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[Antihypertensive treatment can normalize the geometry and the arterial function in the aged patient]
O Hanon1, L Bortolotto, S Legrain
1Service de médecine interne et INSERM U337, hôpital Broussais, Paris.
Insights
Antihypertensive treatment in men over 70 can normalize arterial geometry and function. This suggests high blood pressure, not aging, primarily drives arterial changes in elderly hypertensives.
Area of Science:
- Cardiovascular Medicine
- Gerontology
- Vascular Biology
Context:
- Aging and hypertension synergistically impact arterial system modifications.
- The effects of antihypertensive treatment on these arterial changes are not well understood.
- Elderly men over 70 represent a population with significant age-related vascular changes.
Purpose:
- To investigate the consequences of antihypertensive treatment on arterial geometry and function in men over 70 years old.
- To compare arterial parameters between normotensive, poorly controlled hypertensive, and well-controlled hypertensive elderly men.
Summary:
- Eighty-nine men (mean age 74 years) underwent measurements of carotid and radial artery diameter, intima-media thickness (IMT), and carotid-femoral pulse wave velocity (PWV).
- Poorly controlled hypertensives (HTpc) showed increased PWV compared to normotensives (NT) and well-controlled hypertensives (HTwc).
- Radial artery distensibility was similar across groups, but antihypertensive treatment appeared to normalize arterial properties.
Impact:
- Antihypertensive therapy can normalize both functional and geometric arterial properties in elderly men.
- Arterial modifications in elderly hypertensives are primarily a consequence of high blood pressure itself, rather than solely aging.
- Findings support the importance of blood pressure control in mitigating age-related vascular damage.
Abstract:
The aging process and the elevation of arterial blood pressure (BP) have synergistic effects on the modifications of the arterial system. The effects of the treatment on these modifications are unknown. Our objective was to study the consequences of anti-hypertensive treatment on the geometry and function of the arteries in men over 70 years old. In 89 men aged 74 +/- 2 years, we measured internal diameter and intima-media thickness (IMT) of carotid and radial arteries using high resolution echography (WALL TRACK SYSTEM and NIUS-02), and carotid-femoral pulse wave velocity (PWV) by COMPLIOR. The BP was measured in supine position by Dinamap. In 28 subjects the BP was more than 140/90 mmHg (poor controlled hypertensives-HTpc); in the subjects where BP < 140/90 mmHg, 44 were normotensives (NT) without treatment and 17 were well controlled hypertensives (HTwc) on use of at least one antihypertensive. [table: see text] The PWV was increased in HTpc (20.1 m/s) in comparison with NT (14.6 m/s) and HTwc (16.1 m/s) (p < 0.05). The operational distensibility of radial artery was similar in the three groups. In conclusion, in elderly men aged more than 70 years, the anti-hypertensive treatment can normalize the functional properties and the geometry of muscular and elastic arteries. These results indicate that the arterial modifications observed in elderly hypertensives are consequence of the high blood pressure per se and not only consequent the modifications due to the aging.