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Interrelations of cardiac and arterial vascular wall hypertrophy in essential hypertension
A Geri1, E Agabiti-Rosei, M L Muiesan
1Department of Medical Sciences, University of Brescia, Italy.
Insights
Essential hypertension patients show a correlation between left ventricular mass and minimal vascular resistance. Left ventricular hypertrophy often precedes structural arterial changes in the calves.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Vascular Biology
Background:
- Essential hypertension is a significant risk factor for cardiovascular disease.
- Left ventricular hypertrophy (LVH) and structural vascular changes are common complications.
- The temporal relationship between LVH and arterial remodeling in hypertension is not fully understood.
Purpose of the Study:
- To investigate the correlation between left ventricular mass and structural vascular changes in patients with essential hypertension.
- To determine if left ventricular hypertrophy precedes or follows arterial structural alterations.
Main Methods:
- Echocardiography was used to measure left ventricular mass in 52 hypertensive patients.
- Minimal vascular resistance was calculated using mean arterial pressure and post-ischemic blood flow measured by plethysmography.
- Patients were categorized based on normal or high minimal vascular resistance.
Main Results:
- A statistically significant, albeit low, correlation was found between left ventricular mass and minimal vascular resistance (r = 0.33, P < 0.05).
- Left ventricular hypertrophy was present in 50% of patients with normal minimal vascular resistance.
- Absence of left ventricular hypertrophy was noted in 27% of patients with high minimal vascular resistance.
Conclusions:
- The findings suggest that left ventricular hypertrophy may often precede the development of structural arterial changes in the calf arteries.
- Structural changes in the heart and systemic arteries may not develop concurrently in essential hypertension.
- Further research is warranted to elucidate the precise sequence of cardiovascular remodeling in hypertensive individuals.
Abstract:
Structural vascular changes in the calf arteries and left ventricular mass were measured in 52 essential hypertensive patients (WHO I and II, 35 men and 17 women, age range 21-63 years). Left ventricular mass was measured on M-mode echocardiographic tracings. Structural vascular changes were evaluated indirectly by studying the minimal vascular resistance, calculated from mean arterial pressure and maximal (post-ischaemic) blood flow, measured by venous occlusion plethysmography. A statistically significant correlation between left ventricular mass and minimal vascular resistance was observed (r = 0.33, P < 0.05). The low correlation suggested that structural changes in the heart and in the systemic arteries did not develop simultaneously. In the subgroup of patients with minimal vascular resistance in the normal range, left ventricular hypertrophy was found in 15 out of 30 patients (50% of cases) whereas, in the subgroup of patients with high minimal vascular resistance, absence of left ventricular hypertrophy was found in six out of 22 patients (27% of cases). These results suggest that left ventricular hypertrophy more often precedes arterial structural changes in the calves.