Preferential changes in hepatosplanchnic hemodynamics in patients with borderline hypertension

Area of Science:

• Cardiovascular Physiology
• Hypertension Pathophysiology
• Hemodynamics

Background:

• Human hypertension involves complex systemic and regional hemodynamic alterations.
• Understanding the sequence of these changes is crucial for early detection and intervention.

Purpose of the Study:

• To investigate systemic and regional hemodynamic changes during the development of human hypertension.
• To identify early hemodynamic markers in borderline and essential hypertension.

Main Methods:

• Simultaneous measurement of cardiac index (CI) using indocyanine green (ICG) dye dilution.
• Assessment of hepatosplanchnic blood flow (HBF) via ICG clearance and renal blood flow (RBF) using p-aminohippurate clearance.
• Comparison of hemodynamic parameters in patients with borderline hypertension (BH), essential hypertension (EH), and normotensive controls.

Main Results:

• Patients with BH showed significantly lower HBF and HBF/CI compared to controls, with elevated hepatosplanchnic vascular resistance (HVR).
• Patients with EH exhibited significantly lower HBF, RBF, and RBF/CI, with increased total peripheral resistance (TPR), HVR, and renal vascular resistance (RVR).
• Hemodynamic changes were not uniform across regional circulations in BH, with hepatosplanchnic alterations preceding others.

Conclusions:

• Hemodynamic changes in early hypertension are regionally specific, with the hepatosplanchnic circulation being affected first.
• Altered hepatosplanchnic hemodynamics may serve as an early indicator in the development of human hypertension.
• Progressive increases in TPR, HVR, and RVR characterize established essential hypertension.