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Introduction:Previously, we developed a new device for automatic measurement of flow-mediated vasodilation (FMD) using an oscillometric method. The name of this device is enclosed zone flow-mediated vasodilation (ezFMD). Cardiovascular risk factors are associated with impaired endothelial function measured by FMD. However, there is no information on the relationships between endothelial function measured by ezFMD and cardiovascular risk factors.Methods:We measured ezFMD in 252 subjects who underwent health examinations in Hiroshima University hospital. We investigated cross-sectional associations between ezFMD and cardiovascular risk factors.Results:Univariate regression analysis revealed that ezFMD was significantly correlated with age (r=-0.43, P<0.001), glucose (r=-0.23, P=0.02), smoking pack-years (r=-0.17, P=0.01), high-sensitivity C-reactive protein (r=-0.27, P=0.02), and Framingham risk score (r=-0.24, P=0.005). Endothelial function measured by ezFMD was significantly correlated with conventional FMD (r=0.54, P<0.001). ezFMD was significantly smaller in the at-low risk group (subjects with only 1 cardiovascular risk factor), the at-high risk group (subjects with at least 2 cardiovascular risk factors), and cardiovascular disease group than in the no risk group (no-risk group, 39.8?15.6% vs. at-low risk group, 31.9?17.3%, P=0.01; at-high risk group, 27.0?13.8%, P<0.001; cardiovascular disease group, 20.1?14.7%, P<0.001).Conclusions:ezFMD may be useful marker of endothelial function. ezFMD may be an appropriate marker for detecting asymptomatic subjects at an early stage of atherosclerosis.

Introduction:Cohort studies have shown that an extremely high high-density lipoprotein cholesterol (HDL-C) group had high mortality and morbidity rates of cardiovascular disease and that there was a U-shaped curve between HDL-C levels and mortality and morbidity rates of cardiovascular disease. It is likely that HDL-C is a double-edged sword for atherosclerosis.Hypothesis:We assessed the hypothesis that extremely high HDL-C levels are associated with endothelial dysfunction.Methods:This was a cross-sectional study. We evaluated flow-mediated vasodilation (FMD) and serum levels of HDL-C in 5842 men aged 18 to 92 years who were not receiving lipid-lowering therapy. All participants were divided into four groups by HDL-C level: low HDL-C (<40 mg/dL), moderate HDL-C (40 to 59 mg/dL), high HDL-C (60 to 79 md/dL), and extremely high HDL-C (?80 mg/dL). We were not able to evaluate the amount of alcohol intake since there was limited information on the amount of alcohol drinking in our data base.Results:FMD values were significantly smaller in the low group and the extremely high group than in the high group (P=0.001 and P=0.016, respectively). There was no significant difference in FMD between the low group and the extremely high group. Multiple logistic regression analysis revealed that extremely high HDL-C, but not low HDL-C, was independently associated with a lower quartile of FMD (OR: 1.39, 95% CI: 1.09-1.77; P=0.009).Conclusions:An extremely high level of HDL-C in men (8.1% of this population) was associated with a significant reduction in FMD.

Background and Aims:Primary aldosteronism is the most common cause of secondary hypertension. It is well known that the incidence of cardiovascular events is higher in patients with primary aldosteronism than in patients with essential hypertension. In a previous study, we have shown that aldosterone-producing adenoma is associated with vascular function and structure. The aims were to evaluate the effects of eplerenone on vascular function in the microvasculature and microvasculature, aortic stiffness and Rho-associated kinase (ROCK) activity in patients with idiopathic hyperaldosteronism (IHA).Methods:Vascular function, including reactive hyperemia index (RHI), flow-mediated vasodilation (FMD) and nitroglycerine-induced vasodilation (NID), aortic stiffness including brachial-ankle pulse wave velocity (baPWV) and ROCK activity in peripheral leukocytes were measured before and after 12 weeks of treatment with eplerenone in 50 patients with IHA.Results:After 12 weeks, eplerenone decreased aldosterone renin ratio but did not alter systolic and diastolic blood pressure. Eplerenone treatment increased Log RHI from 0.56?0.25 to 0.69?0.25 (P<0.01) and NID from 12.8?5.8% to 14.9?6.9% (P=0.02), and decreased baPWV from 1540?263 to 1505?281 (P=0.04) and ROCK activity from 1.20?0.54 to 0.89?0.42 (P<0.01), while FMD was not altered from 4.6?3.4% to 4.6?3.6% (P=0.99).Conclusions:Eplerenone improves microvascular endothelial function, vascular smooth muscle function, aortic stiffness and ROCK activity in patients with IHA.