Patients presenting classical cardiovascular risk factors within acceptable or average value ranges often develop cardiovascular disease, suggesting that other risk factors need to be considered. Considering that endothelial progenitor cells (EPC) contribute to endothelial repair, we investigated whether EPC might be such a factor. We compared the ability of peripheral blood EPC to attach to extracellular matrix proteins, and to grow and function in culture, between controlled-hypertensive patients exhibiting Framingham scores (FS)<10% while displaying severe vascular impairment (intima-media thickness/diameter, carotid-femoral pulse wave velocity, brachial artery flow-mediated dilation, carotid and femoral atherosclerotic plaque presence) (Vulnerable group, N=30), and those with FS≥10% and scarce vascular changes (Protected group, N=30). In Protected patients early- and late-EPC, and early- and late-tunneling nanotube (TNT) numbers were significantly higher versus Vulnerable patients. Significant negative associations were found between vascular damage severity and early-EPC, late-EPC, or late-TNT numbers, whereas EPC or TNT numbers and patient´s characteristics or cardiovascular risk factors were not associated. Except for Protected patients, in all controlled-hypertensive patients early- and late-EPC and early- and late-TNT counts were significantly lower than in the Normotensive subjects studied (N=30). We found that the disparity in vascular status between patients presenting both FS≥10%/scarce vascular changes and those displaying both FS<10%/severe vascular impairment, is related to differences in peripheral blood EPC and TNT numbers. These observations support the role of EPC as contributors to vascular injury repair, and suggest that EPC numbers may be a potential cardiovascular risk factor to be included in FS calculation.

中文翻译：

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血压控制不足以使祖细胞对内皮的修复正常化。

表现出经典心血管危险因素在可接受范围或平均值范围内的患者通常会发展为心血管疾病，这表明需要考虑其他危险因素。考虑到内皮祖细胞（EPC）有助于内皮修复，我们调查了EPC是否可能是这种因素。我们比较了表现出Framingham得分（FS）<10％但表现出严重血管损伤（内膜中膜厚度/直径，内膜中层厚度，直径，颈股脉搏波速度，肱动脉血流介导的扩张，颈动脉和股动脉粥样硬化斑块的存在（脆弱组，N = 30）以及FS≥10％且血管变化少的患者（受保护组，N = 30）。在受保护的患者中，早期EPC和晚期EPC以及早期和晚期隧穿纳米管（TNT）的数量明显高于易受伤害的患者。在血管损伤严重程度与早期EPC，晚期EPC或晚期TNT数目之间发现显着的负相关性，而EPC或TNT数目与患者的特征或心血管危险因素则无关。除受保护的患者外，在所有控制性高血压患者中，早期和晚期EPC计数以及早期和晚期TNT计数均显着低于所研究的正常血压受试者（N = 30）。我们发现，同时出现FS≥10％/稀少的血管改变和同时出现FS <10％/严重血管损害的患者之间的血管状态差异与外周血EPC和TNT数量的差异有关。