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Noninvasive detection of an increased vascular mass in untreated hypertensive patients
X Girerd1, J J Mourad, X Copie
1Department of Internal Medicine, Broussais Hospital, Paris, France.
Insights
Hypertension causes structural changes in arteries. Untreated hypertension significantly increases radial artery mass and thickness, but this reverses with effective treatment, highlighting the importance of blood pressure control.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Vascular Biology
Background:
- Arterial structural changes are critical in hypertension's pathophysiology and prognosis.
- The radial artery, a muscular conduit, is a key site for assessing vascular changes.
Purpose of the Study:
- To investigate structural differences in the radial artery of hypertensive patients compared to controls.
- To assess the impact of antihypertensive therapy on radial artery structure.
Main Methods:
- Used high-resolution ultrasound echotracking to measure radial artery internal diameter and intima-media thickness.
- Calculated radial artery mass and thickness/radius ratio.
- Validated radial artery mass in vitro.
Main Results:
- Untreated hypertensive patients showed significantly higher radial artery mass and thickness/radius ratio than controls.
- Treated, well-controlled hypertensive patients had radial artery mass and thickness/radius ratio similar to controls.
- Radial artery mass was independently predicted by mean blood pressure, age, and sex in untreated patients.
Conclusions:
- Hypertension leads to increased radial artery mass and thickness, which is reversible with effective treatment.
- Radial artery structural parameters are valuable indicators of hypertension-related vascular changes.
- Blood pressure control is essential for mitigating adverse vascular remodeling in hypertension.
Abstract:
Structural changes of the arterial vasculature are of major pathophysiologic and prognostic significance in human hypertension. A high-resolution ultrasonic echotracking device was used to measure internal diameter and intima-media thickness of the radial artery, a medium-sized muscular conduit artery, in 60 hypertensive patients and in 40 age-matched control subjects. Of the 60 hypertensives, 33 were never treated and 27 were well-controlled by antihypertensive therapy. Radial artery mass and thickness/radius ratio were used to describe the radial artery structure. Radial artery mass was validated in vitro by comparing the weight of arterial segments to the ultrasonographic determination of their mass, calculated as: rho L(pi Re2-pi Ri2), where rho is the arterial wall density, L the length of the arterial segment, and Re and Ri the ultrasonic values of internal and external radii, respectively. Diastolic internal diameter did not differ among the three groups, but wall thickness, radial artery mass, and thickness/radius ratio were significantly higher in the untreated hypertensive group than in the control group. In treated well-controlled hypertensive subjects, radial artery mass and thickness/radius ratio were not different from that of control subjects. Among the population of untreated patients, significant univariate relations existed between radial artery mass and blood pressure and radial artery mass and age. In multivariate analysis, radial artery mass was independently predicted by mean blood pressure, age, and sex. Circumferential wall stress, calculated from diastolic internal diameter, wall thickness, and diastolic blood pressure, was not different in the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)