Target organ damage (TOD) evaluation in patients with arterial hypertension is necessary in order to estimate cardiovascular risk (CVR) and plan treatment. Increased carotid intima-media thickness (IMT), an index of TOD, represents the diffuse vascular atheromatosis. The integrity of endothelial glycocalyx (EG) plays a vital role in vascular permeability, inflammation and elasticity and finally to cardiovascular disease. Sideview Darkfield imaging allows for non-invasive automated estimation of EG dimensions based on the erythrocyte column distribution. We aimed to investigate any differences in EG levels in untreated patients with essential hypertension.Design and method:
We studied 86 patients with newly diagnosed and never treated essential hypertension (mean age 53 + 7 years, 53 males). Increased perfusion boundary region (PBR) of the sublingual arterial microvessels (ranged from 5–25 micrometers) using Sideview Darkfield imaging (Microscan, Glycocheck) was measured as a non-invasive accurate index of reduced EG thickness. We estimated carotid intima-media thickness using carotid ultrasonography (normal levels IMT < 0.8 mm).Results:
The whole population was divided in two groups regarding IMT levels, group A (IMT < 0.8 mm, n = 30, mean age 52 + 7 years, 17 males) and group B (IMT > 0.8 mm, n = 56, mean age 54 + 7 years, 36 males). Group A and B were also matched for age and sex. No differences were found within groups regarding 24 h systolic and diastolic ABPM as well as PBR 5–25, PBR 10–19 and PBR 20–25. We found that PBR 5–9 was increased in group B (1.19 + 0.1 vs. 1.13 + 0.1, p = 0.04) compared with group A.Conclusions:
EG dimensions are reduced in hypertensive patients with augmented cardiovascular risk. Further studies are needed to confirm our results in a larger population and possibly establish EG measurement as a new cardiovascular risk marker.