ENDOTHELIAL DYSFUNCTION AND ITS DETERMINANTS: A COMPARATIVE ANALYSIS OF CLINICAL AND LIFESTYLE FACTORS IN HYPERTENSIVE ADULTS

Objective: To identify the main clinical, anthropometric, and lifestyle factors associated with endothelial dysfunction in hypertensive individuals by comparing groups based on endothelial function. Design and method: A cross-sectional study was conducted with hypertensive adults aged 18 to 59 years attending a referral center for hypertension treatment. The study protocol was reviewed and approved by the Research Ethics Committee under Opinion No. 6.035.042. The sample size was calculated considering 30% endothelial dysfunction and a 10% error, estimating 81 individuals. The dependent variable was flow-mediated dilation (FMD) categorized by endothelial function impairment, with normal values defined as above 10%. Independent variables included age, sex, race/color, smoking, alcohol consumption, diabetes, regular physical exercise, duration of hypertension diagnosis, waist circumference, body mass index, fasting blood glucose, glycated hemoglobin, total cholesterol, peripheral and central systolic and diastolic blood pressure, Augmentation Index (AIx@75%), and pulse pressure. Analysis was conducted using Stata software, applying parametric tests to compare means and chi-square/Fisher’s tests for categorical variables, with a significance level of 5%. Results: Endothelial dysfunction was identified in 66.7% (66) of participants. Those with endothelial dysfunction had a longer diagnosis duration (11.7 ± 7.9 years) compared to individuals with normal endothelial function (8.3 ± 6.1 years; p = 0.027) and engaged less frequently in regular physical exercise (11; 36.7%) than those with preserved function (37; 61.7%). Central diastolic blood pressure (DBP) was significantly higher in the endothelial dysfunction group (87.1 ± 15.0 mmHg) compared to the normal endothelial function group (80.7 ± 10.3 mmHg; p = 0.039). Other variables showed no association with endothelial function.Conclusions: The lack of regular physical exercise, longer diagnosis duration, and higher central diastolic blood pressure were associated with endothelial dysfunction among hypertensive adults under treatment. Interventions aimed at preventing hypertension, reducing blood pressure (especially central diastolic pressure), and promoting physical activity may be important for preserving vascular health and reducing cardiovascular risk.