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Epicardial coronary arteries are not adequately sized in hypertensive patients

A Nitenberg1, I Antony

  • 1Service d'Explorations Fonctionnelles, Hôpital Louis Mourier, Colombes, France.

Journal of the American College of Cardiology
|January 1, 1996
PubMed

Insights

Hypertensive patients do not show increased coronary artery dimensions despite higher oxygen demand. Instead, elevated coronary flow velocity may contribute to atherosclerosis development in these individuals.

Area of Science:

  • Cardiovascular physiology
  • Clinical cardiology
  • Medical imaging

Background:

  • Myocardial oxygen demand and coronary blood flow determine coronary artery dimensions.
  • Coronary artery dilation is observed in aortic valve disease.

Purpose of the Study:

  • To compare coronary artery dimensions between hypertensive patients and normal subjects.
  • To investigate the relationship between hypertension, coronary artery size, and blood flow velocity.

Main Methods:

  • Quantitative angiography used to measure coronary artery diameters (left main, LAD, circumflex).
  • Study included 10 control subjects and 26 untreated hypertensive patients (with/without left ventricular hypertrophy).
  • Coronary flow velocity measured using Doppler ultrasound in the distal left anterior descending artery.

Main Results:

  • No significant difference in coronary artery diameters between hypertensive patients and controls.
  • Coronary flow velocity was significantly higher in hypertensive patients compared to controls, both at baseline and after isosorbide dinitrate administration.
  • Elevated rate-pressure product in hypertensive patients did not correlate with increased vessel diameters.

Conclusions:

  • Maximal dimensions of large coronary arteries are not increased in hypertensive patients, despite elevated myocardial oxygen demand.
  • Elevated coronary flow velocity in hypertensive patients may increase endothelial shear stress.
  • This elevated flow velocity is a potential determinant in the pathogenesis of atherosclerosis in hypertension.
Abstract

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