Google Scholar Google Scholar Articles by Ichigi, Y. Articles by Kugiyama, K. Search for Related Content PubMed PubMed Citation Articles by Ichigi, Y. Articles by Kugiyama, K.

CLINICAL RESEARCH: ENDOTHELIAL FUNCTION

Increased Ambulatory Pulse Pressure Is a Strong Risk Factor for Coronary Endothelial Vasomotor Dysfunction

Department of Internal Medicine II, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan.

Manuscript received August 18, 2004; revised manuscript received January 18, 2005, accepted January 25, 2005.

^_* Reprint requests and correspondence: Dr. Kiyotaka Kugiyama, Department of Internal Medicine II, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, 1110 Shimokato, Nakakoma-gun, Yamanashi, 409-3898 Japan. (Email: kugiyama{at}yamanashi.ac.jp).

OBJECTIVES: This study was aimed to determine the relationship between pulse pressure (PP) and coronary vasomotor dysfunction, a predictor of coronary events.

BACKGROUND: Pulse pressure is a strong risk factor for coronary artery disease (CAD). However, the mechanisms by which an increase in PP affects the pathogenesis of CAD are unclear.

METHODS: Ambulatory blood pressure (BP) monitoring for 24 h was performed in 103 consecutive patients with normal coronary angiograms (51 hypertensive and 52 normotensive; age 42 to 70 years). The relationship between changes in coronary arterial diameter and blood flow during an intracoronary infusion of acetylcholine (ACh) (5, 10, 50 µg/min), and BP parameters, and other traditional risk factors was evaluated using univariate and multivariate linear regression analyses.

RESULTS: With multivariate analyses, the 24-h PP showed an inverse correlation with the epicardial coronary dilator response to ACh independently of other covariates including age, smoking, and 24-h systolic BP in normotensive as well as hypertensive patients. Furthermore, multivariate analysis showed that the 24-h PP was inversely and independently correlated with the increase in coronary blood flow in response to ACh. The dilator response of epicardial coronary arteries to nitrate was not significantly correlated with 24-h PP.

CONCLUSIONS: Increased 24-h PP is independently associated with endothelial vasomotor dysfunction in conduit and resistance coronary arteries irrespective of the presence of hypertension. Increased ambulatory PP may have an intimate relation to coronary endothelial vasomotor dysfunction.

Abbreviations and Acronyms   ACh = acetylcholine   BP = blood pressure   DBP = diastolic blood pressure   HR = heart rate   NO = nitric oxide   PP = pulse pressure   SBP = systolic blood pressure

This article has been cited by other articles:

				S. M.L. Wallace, Yasmin, C. M. McEniery, K. M. Maki-Petaja, A. D. Booth, J. R. Cockcroft, and I. B. Wilkinson Isolated Systolic Hypertension Is Characterized by Increased Aortic Stiffness and Endothelial Dysfunction Hypertension, July 1, 2007; 50(1): 228 - 233. [Abstract] [Full Text] [PDF]

				S. Aronson, M. L. Fontes, Y. Miao, D. T. Mangano, and for the Investigators of the Multicenter Study of Risk Index for Perioperative Renal Dysfunction/Failure: Critical Dependence on Pulse Pressure Hypertension Circulation, February 13, 2007; 115(6): 733 - 742. [Abstract] [Full Text] [PDF]

				H. Takano, Y. Kodama, Y. Kitta, T. Nakamura, J.-e. Obata, A. Mende, K.-i. Kawabata, Y. Saitoh, D. Fujioka, T. Kobayashi, et al. Transcardiac adiponectin gradient is independently related to endothelial vasomotor function in large and resistance coronary arteries in humans Am J Physiol Heart Circ Physiol, December 1, 2006; 291(6): H2641 - H2646. [Abstract] [Full Text] [PDF]

				C. M. McEniery, S. Wallace, I. S. Mackenzie, B. McDonnell, Yasmin, D. E. Newby, J. R. Cockcroft, and I. B. Wilkinson Endothelial Function Is Associated With Pulse Pressure, Pulse Wave Velocity, and Augmentation Index in Healthy Humans Hypertension, October 1, 2006; 48(4): 602 - 608. [Abstract] [Full Text] [PDF]

				P. Verdecchia, F. Angeli, and S. Taddei At the Beginning of Stiffening: Endothelial Dysfunction Meets "Pulsology" Hypertension, October 1, 2006; 48(4): 541 - 542. [Full Text] [PDF]