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The article discusses a study on the long-term clinical outcomes in patients with critical limb ischemia (CLI), patients with atherosclerotic pepripheral arterial disease (PAD) and patients with Buerger disease who had bone-marrow mononuclear cell (BM-MNC) implantation and in CLI patients who had no BM-MNC implantation. CLI patients with severe rests pain and nonhealing ulcers were enrolled. It notes that BM-MNC implantation may prevent major amputation but patients with diabetes mellitus undergoing hemodialysis may not be eligible for cell therapy.

Thromboangitis obliterans (TAO; Buerger's disease) and atherosclerosis obliterans (ASO) are associated with endothelial dysfunction. The purpose of this study was to evaluate the role of circulating progenitor cells (CPCs) in endothelial function in patients with TAO and ASO. We measured flow-mediated vasodilation (FMD), nitroglycerine-induced vasodilation, and circulating CPCs in 30 patients with TAO and 30 age- and sex-matched healthy subjects and in 40 patients with ASO. FMD was smaller in both the TAO group and ASO group than in the control group (6.6 ± 2.7%, 5.7 ± 3.3% versus 9.5 ± 3.1%, P<0.0001, respectively). There was no significant difference in FMD between the TAO group and ASO group. Nitroglycerine-induced vasodilation was similar in the 3 groups. The number of and migration of circulating CPCs were similar in the TAO group and control group, whereas the number of and migration of circulating CPCs were significantly lower in the ASO group than in other groups (ASO 553 ± 297/mL versus TAO 963 ± 543/mL; control 1063 ± 426/mL and ASO 36 ± 18/hpf versus TAO 62 ± 23/hpf; control 68 ± 18/hpf, P<0.0001, respectively). There was a significant relationship between the number of and migration of CPCs and FMD (r = 0.43 and r = 0.40, P<0.0001, respectively). FMD was impaired in patients with TAO as well as in patients with ASO compared to that in normal control subjects, and the number of and function of circulating CPCs were not decreased in patients with TAO. These findings may partially explain why there are differences in cardiovascular morbidity and mortality rates between patients with TAO and patients with ASO. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension (HT) is the most common cause of cardiovascular diseases, and blood pressure control is very important. Limited information, however, is available concerning the prospective relation between UA and the risk of developing HT. Hypothesis: The aim of this study was to evaluate whether hyperuricemia or their combination predicts prevalence of HT. Methods: We evaluated 803 subjects (412 male subjects, 391 female subjects; mean age 46.7 years) who underwent health examination programs in 2008 and 2013, who were free of HT in 2008. Results: At baseline, hyperuricemia was detected in 105 male subjects (25.5%) and 14 female subjects (3.6%). 803 of 268 subjects developed hypertension for 5 years follow up.Subjects who had higher uric acid (HUA) was significantly higher prevalence of hypertension than those without. (30.7vs. 48.7%, P=0.0001) In the multivariable model, drinking more than one unit, age (more than 50 year), and hyperuricemia remained a significantly independent risk factors for hypertension. Even after adjusting confounding factors, for every 1mg/dl increase in Uric acid, the risk of hypertension was 26% increased. (Figure1) Conclusions: Hyperuricemia is a significant predictor of HT in rural Japanese subjects. [ABSTRACT FROM AUTHOR]

Objective: Nitroglycerine-induced vasodilation has been used as a control test for flow-mediated vasodilation (FMD) to differentiate endothelium-dependent from endothelium-independent response when evaluating endothelial function in humans. Recently, nitroglycerine-induced vasodilation has also been reported to be impaired in patients with atherosclerosis. The purpose of this study was to determine the relationships between nitroglycerine-induced vasodilation and cardiovascular risk factors., Approach and Results: We measured nitroglycerine-induced vasodilation and FMD in 436 subjects who underwent health examinations (mean age, 53 ± 19 years; age range, 19-86 years), including patients with cardiovascular diseases. There was a significant relationship between nitroglycerine-induced vasodilation and FMD (r=0.42; P<0.001). Univariate regression analysis revealed that nitroglycerine-induced vasodilation correlated with age (r=-0.34; P<0.001), systolic blood pressure (r=-0.32; P<0.001), diastolic blood pressure (r=-0.24; P<0.001), heart rate (r=-0.21; P<0.001), glucose (r=-0.23; P<0.001), and smoking pack-year (r=-0.12; P=0.01), as well as Framingham risk score (r=-0.30; P<0.001). Nitroglycerine-induced vasodilation was significantly smaller in patients with cardiovascular disease than in both subjects with and without cardiovascular risk factors (10.5 ± 5.6% versus 13.7 ± 5.4% and 15.3 ± 4.3%; P<0.001, respectively), whereas there was no significant difference in nitroglycerine-induced vasodilation between subjects with and without cardiovascular risk factors. Multivariate analysis revealed that male sex, body mass index, hypertension, diabetes mellitus, baseline brachial artery diameter, and FMD were independent predictors of nitroglycerine-induced vasodilation., Conclusions: These findings suggest that nitroglycerine-induced vasodilation may be a marker of the grade of atherosclerosis. FMD should be interpreted as an index of vascular function reflecting both endothelium-dependent vasodilation and endothelium-independent vasodilation in subjects with impaired nitroglycerine-induced vasodilation.

Objective: Cardiovascular diseases are associated with chronic activation of Rho-associated kinases (ROCKs) and endothelial dysfunction. Both increased ROCK activity and endothelial dysfunction are thought to be closely associated with conventional cardiovascular risk factors. The purpose of this study was to determine the relationships between ROCK activity, endothelial function, and cardiovascular risk factors., Methods and Results: We evaluated ROCK activity in peripheral leukocytes by Western blot analysis and flow-mediated vasodilation by ultrasonography in 242 men who had no cardiovascular or cerebrovascular diseases (mean age, 40±10 years; range, 20 to 73 years). ROCK activity was defined as the ratio of phospho myosin-binding subunit on myosin light chain phosphatase to total myosin-binding subunit. Univariate regression analysis revealed that leukocyte ROCK activity significantly correlated with body mass index (r=0.29, P=0.003); systolic blood pressure (r=0.25, P=0.01); low-density lipoprotein cholesterol level (r=0.21, P=0.04); and Framingham risk factor score, a cumulative cardiovascular risk index for heart attack (r=0.31, P<0.001), and that flow-mediated vasodilation significantly correlated with age (r=-0.23, P=0.02), body mass index (r=0.19, P=0.05), systolic blood pressure (r=-0.22, P=0.03), total cholesterol level (r=-0.21, P=0.04), low-density lipoprotein cholesterol level (r=-0.22, P=0.04), glucose level (r=-0.20, P=0.04), and Framingham risk factor score (r=-0.37, P<0.001). There was a significant correlation between leukocyte ROCK activity and flow-mediated vasodilation (r=-0.41, P<0.001). Multivariate analysis revealed that flow-mediated vasodilation was an independent predictor of leukocyte ROCK activity., Conclusions: These findings suggest that cumulative cardiovascular risk may enhance ROCK activity and endothelial dysfunction, leading to progression of cardiovascular diseases and outcomes.