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Progressive arterial wall stiffening in patients with increasing diastolic blood pressure
F W van den Berkmortel1, M van der Steen, H Hoogenboom
1Department of Medicine, Division of General Internal Medicine, University Hospital Nijmegen, The Netherlands. F.Vandenberkmortel@aig.azn.nl
Insights
In hypertensive individuals, increasing diastolic blood pressure leads to stiffening of carotid arteries but not femoral arteries, highlighting arterial tree heterogeneity.
Area of Science:
- Cardiovascular physiology
- Vascular biology
- Hypertension research
Background:
- Hypertension is a major risk factor for cardiovascular disease.
- Arterial wall properties vary across different vessels.
- Understanding these variations is crucial for cardiovascular risk assessment.
Purpose of the Study:
- To investigate the relationship between increasing diastolic blood pressure and arterial wall dynamics in peripheral arteries of hypertensive patients.
- To explore the heterogeneity of arterial properties within the arterial tree in hypertension.
Main Methods:
- Cross-sectional study of 86 untreated hypertensive patients.
- Patients categorized into quartiles based on diastolic office blood pressure.
- Carotid and femoral artery cross-sectional compliance and distensibility measured using the Wall Track System.
Main Results:
- Carotid arteries showed increased diameter and decreased compliance and distensibility with rising diastolic blood pressure.
- Femoral artery diameter and compliance remained unchanged, while distensibility decreased less markedly.
- These findings indicate differential arterial wall stiffening in response to hypertension.
Conclusions:
- Untreated hypertension causes gradual stiffening of carotid arteries with increasing diastolic blood pressure.
- The common femoral artery exhibits less pronounced changes, suggesting heterogeneity in arterial response.
- This heterogeneity is important for understanding cardiovascular complications in hypertension.
Background:
Hypertension is an established risk factor for cardiovascular disease. Risk factor patterns for various cardiovascular complications are different. We studied the relationship between increasing diastolic blood pressure and arterial wall dynamics of various peripheral arteries in hypertensives to increase insight in the variability of properties within the arterial tree.
Methods:
Eighty-six untreated hypertensives participated in this cross-sectional study. The study-population was divided into quartiles with increasing diastolic office blood pressure. Cross-sectional compliance and distensibility coefficients of the carotid and femoral arteries were determined, using a vessel wall movement detector system (Wall Track System).
Results:
Diameters of both common carotid arteries enlarged (right: from 7.4 +/- 0.2 to 7.9 +/- 0.2 mm) while cross-sectional compliance (right: from 0.61 +/- 0.04 to 0.42 +/- 0.04 mm(2)/kPa) and distensibility coefficients (right: from 14.2 +/- 1.0 to 9.0 +/- 1.0 10(-3)/kPa) gradually dropped with increasing diastolic blood pressure. Cross-sectional compliance and diameter of the right common femoral artery remained unchanged while distensibility coefficient decreased although less gradually when compared with the carotid arteries.
Conclusions:
In untreated hypertensives gradual arterial wall stiffening of the carotid arteries occurred with increasing diastolic blood pressure. Gradual changes were less clear in the common femoral artery which points to the heterogeneity of the arterial tree.