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Arterial wall remodelling and stiffness in hypertension: heterogeneous aspects
1Department of Internal Medecine, INSERM U337, Broussais Hospital, Paris, France.
Insights
Hypertension and aging both decrease large artery distensibility. This review examines how aging and hypertension affect artery structure and function, revealing heterogeneous changes based on vessel location and disease severity.
Area of Science:
- Cardiovascular physiology
- Vascular aging
- Hypertension research
Background:
- Hypertension is linked to large artery hypertrophy and reduced distensibility.
- Arterial aging shares pathological and functional similarities with hypertension, suggesting accelerated aging.
- The distinct contributions of age, pressure, and hypertension to arterial stiffening are debated.
Purpose of the Study:
- To review the effects of aging and hypertension on human large central and medium-sized arteries.
- To analyze structural properties (lumen diameter, wall thickness) and functional properties (distensibility).
Main Methods:
- Review of clinical studies on subjects with hypertension, with and without renal disease.
- Analysis of structural and functional arterial changes in relation to aging and hypertension.
Main Results:
- Age- and hypertension-induced structural changes in arteries are heterogeneous.
- Arterial alterations vary depending on vessel topography.
- The severity of the underlying disease influences structural changes.
Conclusions:
- Aging and hypertension induce complex and varied changes in large artery structure and function.
- Understanding these heterogeneous changes is crucial for managing cardiovascular risk.
Abstract:
1. Hypertension is associated with hypertrophy and decreased operating distensibility of the large artery wall. Because similar pathological and functional changes are observed with ageing, hypertension is often looked upon as an accelerated form of aging. 2. Considering the decrease in arterial distensibility observed with both ageing and hypertension, whether the change is due to age, an increase in distending pressure or to hypertension-induced changes in large artery structural properties may be much debated. 3. The purpose of the present review is to study the effects of aging and hypertension on structural (lumen diameter and arterial wall thickness) and functional (distensibility) properties of large central and medium-sized arteries in humans. 4. From clinical studies in subjects with hypertension with or without advanced renal disease, it is suggested that age- and hypertension-induced structural arterial changes are quite heterogeneous, depending on the topography of the vessel and on the severity of the underlying disease.