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Published on: December 2, 2014
Aortic Compliance and Stiffness Among Severe Longstanding Hypertensive and Non-hypertensive
Lulzim Selim Kamberi1, Daut Rashit Gorani, Teuta Faik Hoxha
1University Clinical Centre of Kosova , Prishtina, Kosovo.
Insights
Hypertension significantly increases aortic stiffness, reducing elasticity. Treatment with antihypertensives and statins can improve aortic function, though it may not fully normalize it compared to healthy controls.
Area of Science:
- Cardiovascular Physiology
- Vascular Biology
- Hypertension Research
Background:
- Hypertension accelerates aortic elastin breakdown, leading to lumen dilatation and collagen-induced stiffening.
- Increased aortic stiffness is a significant predictor of cardiovascular risk and mortality.
- Vascular stiffening can activate the endothelium, potentially promoting atherosclerosis.
Observation:
- A study compared 144 patients with hypertension to a control group of similar age.
- Hypertensive patients exhibited reduced aortic strain and distensibility, with significantly higher stiffness.
- The hypertensive group had a stiffness measure of 9.3 compared to 5.4 in the control group.
Findings:
- After two years of treatment with antihypertensives and statins, hypertensive patients showed improved aortic strain, distensibility, and reduced stiffness.
- Despite treatment, these parameters in the hypertensive group (7.6) remained higher than in the control group (5.38).
Implications:
- Hypertension negatively impacts aortic elasticity and increases aortic stiffness.
- Pharmacological treatment with antihypertensives and statins can halt and improve these aortic abnormalities.
- While treatment offers benefits, long-term management may be necessary to fully restore normal aortic function.
Introduction:
Abnormal aortic function in hypertension is generally attributed to accelerated breakdown of elastin in the aorta, leading to dilatation of the lumen and stiffening of the wall as elastin is replaced with stiffer collagen. Aortic stiffness is an independent predictor of cardiovascular risk and all-cause and cardiovascular mortality. Vascular stiffening can activate endothelium which in turn may promote atherogenesis. Modulation of arterial stiffness has been shown to be successfully managed via changes in lifestyle and put under control of hypertension pharmacologically with antihypertensive drugs and statins.
Methods:
Hundred and forty four patients have been enrolled in this study. They have been divided in two groups, with hypertension and group of control. Groups were with no age difference.
Results:
Group with hypertension were with reduced aortic strain, distensibility (compliance) and have higher stiffness than control group; GrHTA =9.3 compared to GC=5.4. After successful treatment of hypertension with antihypertensives and statins, for two years, these parameters showed improvement, but still remain out of normal range compared to control group; 7.6 vs. 5.38.
Conclusions:
Hypertensive patients have reduced aortic elasticity and increased stiffness which can be stopped and improved after treatment with antihypertensive and statin.
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