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. 2018 May;20(5):935-941.
doi: 10.1111/jch.13269. Epub 2018 Mar 31.

Association of endothelial dysfunction with cardiovascular risk factors and new-onset diabetes mellitus in patients with hypertension

Cristina Bergmann Triches  1 , Saurus Mayer  2 , Beata Marie Redublo Quinto  2 , Marcelo Costa Batista  2   3 , Maria Teresa Zanella  1
Affiliations

Association of endothelial dysfunction with cardiovascular risk factors and new-onset diabetes mellitus in patients with hypertension

Cristina Bergmann Triches et al. J Clin Hypertens (Greenwich). 2018 May.

Abstract

Asymmetric dimethylarginine (ADMA), which is the main endogenous inhibitor of nitric oxide synthase, plays a critical role in the process of endothelial dysfunction. The authors evaluated the association between high plasma ADMA levels in patients with hypertension and the presence of cardiovascular risk factors and the development of type 2 diabetes mellitus (DM) and cardiovascular outcomes, including death. The authors evaluated 191 patients with hypertension who were stratified into two groups according to the median value of basal ADMA: those with high levels of plasma ADMA (>0.55 μmol/L) and low levels of plasma ADMA (≤0.55 μmol/L) who were prospectively evaluated over 5.8 years. High ADMA levels were seen in patients with higher weight, body mass index, waist circumference, triglycerides, uric acid, and high-sensitivity C-reactive protein, and lower levels of high-density lipoprotein cholesterol and in patients with type 2 DM. There was an association between high plasma ADMA levels and the occurrence of cardiovascular death. In a subgroup of patients with hypertension free from metabolic syndrome and DM at baseline, there was an association between high ADMA levels and the development of type 2 DM. This study confirms the association of high plasma ADMA levels and the presence of cardiovascular risk factors in patients with hypertension and suggests a positive predictive value of high plasma ADMA levels for cardiovascular death in patients with hypertension and also for the development of type 2 DM in a subgroup of patients with hypertension free from metabolic abnormalities.

Keywords: asymmetrical dimethylarginine; cardiovascular death; cardiovascular disease; cardiovascular risk factors; metabolic syndrome; type 2 diabetes mellitus.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Mean plasma asymmetric dimethylarginine (ADMA) level according to the number of metabolic syndrome (MS) factors
Figure 2
Figure 2
Cardiovascular death according to baseline plasma asymmetric dimethylarginine (ADMA) level
Figure 3
Figure 3
Development of type 2 diabetes mellitus (DM) in patients free from metabolic syndrome (MS) and DM at baseline
See this image and copyright information in PMC

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