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Predictive value of endothelial dysfunction: a call to action Lorenzo Ghiadoni a and Guido Grassi b,c

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A

ssessment of subclinical target organ damage (TOD), including left ventricular mass index, carotid intima-media thickness (IMT) or plaque, carotid-to-femoral pulse wave velocity (cf-PWV), plasma creatinine and microalbuminuria, is recommended in hypertensive patients for a better characterization of their cardiovascular risk profile [1]. Earlier vascular alterations, such as endothelial dysfunction, have been also suggested for their potential use for risk prediction. Indeed, endothelium plays a pivotal role in vascular pathophysiology and impaired brachial artery flow-mediated dilation, the most widely used noninvasive method to detect endothelial dysfunction, might integrate the long-lasting cumulative effects of risk factors being detected when interventions may be still very effective [2]. In the present issue of the Journal of Hypertension, Yang et al. [3] evaluated the ability of brachial artery flow-mediated dilation to predict TOD progression in 199 patients with essential hypertension over a 3-year follow-up. Patients were divided according to baseline flow-mediated dilation in those with normal (10%) or impaired (

Predictive value of endothelial dysfunction: a call to action.

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