Aortic stiffness and distensibility among hypertensives

Hypertension is one among many factors that contribute to aortic stiffness, which has repercussions mainly on the heart. To assess aortic stiffness among essential hypertensives of South India and its relationship with gender. An analytical study was designed to assess aortic stiffness among 60 nonobese, nonalcoholic, nonsmoking, and non-caffeine consuming essential hypertensives without any overt illness or infection, and compared with 30 healthy age- and sex-matched nonhypertensives. They were assessed clinically and also by laboratory means. Their left ventricular mass (LV) and left ventricular ejection fraction (LVEF) were measured using Transthoracic echocardiogram. Aortic systolic and diastolic diameters were measured by using M-mode echocardiography during consecutive beats and averaged for each case. Finally, aortic stiffness was calculated. The data were analyzed statistically. Hypertensives were divided into Group I, consisting of patients with hypertension at least for 5 years, who were not adherent to medication, and Group II, consisting of patients with hypertension of duration between 6 months and 1 year. There were 20 males and 10 females in each group. There was no significant difference between the hypertensive groups and a control, normotensive, group with regard to BMI or total cholesterol. The means of LV mass (in grams), systolic BP (in mmHg), diastolic BP (in mmHg), aortic systolic diameter (in mm), aortic diastolic diameter (in mm), aortic distensibility (in mm), and aortic stiffness found in Group I, Group II, and controls were 105.8 +/- 23.8, 101.5 +/- 21, and 84 +/- 9.8; 138 +/- 14.2, 153 +/- 17.1, and 120 +/- 8.3; 90.5 +/- 11.6, 101.7 +/- 17.1, and 76.5 +/- 5; 30.85 +/- 2.6, 28.7 +/- 2.6, and 27.7 +/- 2.4; 28.7 +/- 2.2, 25.8 +/- 2.5, and 24.2 +/- 2.5; 2.14 +/- 0.3, 2.84 +/- 0.5, and 3.5 +/- 0.6; and 1.31 +/- 0.09, 1.14 +/- 0.1, and 1.04 +/- 0.08, respectively. The differences between the hypertensive groups and the control group were significant. Aortic stiffness was greater in hypertensives and it was independent of gender, but increased with duration of hypertension. Hypertension has effects on the aorta (decreased aortic distensibility and increased aortic stiffness) and left ventricle (increased left ventricular mass and left ventricular hypertrophy). These changes can be identified and monitored while the patient is on antihypertensive therapy along with life-style modifications, as these are reversible. Nevertheless, these aspects do not receive due attention in medical education and training on hypertension.