The Relationship Between Digital Vascular Function and Combination Hypertension Therapy in Patients with Newly Diagnosed Hypertension

Endothelial dysfunction plays a key role in cardiovascular diseases and hypertension is associated to endothelial dysfunction. Measuring digital vascular function through peripheral arterial tonometry is an innovative method to evaluate endothelial function. The aim of this study was to evaluate the changes in digital vascular function in hypertensive patients before and after anti-hypertension therapy. We recruited 54 newly diagnosed hypertensive patients and 40 normotensive participants. Among these 54 hypertensive patients, 29 received a complete 3 months combination anti-hypertension therapy with angiotensin-converting enzyme inhibitors (or angiotensin receptor antagonist) and calcium channel blockers. Their digital vascular function were evaluated through peripheral arterial tonometry before and after anti-hypertensive therapy and compared with the normotensive participants’ data. The percentage of endothelial dysfunction was nonsignificantly higher (13% V.S 7.9%, P .34) in hypertensive group than in normotensive group. After combination antihypertensive therapy, the reactive hyperemia indices (RHIs) of the majority of the patients (65%) improved albeit nonsignificantly (mean RHI before therapy 2.07 +/- 0.39, mean RHI after therapy 2.03 +/- 0.79, P=.825). However, the hyperemia ratio of 0.879 of the control arm was a significant predictor (P .0273 and 0.003 respectively) of the RHI response of after pharmacological therapy. The hypertensive patients showed a nonsignificant higher percentage of the endothelial dysfunction than did the normotensive participants. Combination therapy did not significantly improve RHI. A hyperemia ratio of 0.879 of the control arm was a significant predictor of the response of RHI after pharmacological therapy.