ABSTRACT
Hypertension and central obesity are two conditions closely linked, but the mechanisms responsible for obesity-associated hypertension are still unclear. In the last few years, several studies addressed the role of endothelin-1 (ET-1) in the development and maintenance of hypertension. This study was designed to evaluate plasma ET-1 in normotensive and hypertensive central obese subjects compared with a lean healthy group. Our final goal was to analyze the relationship between plasma ET-1, blood pressure, and left ventricular structure and function in central obese subjects (both normotensives and hypertensives). ET-levels have been assessed by the radioimmunoassay method in 20 lean normotensives and in 57 central obese subjects; 30 of them were hypertensives and 27 of them were normotensives. Twenty-four-hour mean blood pressure (MBP/24 h) by noninvasive ambulatory blood pressure monitoring, left ventricular mass/ height (LVM/H), and left ventricular ejection fraction (LVEF) by echocardiography and peak filling rate (PFR) by radionuclide study were also measured. ET levels were significantly (P < .05) higher in obese hypertensives and obese normotensives than in lean normotensives. In addition, ET levels were significantly (P < .05) higher in obese hypertensives than in obese normotensives. ET were directly related to LVM/ H (r = 0.86; P < .001) and MBP/24 h (r = 0.48; P < .009) but only in obese hypertensives. Multiple regression analysis indicated that ET-1 plasma levels remain an independent predictor of MBP/ 24 h and LVM/H also when age was included in the analysis. These data suggest that obesity-associated hypertension is characterized by an endothelial dysfunction that may contribute to the higher cardiovascular risk detectable in these patients.
Subject(s)
Endothelin-1/blood , Hypertension/complications , Obesity, Morbid/complications , Adult , Blood Pressure Monitoring, Ambulatory , Body Constitution , Body Height , Body Mass Index , Echocardiography , Female , Heart Rate , Humans , Hypertension/blood , Hypertension/physiopathology , Male , Obesity, Morbid/blood , Obesity, Morbid/physiopathology , Radioimmunoassay , Radionuclide Angiography , Regression Analysis , Stroke Volume , Ventricular Dysfunction, Left/complications , Ventricular Dysfunction, Left/diagnosis , Ventricular Dysfunction, Left/physiopathologyABSTRACT
40 patients were evaluated for skin temperature changes from baseline measurements and after 6 mg subcutaneous sumatriptan administration. During examination, skin temperature were recorded on a color picture at 10', 20', 30', 60', 90' and 120 minutes after sumatriptan administration. At the some time, heart rate (HR), systolic (SBP), diastolic (BDP) blood pressure and ECG-monitoring were automatically recorded. The patients were subgrouped as follow: 20 non migrainous control subjects (6 males and 14 females) aged 19 to 55 years (mean age 39.5 +/- 15.4); 20 headache free migrainous patients (6 males and 14 females) aged 25 to 46 years (mean age 37.8 +/- 8.4). Our data demonstrate a significant reduction in skin temperature (face) in all patients studied. 10 minutes after sumatriptan administration a significant increase (p > 0.001) both in SBP and BDP was observed. This findings suggest that sumatriptan show a vasoconstrictor effect as demonstrate by reduction in face temperature both in nonmigrainous and in migrainous patients. The unchange in HR and ECG and the transient increase in blood pressure, not associated with clinical symptoms, suggest that this drug may be used in migrainous patients.
