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Acute reduction of blood pressure by nitroglycerin does not normalize large artery stiffness in essential

Andrew D Stewart1, Benyu Jiang, Sandrine C Millasseau

  • 1Cardiovascular Division, King's College London School of Medicine, St Thomas' Hospital, London, United Kingdom.

Hypertension (Dallas, Tex. : 1979)
|August 16, 2006
PubMed

Insights

Arterial stiffness is higher in hypertension, but not due to blood pressure. Structural changes in the arterial wall, not elevated pressure, explain this increased stiffness in hypertensive individuals.

Area of Science:

  • Cardiovascular Physiology
  • Hypertension Research
  • Arterial Biomechanics

Background:

  • Elevated large elastic artery stiffness is a hallmark of hypertension.
  • Increased arterial stiffness may be attributed to sustained higher distending pressures.

Purpose of the Study:

  • To investigate whether acute changes in blood pressure affect arterial stiffness differently in normotensive versus hypertensive individuals.
  • To determine if elevated arterial stiffness in hypertension is solely due to increased blood pressure or involves structural alterations.

Main Methods:

  • Carotid-femoral pulse wave velocity and carotid artery distensibility were measured in normotensive and hypertensive subjects.
  • Blood pressure was acutely manipulated using intravenous nitroglycerin and angiotensin II in normotensive subjects, and nitroglycerin in hypertensive subjects.

Main Results:

  • Hypertensive subjects exhibited significantly higher pulse wave velocity and lower carotid distensibility compared to normotensive controls.
  • Acute blood pressure reduction in hypertensive subjects did not normalize arterial stiffness, which remained significantly elevated.
  • In normotensive subjects, acute blood pressure changes induced expected alterations in arterial stiffness.

Conclusions:

  • Elevated arterial stiffness in hypertension is not explained by acute changes in blood pressure.
  • Structural changes within the arterial wall, independent of distending pressure, are likely responsible for increased stiffness in hypertensive individuals.

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