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Atherosclerosis and hypertension
Insights
Essential hypertension accelerates aortic atherosclerosis development and influences coronary artery lesions. Symptomatic hypertension also impacts aortic atherosclerosis but has a lesser effect on coronary atherosclerosis.
Area of Science:
- Cardiovascular Pathology
- Hypertension Research
- Atherosclerosis Studies
Background:
- Essential hypertension is a major risk factor for cardiovascular disease.
- Atherosclerosis, the hardening of arteries, is a primary complication of hypertension.
- Understanding the specific impact of hypertension on different types of atherosclerotic lesions is crucial for risk stratification.
Purpose of the Study:
- To investigate the influence of essential hypertension on the development and progression of aortic and coronary atherosclerosis.
- To compare the effects of essential hypertension with varying degrees of atherosclerosis.
- To examine geographical variations in atherosclerosis among hypertensive individuals.
Main Methods:
- Autopsy studies were conducted on 3134 subjects diagnosed with essential hypertension.
- Subjects were categorized into low, average, and high atherosclerosis groups for comparison.
- Aortic and coronary artery lesions were analyzed to assess the extent and type of atherosclerosis.
Main Results:
- Essential hypertension accelerated most types of aortic lesions compared to average atherosclerosis, but not fatty streaks.
- Compared to high atherosclerosis, essential hypertension accelerated fibrous plaque development but not complicated or calcified lesions.
- Coronary artery fibrous plaque was more extensive in hypertensives than in low/average groups but similar to the high group.
Conclusions:
- Essential hypertension significantly accelerates aortic atherosclerosis development across various lesion types.
- The impact of essential hypertension on coronary atherosclerosis is complex, affecting fibrous plaque more than complicated or calcified lesions.
- Symptomatic hypertension also accelerates aortic atherosclerosis and contributes to coronary atherosclerosis, though less severely than essential hypertension.
Abstract:
Autopsy studies of atherosclerosis of the aorta and the coronary arteries were carried out in 3134 subjects with essential hypertension. A comparison was made with low, average, and high atherosclerosis groups. Essential hypertension was found to accelerate the development of all types of aortic lesion, except fatty streak, as compared with the standardized average atherosclerosis group, and to accelerate the development of fibrous plaque but not complicated and calcified lesions as compared with the high atherosclerosis group. The extent of fibrous plaque in the coronary arteries was greater in the essential hypertension group than in the low and standardized average atherosclerosis groups but did not differ from that in the high atherosclerosis group. The extent of complicated and calcified lesions and the prevalence of coronary stenosis were higher in the high atherosclerosis group than in cases of hypertension. Geographical differences in atherosclerosis among hypertensives in different towns reflected the findings for the whole material. Symptomatic hypertension was found to accelerate aortic atherosclerosis at least to the same extent as essential hypertension. It was conductive to coronary atherosclerosis but not to the same extent as essential hypertension. Coronary stenosis and various manifestations of coronary heart disease were rare in symptomatic hypertension.