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Ascending aorta distensibility abnormalities in hypertensive patients and response to nifedipine administration
C Stratos1, C Stefanadis, I Kallikazaros
1Department of Cardiology, University of Athens Medical School, Hippokration Hospital, Greece.
Insights
Arterial hypertension reduces ascending aorta distensibility. Nifedipine improved aortic distensibility in both hypertensive and normal subjects, but the effect was less pronounced in hypertensive individuals.
Area of Science:
- Cardiovascular physiology
- Hypertension research
- Pharmacology
Background:
- Arterial hypertension is associated with structural and functional changes in the aorta.
- Ascending aorta distensibility is a key indicator of aortic health and cardiovascular risk.
- Understanding how antihypertensive medications affect aortic mechanics is crucial for patient management.
Purpose of the Study:
- To investigate the distensibility of the ascending aorta in patients with arterial hypertension compared to normal subjects.
- To evaluate the effects of nifedipine, a calcium antagonist, on ascending aorta distensibility in both groups.
- To determine if the response to nifedipine differs between hypertensive and normotensive individuals.
Main Methods:
- Ascending aorta distensibility was measured using echocardiography and invasive pressure measurements.
- Distensibility was calculated using a validated formula based on changes in aortic diameter and pulse pressure.
- 22 male hypertensive patients and 12 age-matched male normotensive subjects were studied before and after nifedipine administration.
Main Results:
- Hypertensive patients exhibited lower basal ascending aorta distensibility and aortic strain compared to normotensive subjects.
- A significant inverse correlation was observed between mean aortic pressure and aortic distensibility (r = -0.81).
- Nifedipine administration increased aortic distensibility in both groups, with a blunted response noted in hypertensive patients.
Conclusions:
- Ascending aorta distensibility is significantly reduced in individuals with arterial hypertension.
- Nifedipine effectively enhances ascending aorta distensibility in both hypertensive and normotensive individuals.
- The therapeutic benefit of nifedipine on aortic distensibility is diminished in patients with arterial hypertension.
Purpose:
The purpose of the present investigation was to study the distensibility of the ascending aorta in patients with arterial hypertension and normal subjects before and after administration of a calcium antagonist, nifedipine.
Patients And Methods:
The distensibility of the ascending aorta was measured before and after nifedipine administration in 22 male hypertensive patients and 12 age-matched male normotensive subjects. Aortic distensibility was calculated as a function of changes in aortic diameter and pulse pressure, using the formula: 2 x (pulsatile change in aortic diameter)/[(diastolic aortic diameter) x (aortic pulse pressure)]. Aortic diameters were measured by echocardiography and aortic pressures were obtained by catheterization of the ascending aorta.
Results:
In the basal state, the distensibility of the ascending aorta and aortic strain were lower in hypertensive patients than in normotensive subjects (p < 0.001); the lower aortic distensibility, however, was associated with a greater distending pressure. A good inverse correlation (r = -0.81) was found between mean aortic pressure and aortic distensibility. The aortic distensibility was increased after nifedipine administration in both groups; this increase in aortic distensibility, however, was lower in the patients with hypertension compared with normotensive subjects (p < 0.001).
Conclusions:
Aortic distensibility is decreased in patients with arterial hypertension. Nifedipine administration increased the distensibility of the ascending aorta both in patients with arterial hypertension and in normotensive subjects. The increase of aortic distensibility after nifedipine administration was lower in hypertensive patients.