Flow-mediated dilation showed marked endothelial dysfunction in both conditions, with greater impairment in atherosclerosis (SMD -0.92; 95% CI -1.07 to -0.77) than hypertension (SMD -0.72).
Meta-Analysis
Is flow-mediated dilation (FMD) more impaired in adults with atherosclerosis compared to those with hypertension?
Endothelial dysfunction, as measured by flow-mediated dilation, is significantly impaired in both hypertension and atherosclerosis, with a greater degree of impairment observed in atherosclerosis.
Effect estimate: SMD -0.92 (atherosclerosis) vs SMD -0.72 (hypertension) (95% CI -1.07 to -0.77 (atherosclerosis); -0.83 to -0.62 (hypertension))
ABSTRACT Background: Flow-mediated dilation (FMD) is a key noninvasive method for assessing endothelial function, an important factor in both hypertension and atherosclerosis. However, the relative extent of impairment across these two conditions remains uncertain. Objectives: To compare endothelial-dependent vasodilation in adults with hypertension and atherosclerosis and to assess heterogeneity, reporting bias, and certainty of evidence. Methods: This paper used Preferred Reporting Items (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 as a guideline to conduct a systematic review and meta-analysis. The searches were conducted in PubMed, Embase, and the Cochrane Library until September 2025. Qualified studies were human based (participants aged ≥18 years), had reported FMD, and had sufficient data to be analyzed. The effect sizes were pooled using a random-effects model with the help of the R software (version 4.4.1) using metafor package. Results: Fourteen articles were found to have passed the inclusion criteria. Standardized mean differences (SMDs) that were pooled showed an impaired FMD in both conditions but more in atherosclerosis (SMD − 0.92, 95% confidence interval CI −1.07 to − 0.77) than in hypertension (SMD − 0.72, 95% CI − 0.83 to − 0.62). Heterogeneity was none ( I 2 = 0%) with hypertension and moderate ( I 2 = 55) with atherosclerosis, and there was low evidence of publication bias (Egger P > 0.1). Conclusion: Both hypertension and atherosclerosis are characterized by marked endothelial dysfunction, with a trend toward greater impairment in atherosclerosis. Future research should prioritize the standardization of FMD protocols to improve comparability across studies.
Madaniah Omar Zakari (Tue,) conducted a meta-analysis in Hypertension and atherosclerosis. Atherosclerosis vs. Hypertension was evaluated on Endothelial-dependent vasodilation assessed by flow-mediated dilation (FMD) (SMD -0.92 (atherosclerosis) vs SMD -0.72 (hypertension), 95% CI -1.07 to -0.77 (atherosclerosis); -0.83 to -0.62 (hypertension)). Flow-mediated dilation showed marked endothelial dysfunction in both conditions, with greater impairment in atherosclerosis (SMD -0.92; 95% CI -1.07 to -0.77) than hypertension (SMD -0.72).