Endothelial dysfunction and the role of hypertension in Nepalese subjects with major coronary risk factors
Journal Title: Nepalese Heart Journal - Year 2016, Vol 13, Issue 1
Abstract
Background and Aims: Hypertension is one of the major coronary heart disease risk factors. Endothelial dysfunction is thought to be the preclinical vascular changes in the pathogenesis of atherosclerosis and it its major manifestation; coronary heart disease. This study was designed to assess the endothelial function in subjects with major coronary risk factors including hypertension. Methods: The study was conducted in a tertiary referral centre in Central Nepal. A cross-sectional study was conducted on the cohort of 100 subjects with at least one out of six major coronary heart disease risk factors. JNC 7 criteria were used to defne hypertension. Brachial artery flow-mediated dilation was measured using high-resolution ultrasound. Endothelial dysfunction was defned as flow-mediated dilation value <9.99%. The association between endothelial dysfunction and hypertension was assessed by univariate and multivariate analysis. Results: Out of 100 subjects with coronary risk factors (mean age 46.75±9.95 years, mean number of risk factors 2.81±1.17), 65% subjects were hypertensive and 35% were non-hypertensive. Hypertension as a risk factor was evident in 80.39% and 48.98% subjects with abnormal and normal endothelial response respectively (p = 0.001). In addition, 63.08% and 28.57% subjects with and without hypertension had endothelial dysfunction respectively (p = 0.01). Hypertension was the only coronary risk factor associated with endothelial dysfunction in a multivariate model (p = 0.04). Conclusion: Hypertension was strongly associated with endothelial dysfunction and it could be the best predictor of endothelial dysfunction and subsequent coronary heart disease in coronary heart diseases risk factor cohorts.
Authors and Affiliations
Mani Prasad Gautam| Bharatpur Hospital, Bharatpur, Nepal, Samir Gautam| Gautam Buddha Community Heart Hospital, Butwal, Nepal, Usha Ghimire| Communication and Management Institute Private Limited, Kathmandu, Nepal, Sogunuru Guruprasad| Department of Cardiology, College of Medical Sciences, Bharatpur, Nepal Corresponding Author: Mani Prasad Gautam, Bharatpur Hospital, Bharatpur, Nepal, Rabin Bhattacharya| Department of Cardiology, College of Medical Sciences, Bharatpur, Nepal Corresponding Author: Mani Prasad Gautam, Bharatpur Hospital, Bharatpur, Nepal, Gangapatnam Subramanyam| Department of Cardiology, College of Medical Sciences, Bharatpur, Nepal Corresponding Author: Mani Prasad Gautam, Bharatpur Hospital, Bharatpur, Nepal
Keywords
Related Articles
- EP ID EP15769
- DOI http://dx.doi.org/10.3126/njh.v13i1.14539
- Views 351
- Downloads 18
Prevalence of Hypertension in Semi-Urban area of Nepal
Hypertension is one of the major cardiovascular problems in middle and low income countries. There are few studies conducted in Nepal which shows signifcant number of hypertensive population in suburban area. Systematic...
Study of the Side effects profle of different anthypertensive drugs among the Hypertensive patent
Hypertension is the leading cause of morbidity and mortality worldwide. Because hypertension is usually asymptomatc yet requires long term therapy, consideraton of potental of undesirable effects of drugs used for its...
Assessment of atrial septal defects rims on transesophageal echocardiogram at Shahid Gangalal National Heart Centre, Kathmandu, Nepal
Background and Aims: Transcatheter Atrial septal defects (ASD) closure has become the better alternative to surgical closure. Morphological variations of ASD are frequent. We aim to study the rims of ASD in Transesophag...
Multivessel primary PCI in patient with peripheral arterial disease
Thrombosis of multiple coronary arteries is extremely rare fnding in the setting of acute myocardial infarction. This often leads to cardiogenic shock and sudden cardiac death. We report a case of 61 years old gentleman...
Predictors of in-hospital mortality following mitral or double valve replacement for rheumatic heart disease
Backgrounds and Aims: Factors affecting outcome of mitral valve replacement in rheumatic population of Nepal is unknown. The aim of this study was to identify the predictors of in-hospital mortality in patients undergo...