Endothelial dysfunction indicates target organ damage in hypertensive patients. The integrity of endothelial glycocalyx (EG) plays a vital role in vascular permeability, inflammation and elasticity, and finally to cardiovascular disease. The authors aimed to investigate the role of increased HDL cholesterol (HDLâC) levels, which usually are considered protective against cardiovascular disease, in EG integrity in older hypertensive patients. The authors studied 120 treated hypertensive patients older than 50 years were divided regarding HDLâC tertiles in group HDLH (HDLâC â„ 71 mg/dL, upper HDLâC tertile) and group HDLL (HDLâC < 71 mg/dL, two lower HDLâC tertiles). Increased perfusion boundary region (PBR) of the sublingual arterial microvessels (ranging from 5 to 9 ”m) using Sideview Darkfield imaging (Microscan, Glycocheck) was measured as a nonâinvasive accurate index of reduced EG thickness. PBR 5â9 was significantly decreased in group HDLH (P = 0.04). In the whole population, HDLâC was inversely but moderately related to PBR 5â9 (r = â0.22, P = 0.01). In a multiple linear regression analysis model, using age, BMI, smoking habit, HDLâC, LDLâC, and office SBP, as independent variables, the authors found that BMI (ÎČ = 0.25, P = 0.006) independently predicted PBR 5â9 in the whole population. In older hypertensive patients, HDLâC ranging between 71 and 101 mg/dL might moderately protect EG and subsequently endothelial function. Future studies in several groups of lowâ or highârisk hypertensives are needed in order to evaluate the beneficial role of extremely elevated HDLâC regarding cardiovascular risk evaluation as well as endothelial glycocalyx as a novel index of target organ damage in essential hypertension.
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