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[Visco-elastic properties of common carotid artery in treated hypertension]
Insights
Long-term antihypertensive treatment normalizes blood pressure but not arterial diameter in hypertensive patients. Structural vascular changes persist despite effective blood pressure control, indicating treatment limitations.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Hypertension Research
Background:
- Hypertension is associated with structural arterial changes.
- Non-invasive methods allow measurement of arterial diameter variations.
- The impact of antihypertensive treatment on arterial structure is debated.
Purpose of the Study:
- To investigate if long-term antihypertensive treatment normalizes vascular changes in hypertension.
- To compare arterial geometry and function in normotensive, treated hypertensive, and untreated hypertensive individuals.
Main Methods:
- A transversal study using a vascular echo-tracking device with Doppler shift.
- Measured common carotid artery diameter (diastolic and systolic) and elastic properties.
- Compared 46 normotensive subjects, 25 treated hypertensive patients, and 56 untreated hypertensive patients.
Main Results:
- Arterial diameter increased significantly with age across all groups.
- In patients under 60, treated hypertensives had larger carotid diameters than normotensives.
- Carotid artery diameter in treated hypertensives was similar to untreated hypertensives, suggesting persistent structural changes.
Conclusions:
- Long-term antihypertensive therapy effectively controls blood pressure but does not fully normalize common carotid artery diameter.
- Persistent structural arterial changes are indicated in treated hypertensive patients.
- Further research into treatments addressing vascular remodeling in hypertension is warranted.
Abstract:
It is now possible to measure clinically by a non-invasive method systolo-diastolic variations of the internal diameter of large arteries over 4 to 10 cardiac cycles with an original vascular echo-tracking device using Doppler shift. By the means of a transversal study of healthy subjects and patients followed up in the hypertension clinique, the authors set out to determine whether long-term non-specific antihypertensive treatment could, by correcting the blood pressure, also normalise the vascular changes encountered in hypertension. This study compared 46 normotensive subjects (Group I), 25 essential hypertensive patients with normal blood pressure recordings after at least 3 months' treatment (Group II) and 56 untreated essential hypertensive patients of the same average age (range 24 to 78 years). The common carotid artery was chosen for study of its geometry (internal diastolic diameter: Dd) and function (relative systolic expansion Ds-Dd/Dd; Perterson's elastic modulus; cross sectional compliance). The arterial diameter increased significantly with age in all three patients groups. In patients under 60 years of age, the diameter, corrected for age and sex, was significantly greater in Group II than in Group I, and similar in Groups II and III. This suggests that in spite of correcting blood pressure by long-term therapy (4.1 +/- 4.1 years), the internal diameter of a large artery such as the common carotid artery remains increased, which is in favour of the persistence of structural arterial changes rather than a prolonged vasodilator effect of the antihypertensive agents used.(ABSTRACT TRUNCATED AT 250 WORDS)