Journal of Hypertension

Skip Navigation LinksHome > August 2001 - Volume 19 - Issue 8 > Blood pressure, endothelial function and circulating endothe...
Journal of Hypertension:
Original papers: Endothelium

Blood pressure, endothelial function and circulating endothelin concentrations in liver transplant recipients

Cífková, Renataa; Pit'ha, Jana; Trunecuka, Pavelb; Lánská, Vera; Jindra, Antonínd; Plásuková, Markétaa; Peterková, Ludmilaa; Hrncuárková, Halimab; Horký, Kareld

Collapse Box

Abstract

Objectives: To study candidates for liver transplant before and 6 weeks after transplant, and to elucidate the role of endothelial dysfunction and plasma endothelin concentrations in the development of hypertension.

Design: Prospective follow-up study.

Setting: Institutional, outpatient.

Patients and controls: Fifteen patients (11 men, four women, mean age 46.7 ± 13.2 years) with end-stage liver disease (ESLD) and healthy volunteers of comparable age and sex.

Methods: We performed office blood pressure readings and 24 h ambulatory blood pressure monitoring (ABPM), measurements of endothelial-dependent vasodilatation using high-resolution ultrasound in the brachial artery at rest and during reactive hyperemia, and plasma endothelin-1 assays 3 months before and 6 weeks after the transplant.

Results: Office systolic and diastolic blood pressures increased significantly 6 weeks after liver transplantation (from 116.6 ± 14.1 to 139.9 ± 19.5 mmHg and from 68.6 ± 9.5 to 84.1 ± 9.8 mmHg, respectively; both P < 0.001). Hypertension based on office blood pressure readings increased from 6.7 to 40% (P < 0.05). Mean 24 h systolic blood pressure increased from 118.7 ± 10.3 to 140.0 ± 19.0 mmHg (P < 0.001), mean 24 h diastolic blood pressure increased from 86.0 ± 7.7 to 104.8 ± 13.9 mmHg (P < 0.001) and heart rate increased from 74.8 ± 10.2 to 80.2 ± 8.2 beats/min (P < 0.05). Brachial artery flow-mediated dilatation did not change throughout the study (before transplant: 4.2 ± 4.0%; after transplant: 6.3 ± 5.4%; NS) and did not differ from that in controls (5.2 ± 3.8%). Plasma endothelin-1 was increased in patients with ESLD (15.3 ± 2.6 pg/ml) compared with controls (5.6 ± 0.4 pg/ml; P < 0.001) and remained unchanged 6 weeks after liver transplantation (14.1 ± 3.7 pg/ml).

Conclusion: Our results show increased blood pressure with suppressed circadian blood pressure variability in liver graft recipients 6 weeks after transplant and no change in endothelial function and plasma endothelin concentrations. Therefore, the blood pressure increase documented in our study cannot be explained by endothelial dysfunction. Twenty-four hour ABPM should be performed routinely in patients who have undergone liver transplant.

© 2001 Lippincott Williams & Wilkins, Inc.

Login

Article Tools

Share

Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.