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Endothelial dysfunction assessment by flow-mediated dilation in a high-altitude population

INTRODUCTION: Endothelial function at high altitude has been measured only in populations that are genetically adapted to chronic hypoxia. The objective of this study was to evaluate endothelial dysfunction (ED) in a nongenetically adapted high-altitude population of the Andes mountains, in Huancayo...

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Autores principales: Calderón-Gerstein, Walter S, López-Peña, Antonio, Macha-Ramírez, Raúl, Bruno-Huamán, Astrid, Espejo-Ramos, Roxana, Vílchez-Bravo, Stephany, Ramírez-Breña, María, Damián-Mucha, Milagros, Matos-Mucha, Adriana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701560/
https://www.ncbi.nlm.nih.gov/pubmed/29200863
http://dx.doi.org/10.2147/VHRM.S151886
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author Calderón-Gerstein, Walter S
López-Peña, Antonio
Macha-Ramírez, Raúl
Bruno-Huamán, Astrid
Espejo-Ramos, Roxana
Vílchez-Bravo, Stephany
Ramírez-Breña, María
Damián-Mucha, Milagros
Matos-Mucha, Adriana
author_facet Calderón-Gerstein, Walter S
López-Peña, Antonio
Macha-Ramírez, Raúl
Bruno-Huamán, Astrid
Espejo-Ramos, Roxana
Vílchez-Bravo, Stephany
Ramírez-Breña, María
Damián-Mucha, Milagros
Matos-Mucha, Adriana
author_sort Calderón-Gerstein, Walter S
collection PubMed
description INTRODUCTION: Endothelial function at high altitude has been measured only in populations that are genetically adapted to chronic hypoxia. The objective of this study was to evaluate endothelial dysfunction (ED) in a nongenetically adapted high-altitude population of the Andes mountains, in Huancayo, Peru (3,250 meters above sea level). METHODS: Participants included 61 patients: 28 cases and 33 controls. The cases were subjects with hypertension, diabetes mellitus, obesity, or a history of stroke or coronary artery disease. Flow-mediated vasodilation (FMD) of the brachial artery was measured in the supine position, at noon, after 5 minutes of resting. The brachial artery was identified above the elbow. Its basal diameter was measured during diastole, and FMD was tested after 5 minutes of forearm ischemia. Intima–media complex in the right carotid artery was also determined. An increase in the artery’s baseline diameter <10% indicated a positive test. Endothelium-independent vasodilation was evaluated with sublingual nitrate administration. The intima–media complex in the right carotid artery was also measured. RESULTS: 100% of diabetics had ED; ED was also found in 68.8% of obese individuals, 55% of hypertensive patients, and 46.5% of controls. Age, height, body mass index, and waist diameter were higher in the cases as compared with the controls. A total of 57.9% (n=11) of the cases and 45.2% (n=19) of the controls presented ED. Patients without ED had a mean increase in brachial artery diameter of 23.16%, while in those with ED it was only 3.84%. Individuals with diabetes or hypertension had a greater thickness of the carotid artery intima media layer (1.092 versus 0.664 cm) (p=0.037). A positive test for ED was associated with a greater basal diameter of the brachial artery (4.66±0.62 versus 4.23±0.59 cm) (p=0.02). A total of 7 patients presented paradoxical response, developing posthyperemia vasoconstriction. DISCUSSION: The proportion of ED was high among controls and among patients with risk factors. Controls showed better FMD profiles than subjects studied in Tibet and the Himalayas.
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spelling pubmed-57015602017-11-30 Endothelial dysfunction assessment by flow-mediated dilation in a high-altitude population Calderón-Gerstein, Walter S López-Peña, Antonio Macha-Ramírez, Raúl Bruno-Huamán, Astrid Espejo-Ramos, Roxana Vílchez-Bravo, Stephany Ramírez-Breña, María Damián-Mucha, Milagros Matos-Mucha, Adriana Vasc Health Risk Manag Original Research INTRODUCTION: Endothelial function at high altitude has been measured only in populations that are genetically adapted to chronic hypoxia. The objective of this study was to evaluate endothelial dysfunction (ED) in a nongenetically adapted high-altitude population of the Andes mountains, in Huancayo, Peru (3,250 meters above sea level). METHODS: Participants included 61 patients: 28 cases and 33 controls. The cases were subjects with hypertension, diabetes mellitus, obesity, or a history of stroke or coronary artery disease. Flow-mediated vasodilation (FMD) of the brachial artery was measured in the supine position, at noon, after 5 minutes of resting. The brachial artery was identified above the elbow. Its basal diameter was measured during diastole, and FMD was tested after 5 minutes of forearm ischemia. Intima–media complex in the right carotid artery was also determined. An increase in the artery’s baseline diameter <10% indicated a positive test. Endothelium-independent vasodilation was evaluated with sublingual nitrate administration. The intima–media complex in the right carotid artery was also measured. RESULTS: 100% of diabetics had ED; ED was also found in 68.8% of obese individuals, 55% of hypertensive patients, and 46.5% of controls. Age, height, body mass index, and waist diameter were higher in the cases as compared with the controls. A total of 57.9% (n=11) of the cases and 45.2% (n=19) of the controls presented ED. Patients without ED had a mean increase in brachial artery diameter of 23.16%, while in those with ED it was only 3.84%. Individuals with diabetes or hypertension had a greater thickness of the carotid artery intima media layer (1.092 versus 0.664 cm) (p=0.037). A positive test for ED was associated with a greater basal diameter of the brachial artery (4.66±0.62 versus 4.23±0.59 cm) (p=0.02). A total of 7 patients presented paradoxical response, developing posthyperemia vasoconstriction. DISCUSSION: The proportion of ED was high among controls and among patients with risk factors. Controls showed better FMD profiles than subjects studied in Tibet and the Himalayas. Dove Medical Press 2017-11-21 /pmc/articles/PMC5701560/ /pubmed/29200863 http://dx.doi.org/10.2147/VHRM.S151886 Text en © 2017 Calderón-Gerstein et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Calderón-Gerstein, Walter S
López-Peña, Antonio
Macha-Ramírez, Raúl
Bruno-Huamán, Astrid
Espejo-Ramos, Roxana
Vílchez-Bravo, Stephany
Ramírez-Breña, María
Damián-Mucha, Milagros
Matos-Mucha, Adriana
Endothelial dysfunction assessment by flow-mediated dilation in a high-altitude population
title Endothelial dysfunction assessment by flow-mediated dilation in a high-altitude population
title_full Endothelial dysfunction assessment by flow-mediated dilation in a high-altitude population
title_fullStr Endothelial dysfunction assessment by flow-mediated dilation in a high-altitude population
title_full_unstemmed Endothelial dysfunction assessment by flow-mediated dilation in a high-altitude population
title_short Endothelial dysfunction assessment by flow-mediated dilation in a high-altitude population
title_sort endothelial dysfunction assessment by flow-mediated dilation in a high-altitude population
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5701560/
https://www.ncbi.nlm.nih.gov/pubmed/29200863
http://dx.doi.org/10.2147/VHRM.S151886
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