Arterial compliance and blood pressure

As a result of the dual function of arteries, the conduit and cushioning functions, arterial pressure has 2 components: the steady component, characterised by mean blood pressure, and the pulsatile component, characterised by pulse pressure. Arterial compliance mostly depends on arterial intrinsic elastic properties, and is a determinant of the propagation speed of the pulse pressure wave. Decreased arterial compliance is responsible for both an increase in the incident pressure wave and the higher effect of reflected pressure waves. This increases systolic pressure and ventricular afterload, and generates left ventricular hypertrophy. Arterial structural changes that accompany the aging process result in a loss of distensibility and compliance. In essential as well as in secondary hypertension, arterial compliance is reduced, and age-related structural changes of the arterial wall are accelerated. Whether the change in arterial compliance is a passive consequence of the increase in blood pressure or is related to changes in the arterial wall structure remains unclear. Calcium antagonists improve the distensibility and compliance of large and small arteries, contributing significantly to the improvement in the management of essential and secondary hypertension.