Document Detail


African Americans with LVH demonstrate depressed sensitivity of the coronary microcirculation to stimulated relaxation.
MedLine Citation:
PMID:  12913059     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Excess coronary heart disease morbidity and mortality among African Americans remains an important yet unexplained public health problem. We hypothesized that adverse outcome is in part due to intrinsic or acquired abnormalities in coronary endothelial function and vasoreactivity. We compared dose-response curves relating changes in coronary blood flow and epicardial diameter to graded infusions of acetylcholine in 50 African American and 65 white subjects with hypertensive left ventricular hypertrophy (LVH) and normal coronary arteries. These groups were similar for age, body mass index, mean arterial pressure, and indexed left ventricular mass. The same protocol was conducted in 24 normotensive African American and 56 similar white subjects. We found significant depression in the coronary blood flow dose-response curve relation among African Americans when compared with white subjects with similar LVH (P<0.03). Racial differences were observed at all doses of acetylcholine but were less precisely estimated at the highest dose. The same testing among normotensive subjects revealed similar dose-response curves with no significant effect of race. Qualitatively similar results were found with respect to coronary diameter. Adenosine responses, a measure of endothelium-independent function, were similar after partitioning by LVH. Our study demonstrates that there are racial differences in sensitivity of coronary arteries to acetylcholine-stimulated relaxation among those with LVH. These results provide a mechanism whereby racial differences in coronary vasoreactivity might contribute to adverse coronary heart disease outcome among African Americans, a group in whom LVH is prevalent.
Authors:
Jan Laws Houghton; David S Strogatz; Mikhail T Torosoff; Vivienne E Smith; Steven A Fein; Patricia A Kuhner; Edward F Philbin; Albert A Carr
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.     Date:  2003-08-11
Journal Detail:
Title:  Hypertension     Volume:  42     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-09-05     Completed Date:  2004-02-05     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  269-76     Citation Subset:  IM    
Affiliation:
Division of Cardiology, A-44, Albany Medical College, 47 New Scotland Ave, Albany, NY 12208, USA. Houghtj@mail.amc.edu
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MeSH Terms
Descriptor/Qualifier:
Acetylcholine / diagnostic use,  pharmacology
Adult
African Americans*
Analysis of Variance
Coronary Circulation*
Echocardiography
Endothelium, Vascular / physiopathology
European Continental Ancestry Group
Female
Humans
Hypertension / complications
Hypertrophy, Left Ventricular / complications,  ethnology*,  physiopathology*
Male
Middle Aged
Myocardial Ischemia / diagnosis,  ultrasonography
Social Class
Vascular Resistance / drug effects
Vasodilation / drug effects
Grant Support
ID/Acronym/Agency:
HL50262/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
51-84-3/Acetylcholine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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