| Research Abstract |
1. Although there were many reports indicating endothelia dysfunction in the cardiovascular diseases, its evaluation method has not been established in the clinical labortary medicine. The goals of the present study were 1)to establish the routine clinical method to evaluate the endothelium-dependent vasodilation(EDV), and 2)to study the endothelial function in life-style related diseases or coronary risk factors using this methods.
2. Forearm blood flow(FBF)was determined by strain-gauge plethysmography. EDV was evaluated as the increases in FBF in response to intra-arterial infusion of acetylcholine(invasive method)and to reactive hyperemia(noninvasive method).
3. In patients with essential hypertension(EHT), the both responses of FBF to acetylcholine and reactive hyperemia were attenuated. There was a positive and significant correlation between the results of invasive and noninvasive methods.
4. In EHT, EDV was improved by the antihypertensive treatment with ACE inhibitors, but not with calcium antagonists, diuretics or β-blockers. Regular aerobic exercise also improved EVD in EHT.
5. In obese patients with EHT, EVD was smaller than in lean patients. The body weight reduction by low calorie diet improved EVD in obese patients.
6. In postmenopausal women, EVD was attenuated, but improved by the estrogen replacement therapy.
7. In summary, endothelial function can be evaluated by the noninvasive measurements of EDV with reactive hyperemia. EDV was disturbed in EHT, obesity and postmenopausal women. Their disturbed EDV was improved by life style modification and the specific drug treatments.
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