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Assessment of ventricular-arterial coupling in early stage middle-aged hypertensives

Andrea Vitali1,2, Giuseppe Biondi Zoccai3,4, George W Booz5

  • 1Department of Medicine and Surgery, UniCamillus University, Rome, Italy. andreavitali.cardio@libero.it.

Journal of Human Hypertension
|July 8, 2025
PubMed

Insights

Lifestyle changes and antihypertensive drugs improve ventricular-arterial coupling (VAC) in early hypertension. Improvements in blood pressure, heart rate, and arterial stiffness were observed, highlighting their role in cardiovascular prevention.

Area of Science:

  • Cardiovascular Physiology
  • Clinical Hypertension Research
  • Echocardiography and Vascular Assessment

Background:

  • Ventricular-arterial coupling (VAC) is crucial for cardiovascular health, but is often impaired by aging and comorbidities like hypertension.
  • Early-stage, middle-aged hypertensives without organ damage present a key group to study interventions impacting VAC.
  • Assessing myocardial function and arterial stiffness is vital for understanding VAC alterations.

Purpose of the Study:

  • To investigate the impact of lifestyle modifications and antihypertensive drug treatment on VAC in early-stage hypertensive individuals.
  • To evaluate changes in arterial elastance (Ea), pulse wave velocity (cfPWV), and myocardial work (MW) parameters following interventions.
  • To determine the relationship between VAC and vascular/myocardial parameters in hypertensive patients.

Main Methods:

  • Retrospective observational study of 126 individuals (hypertensives and normotensives), mean age 40.
  • Assessment of clinical, echocardiographic, and vascular parameters including Ea, cfPWV, global longitudinal strain (GLS), and myocardial work (MW).
  • Interventions included lifestyle change recommendations and subsequent antihypertensive drug treatment for persistent high blood pressure.

Main Results:

  • Hypertensives initially showed higher blood pressure (BP), heart rate (HR), and myocardial work (MW) components (GWI, GCW, GWW).
  • Lifestyle changes improved BP, HR, VAC, Ea, cfPWV, global wasted work (GWE), and GLS.
  • Antihypertensive treatment further improved BP, HR, VAC, Ea, cfPWV, and all MW parameters, including GLS.

Conclusions:

  • Lifestyle changes and antihypertensive drug treatment effectively improve VAC in early-stage hypertension.
  • Reduced BP, smoking cessation, and HR control are significant factors in cardiovascular prevention through VAC enhancement.
  • VAC demonstrates a linear relationship with arterial stiffness (cfPWV) and myocardial function (GLS) post-intervention.

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