The Correlation Between Arterial Hypertension and Endothelial Function

Arterial hypertension is defined by a stable increase in systemic arterial blood pressure (BP) values, i.e. systolic value of 140 mmHg or more and/or diastolic one of 90 mmHg or more. Its prevalence is about 30–45% of the general population; representing a well-known cardiovascular (CV) risk factor [1]. In addition to BP values, the assessment of target organ damage has a pivotal role in stratification of total CV risk of patients. Current guidelines for the management of arterial hypertension suggest several tools for evaluating hypertensionrelated asymptomatic organ damage, such as ectrocardiography,   echocardiography, vascular ultrasound examination (carotid wall thickening or plaque, carotid-femoral pulse wave velocity, anklebrachial index), and estimated glomerular filtration rate and micro albuminuria for study of renal function. However, these techniques are able to detect a already established structural lesion, while, on the other hand, the evaluation of early phases of atherosclerosis is crucial in primary CV prevention. Endothelial dysfunction represents the earliest stage of atherosclerosis, occurring before the evidence of morphological vascular alterations at Doppler ultrasonography and angiography [2]. Its impairment is able to significantly predict CV events independently of traditional risk factors [3], as well as the recovery of endothelial function predicts the increase in CV eventfree survival [4].