Hypertension and Injury

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Hypertension, Endothelial Microparticle Release, and Endothelial Function: Role of Pressure, Shear, and Stretch

Conditions
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Arterial Hypertension, CAD

Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| male subjects with arterial hypertension<br>Measurements will be taken at baseline. | |
| male subjects without arterial hypertension and no CAD<br>Measurements will be taken at baseline. | |
| male subjects with hypertensive crises<br>Measurements will be taken before and after 4 hours and normalization of arterial blood pressure by urapidil. | |
| male subjects with stable CAD<br>Measurements will be taken before and after transfemoral coronary diagnostic angiography. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| endothelial function | endothelial function measured by flow-mediated dilation (FMD) for Subgroup 1 and 2 | Baseline | 
| Changes in endothelial function | endothelial function measured by flow-mediated dilation (FMD) for Subgroup 3 | 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 | Baseline and 4 hours after procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Microparticle | Microparticles (CD31+/41-, CD144+, and CD62e+) will be discriminated by flow cytometry for Subgroup 1 and 2 | Baseline | 
| Changes in Microparticle | Microparticles (CD31+/41-, CD144+, and CD62e+) will be discriminated by flow cytometry for Subgroup 3 | 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 | Baseline and 4 hours after procedure | 
| Wall Shear Stress | measured by ultrasound in brachial artery for Subgroup 1 and 2 | Baseline | 
| Changes in Wall Shear Stress | measured by ultrasound in brachial artery for Subgroup 3 | Baseline and 4 hours | 
| Changes in Wall Shear Stress | measured by ultrasound in brachial artery for Subgroup 4 before and after transfemoral coronary diagnostic angiography | Baseline and 4 hours after procedure | 
| changes in fractional diameter (FDC) | measured by ultrasound in brachial artery for Subgroup 1 and 2 | Baseline | 
| changes in fractional diameter (FDC) | measured by ultrasound in brachial artery for Subgroup 3 | Baseline and after 4 hours | 
| Changes in fractional diameter (FDC) | measured by ultrasound in brachial artery for Subgroup 4 before and after transfemoral coronary diagnostic angiography | Baseline and 4 hours after procedure | 
| pulse wave velocity | measured for Subgroup 1 and 2 | Baseline | 
| Changes in pulse wave velocity | measured for Subgroup 3 | Baseline and after 4 hours | 
| Changes in pulse wave velocity | measured for Subgroup 4 before and after transfemoral coronary diagnostic angiography | Baseline and 4 hours after procedure | 
| augmentation index | measured for Subgroup 1 and 2 | baseline | 
| Changes in augmentation index | measured for Subgroup 3 | Baseline and after 4 hours | 
| Changes in augmentation index | measured for Subgroup 4 before and after transfemoral coronary diagnostic angiography | Baseline and 4 hours after procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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arterial hypertension, microparticle, endothelial function