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Opposing effects of ageing on distal and proximal large arteries in hypertensives
P Boutouyrie1, S Laurent, A Benetos
1Department of Internal Medicine, INSERM U 337, Broussais Hospital, Paris, France.
Insights
Hypertension accelerates arterial aging, particularly in central arteries. Distal arteries show opposing age-related changes in hypertensive patients, maintaining adequate vascular storage capacity.
Area of Science:
- Vascular biology and aging research.
- Cardiovascular physiology and hypertension studies.
Background:
- Aging accelerates arterial stiffening, with hypertension exacerbating these changes.
- Proximal large arteries are well-studied, but distal large arteries remain less investigated regarding aging effects.
Purpose of the Study:
- To compare arterial storage capacity across different arterial sites in normotensive and hypertensive individuals.
- To investigate the differential effects of aging on arterial storage capacity in various vascular beds.
Main Methods:
- Utilized high-resolution ultrasonic echo-tracking devices to assess arterial diameter and variations.
- Measured end-diastolic diameter, stroke-related diameter changes, and cross-sectional area in common carotid, abdominal aorta, femoral, brachial, and radial arteries.
- Studied 50 untreated essential hypertensive patients and 32 normotensive subjects.
Main Results:
- End-diastolic diameter increased with age in proximal arteries (carotid, aorta) but not distal ones.
- Normotensives showed age-related decreases in relative diameter change in proximal arteries.
- Hypertensives exhibited age-related decreases in proximal arteries but increases in distal femoral and radial arteries, maintaining storage capacity.
Conclusions:
- In hypertensive individuals, proximal large artery enlargement compensates for reduced diameter changes, preserving vascular storage.
- Aging has contrasting effects on central elastic arteries versus distal muscular arteries.
- Arterial remodeling in hypertension influences age-related vascular changes differently across the arterial tree.
Aim:
Hypertension has been reported to accelerate the alterations in large arteries induced by ageing. Distal large arteries have been poorly investigated in contrast to proximal large arteries. The objectives of this cross-sectional study were (1) to compare the storage capacity of different arterial sites in normotensive subjects or hypertensive patients; and (2) to compare the different arterial sites with respect to the effects of ageing on storage capacity, in normotensives and in hypertensives.
Methods:
Two recently developed ultrasonic echo-tracking devices, offering a high resolution for the assessment of internal arterial diameter and its systolo-diastolic variations, were used to measure end-diastolic diameter, absolute (change at end-systole minus change at end-diastole) and relative (absolute change divided by change at end-diastole) changes in diameter with stroke and the absolute change in cross-sectional area (3.14 x the end-diastolic diameter x half the absolute stroke change in diameter) at the site of the common carotid artery, the abdominal aorta, the common femoral artery, the brachial artery and the radial artery in 50 untreated essential hypertensive patients and 32 normotensive subjects.
Results:
In both groups, the end-diastolic diameter increased with age for the common carotid artery and the abdominal aorta but not for the common femoral, brachial or radial arteries. In the normotensives, the relative stroke change in diameter was negatively correlated with age for the common carotid artery (P < 0.001) and the abdominal aorta (P < 0.001), and not correlated for the common femoral, brachial and radial arteries. In hypertensives, the relative stroke change in diameter was negatively correlated with age for the common carotid artery (P < 0.05) and the abdominal aorta (P < 0.05), positively correlated with age for the common femoral (P < 0.05) and the radial arteries (P < 0.05) and not correlated for the brachial artery. Similar results were observed for the relationships between the absolute change in cross-sectional area and age.
Conclusions:
In hypertensives, enlargement of the proximal large arteries offsets the decrease in the relative stroke change in diameter and maintains an adequate storage capacity. It thus appears that ageing exerts opposing effects on central elastic large arteries and distal muscular medium-sized arteries.