{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:09:22Z","timestamp":1789996162080,"version":"4.0.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T00:00:00Z","timestamp":1766188800000},"content-version":"vor","delay-in-days":1851,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,11,25]],"date-time":"2020-11-25T00:00:00Z","timestamp":1606262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Endothelial dysfunction and heart failure are associated, but no prospective studies demonstrated that impaired endothelium-dependent vasodilation predicts incident heart failure. We designed this study to test whether endothelial dysfunction is associated with incident heart failure in a group of hypertensives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We enrolled 735 White never-treated hypertensive outpatients free from heart failure, diabetes, chronic kidney disease, and previous cardiovascular events. Endothelium-dependent vasodilation was investigated by intra-arterial infusion of acetylcholine, and laboratory determinations were obtained by standard procedures. During the follow-up [median 114 months (range 26\u2013206)], there were 208 new cases of heart failure (3.1 events\/100 patient-years). Dividing the study population in progressors and non-progressors, we observed that progressors were older, showed a higher prevalence of being female, and had a higher baseline heart rate, glucose, insulin, Homeostatic Model Assessment (HOMA), creatinine, and high-sensitivity C-reactive protein (hs-CRP) mean values, while estimated glomerular filtration rate and maximal acetylcholine-stimulated forearm blood flow were lower. In the multiple Cox regression analysis, female gender [hazard ratio (HR) = 1.454, 95% CI = 1.067\u20131.981], fasting glucose (HR = 1.186, 95% CI = 1.038\u20131.357), hs-CRP (HR = 1.162, 95% CI = 1.072\u20131.259), HOMA (HR = 1.124, 95% CI = 1.037\u20131.219), acetylcholine-stimulated forearm blood flow (HR = 0.779, 95% CI = 0.695\u20130.874), and estimated glomerular filtration rate (HR = 0.767, 95% CI = 0.693\u20130.849) maintained an independent association with the outcome. Successively, testing the interaction between forearm blood flow and hs-CRP, we observed that patients who have hs-CRP values above the median and forearm blood flow under the median show a higher risk of developing heart failure (HR = 7.699, 95% CI = 4.407\u201313.451).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The present data demonstrate that an impaired endothelium-dependent vasodilation and hs-CRP predict development of incident heart failure in hypertensives.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13088","type":"journal-article","created":{"date-parts":[[2020,11,25]],"date-time":"2020-11-25T10:33:36Z","timestamp":1606300416000},"page":"399-407","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Endothelial Dysfunction and C-Reactive Protein Predict the Incidence of Heart Failure in Hypertensive Patients"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7290-9470","authenticated-orcid":false,"given":"Raffaele","family":"Maio","sequence":"first","affiliation":[{"name":"Division of Geriatrics, Azienda Ospedaliero\u2014Universitaria Mater Domini , Catanzaro ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2456-1123","authenticated-orcid":false,"given":"Maria","family":"Perticone","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro , Viale Europa, Catanzaro, 88100 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7681-8568","authenticated-orcid":false,"given":"Edoardo","family":"Suraci","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro , Viale Europa, Catanzaro, 88100 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1674-5317","authenticated-orcid":false,"given":"Angela","family":"Sciacqua","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro , Viale Europa, Catanzaro, 88100 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1618-7688","authenticated-orcid":false,"given":"Giorgio","family":"Sesti","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine, University of Rome-La Sapienza , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2402-0981","authenticated-orcid":false,"given":"Francesco","family":"Perticone","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, 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