关键词: arterial stiffness endothelial dysfunction erythropoietin (epo) hypertension malondialdehyde (mda) nitric oxide (no) oxidative stress oxygen sensing proteins pulse wave velocity (pwv) vascular endothelial growth factor (vegf)

来  源:   DOI:10.7759/cureus.62416   PDF(Pubmed)

Abstract:
Background and objective While hypertension (HTN) is a major health-related threat globally, it is often an under-reported clinical condition as most of the stage I hypertensive patients do not present with any symptoms. The relationship between endogenous oxygen-sensing protein [erythropoietin (EPO) and vascular endothelial growth factor (VEGF)] levels and vascular stress in hypertensive patients is not fully understood as the mechanistic pathway by which these oxygen-sensing proteins alter the vascular physiology and cause hypertension is still a matter of debate. In light of this, we explored the role of these two proteins in the development of vascular stress including increased pulse wave velocity (PWV). We aimed to examine the correlation between oxygen-sensing proteins and vascular stress markers including PWV in hypertensive patients. Materials and methods We conducted a cross-sectional study involving age-matched participants classified into three groups (group 1: normotensive persons, n=36; group 2: stage I hypertensive patients, n=36; and group 3, stage II hypertensive patients, n=36). Adiposity-related parameters such as waist circumference (WC), hip circumference (HC), BMI, and waist-hip ratio (WHR) were measured. BP was recorded manually in resting posture by using a sphygmomanometer. PWV, which predicts the progression of BP and the development of HTN, was recorded using a periscope, which works based on the oscillometric method. Vascular stress-induced oxidative stress parameters [serum malondialdehyde (MDA) and serum nitric oxide (NO)] were also estimated by using a UV spectrophotometer. Quantitative estimations of oxygen-sensing proteins (serum EPO and serum VEGF) were done by using the ELISA kit method. The results were expressed as mean ± standard deviation (SD). The correlation between the variables was done using Spearman\'s correlation. A p-value <0.05 was considered statistically significant. Results Adiposity indices and vascular stiffness parameters were found to be significantly (p <0.05) increased in group 2 and group 3 compared to group 1. The levels of serum MDA were found to be significantly (p<0.05) increased in group 2 and group 3 than group 1, whereas the levels of serum NO were significantly (p<0.05) decreased in group 3 and group 2 than group 1. A significant (p<0.05) positive correlation was observed between the PWV and EPO (r=0.492) while a significant (p<0.05) negative correlation was observed between PWV and VEGF (r=-0.406) among the study population. Conclusion The results are indicative of the influence of vascular stress in stage I and II hypertensive patients. Furthermore, the relationship between oxygen-sensing proteins and vascular stress in hypertensive patients has also been established.
摘要:
背景与目的高血压(HTN)是全球范围内与健康相关的主要威胁,这通常是一种报道不足的临床病症,因为大多数I期高血压患者没有任何症状.内源性氧敏感蛋白[促红细胞生成素(EPO)和血管内皮生长因子(VEGF)]水平与高血压患者血管应激之间的关系尚未完全理解为这些氧敏感蛋白改变血管生理并引起高血压的机制途径。鉴于此,我们探讨了这两种蛋白在血管应激(包括脉搏波传导速度(PWV)增加)发展中的作用。我们旨在研究高血压患者中氧敏感蛋白与包括PWV在内的血管应激标志物之间的相关性。材料和方法我们进行了一项横断面研究,涉及年龄匹配的参与者,分为三组(第1组:血压正常的人,n=36;第2组:I期高血压患者,n=36;第3组,II期高血压患者,n=36)。与肥胖相关的参数,如腰围(WC),臀围(HC),BMI,测量腰臀比(WHR)。使用血压计以静息姿势手动记录BP。PWV,预测了BP的发展和HTN的发展,是用潜望镜记录的,基于示波法工作。还使用UV分光光度计估算了血管应激诱导的氧化应激参数[血清丙二醛(MDA)和血清一氧化氮(NO)]。使用ELISA试剂盒方法对氧敏感蛋白(血清EPO和血清VEGF)进行定量评估。结果表示为平均值±标准偏差(SD)。变量之间的相关性是使用Spearman相关性进行的。P值<0.05被认为是统计学上显著的。结果与第1组相比,第2组和第3组的脂肪指数和血管硬度参数显着增加(p<0.05)。第2组和第3组的血清MDA水平明显高于第1组(p<0.05),而第3组和第2组的血清NO水平明显低于第1组(p<0.05)。在研究人群中,PWV和EPO之间存在显着(p<0.05)正相关(r=0.492),而PWV和VEGF之间存在显着(p<0.05)负相关(r=-0.406)。结论该结果指示了I期和II期高血压患者血管应激的影响。此外,高血压患者的氧敏感蛋白与血管应激之间的关系也已建立。
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