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Stiffness of the common carotid artery in treated hypertensive patients
Insights
Antihypertensive treatment lowers blood pressure but may not fully restore arterial distensibility in patients with hypertension. Long-term effects on arterial wall function require further investigation.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Hypertension Research
Background:
- Hypertension accelerates arterial aging and damage.
- Antihypertensive treatment aims to prevent this arterial damage.
- The impact of normalized blood pressure on arterial distensibility is not fully understood.
Purpose of the Study:
- To compare arterial distensibility in treated hypertensive, untreated hypertensive, and normotensive individuals.
- To assess if antihypertensive treatment normalizes arterial wall properties.
Main Methods:
- Cross-sectional study comparing 46 normotensive subjects and 81 hypertensive patients.
- Non-invasive assessment of common carotid artery (CCA) properties using pulsed ultrasound echo-tracking.
- Analysis included end-diastolic diameter, stroke diameter changes, and Peterson modulus.
Main Results:
- Age significantly correlated with CCA dimensions and function in all groups.
- Well-controlled hypertensives had lower blood pressure and Peterson elastic modulus than untreated hypertensives.
- Despite normalized blood pressure, treated hypertensives showed altered arterial distensibility compared to normotensives.
Conclusions:
- Antihypertensive treatment may not completely reverse arterial lesions caused by hypertension.
- Long-term antihypertensive therapy's effect on arterial distensibility warrants further study.
- Arterial stiffness may persist even after successful blood pressure control.
Abstract:
Antihypertensive treatment, by lowering blood pressure and correcting functional and/or structural abnormalities of the arterial wall, may prevent the arterial damage due to the accelerated ageing process. The objective of the present study was to determine, using a cross-sectional approach, whether arterial distensibility of patients whose blood pressure had been normalized for several months by antihypertensive treatment, was significantly higher than that of untreated hypertensive patients. The properties of the vessel wall of the common carotid artery (CCA) were studied non-invasively, using an original pulsed ultrasound echo-tracking system based on Doppler shift, during a study comparing 46 normotensive subjects and 81 age-matched hypertensive patients. The latter group included 25 patients well controlled by antihypertensive treatment for at least 3 months and 56 untreated hypertensives. The three groups did not differ with respect to age, total and high-density lipoprotein cholesterol, blood glucose and smoking. In each group, there were significant relationships between age and CCA dimensional and functional data, including end-diastolic diameter, absolute and relative stroke changes in diameter and Peterson modulus, indicating a widening of the CCA with advancing age and a decrease in its buffering function. When compared with untreated hypertensives, well controlled hypertensives had significantly lower blood pressure and Peterson elastic modulus according to age. However, although blood pressure of well controlled hypertensives was not significantly different from that of normotensive subjects, their arterial distensibility remained altered compared with that of normotensive subjects (significant increase in Peterson elastic modulus). These results suggest that long-term antihypertensive treatment may not fully reverse arterial lesions due to the hypertensive disease.