Impaired endothelium-dependent vasodilation of forearm resistance vessels in hypercholesterolaemia

P. J. Chowienczyk*, G. F. Watts, J. R. Cockcroft, J. M. Ritter

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

463 Citations (Scopus)

Abstract

Endothelium-dependent vasodilation in response to acetylcholine is impaired in the coronary microvasculature of hypercholesterolaemic subjects. Outside the coronary circulation, however, it has been suggested that hypercholesterolaemia results in a functional abnormality of vascular smooth muscle rather than in endothelial dysfunction. We examined vasodilator responses to acetylcholine, methacholine, and the endothelium-independent vasodilator sodium nitroprusside in the forearm resistance vessels of 12 men with primary hypercholesterolaemia and 12 normocholesterolaemic male controls. Endothelium-dependent vasodilation in response to acetylcholine was impaired in hypercholesterolaemic patients compared with controls: at the highest dose of drug (15 μg per min) mean blood flow in the forearms of the hypercholesterolaemic group was only 52% (95% Cl 31-88%) of that in the control group. Responses to sodium nitroprusside and to methacholine in the two study groups were not significantly different. These results indicate that endothelial dysfunction in hypercholesterolaemic subjects is generalised and extends to vascular beds outside the coronary circulation. Selective impairment to acetylcholine suggests that, at a molecular level, the defect is limited to a specific pathway.

Original languageEnglish
Pages (from-to)1430-1432
Number of pages3
JournalThe Lancet
Volume340
Issue number8833
DOIs
Publication statusPublished - 12 Dec 1992

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