Hypertension and Injury

Klinik für Kardiologie, Pneumologie und Angiologie80 enrolled

Overview

Membrane microparticles are submicron fragments of membrane vesicles shed from various cell types. Circulating endothelial microparticles have been proposed as markers of endothelial injury. However, which mechanical forces contribute to their release is not clear.

In a first series subjects (50% hypertensives) with and without arterial hypertension and no Coronary Artery Disease (CAD) (n=50) will be recruited. MP subpopulations will be discriminated by flow cytometry according to the expression of established surface antigens including CD31+/41-, CD144+, and CD62e+. Besides office and ambulatory 24h blood pressure measurements, pulse wave analysis will be performed to determine central blood pressure, augmentation index (AIX), and pulse wave velocity. Endothelial function (Flow-mediated dilation, FMD), arterial pulsatile stretch (fractional diameter changes, FDC), and wall-shear-stress (WSS) will be measured in the same segment of the brachial artery (BA) by ultrasound. In a second series, the investigators will take measurements in subjects with hypertensive crises (SBP\>180 mmHg) (n=20) before and after 4h and normalization of arterial BP by urapidil. In a third series, the investigators will take measurement in subjects with stable CAD (n=10) before and after transfemoral coronary diagnostic angiography.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Arterial Hypertension CAD

Eligibility

Sex: MALEMin age: 50 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * male subjects with or without arterial hypertension, hypertensive crises, stable CAD * written informed consent Exclusion Criteria: * subjects with manifest peripheral artery, or cerebrovascular disease, acute inflammation (CRP\>0.6 mg/dl), malignancies, arrhythmias

Locations (1)

Division of Cardiology, Pulmonology and Vascular Medicine Duesseldorf,

Düsseldorf, North Rhine-Westphalia, Germany

Outcomes

Primary Outcomes

endothelial function

endothelial function measured by flow-mediated dilation (FMD) for Subgroup 1 and 2

Time frame: Baseline

Changes in endothelial function

endothelial function measured by flow-mediated dilation (FMD) for Subgroup 3

Time frame: Baseline and after 4 hours

Changes in endothelial function

endothelial function measured by flow-mediated dilation (FMD) for Subgroup 4 before and after transfemoral coronary diagnostic angiography

Time frame: Baseline and 4 hours after procedure

Secondary Outcomes

Microparticle

Microparticles (CD31+/41-, CD144+, and CD62e+) will be discriminated by flow cytometry for Subgroup 1 and 2

Time frame: Baseline

Changes in Microparticle

Microparticles (CD31+/41-, CD144+, and CD62e+) will be discriminated by flow cytometry for Subgroup 3

Time frame: Baseline and after 4 hours

Changes Microparticle

Microparticles (CD31+/41-, CD144+, and CD62e+) will be discriminated by flow cytometry for Subgroup 4 before and after transfemoral coronary diagnostic angiography

Time frame: Baseline and 4 hours after procedure

Wall Shear Stress

measured by ultrasound in brachial artery for Subgroup 1 and 2

Time frame: Baseline

Changes in Wall Shear Stress

Data from ClinicalTrials.gov

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