Background Atrial fibrillation (AF) and hypertension commonly co-exist and both are associated with endothelial dysfunction. A key consequence of normal endothelial function in vivo is the ability to release nitric oxide (NO) in response to physiological stimuli, such as increased flow, reflecting flow-dependent endothelium-mediated dilatation (FMD). FMD measurement using a high-resolution ultrasound has become a reliable and reproducible technique for assessment of endothelial dysfunction.
Purpose To investigate whether endothelium-dependent FMD is more abnormal in patients with AF and hypertension when compared to hypertension alone.
Design In a cross-sectional comparison, we studied two patient groups: AF and hypertension (n = 61) and hypertension control group (n = 33). High-resolution ultrasound was used to measure brachial artery diameter at rest and during reactive hyperaemia (endothelium-dependent FMD). Data was analysed using SPSS software.
Results Participants were matched for age, sex and body mass index (BMI). There was no significant difference in FMD between permanent AF and hypertension group and hypertension control group (4.6%, 95% confidence interval (CI) [2.6 – 5.9] vs 2.6%, 95% CI [1.9 – 5.3]; p = 0.25). No variables were identified on univariate analysis and only heart rate was identified on multivariate analysis as an independent predictor of FMD (p = 0.04).
Conclusions First study investigating FMD in patients with permanent AF and hypertension together to assess whether presence of AF worsens the endothelial dysfunction seen in patients with hypertension. Endothelium-dependent FMD is impaired in patients with AF and hypertension. The presence of AF does not incrementally worsen endothelial dysfunction, nor was AF an independent predictor of endothelial dysfunction on multivariate analysis.
Conflict of Interest undefined
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