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Summary:Five groups of 20 patients each were studied to analyze the vascular dynamics and structure of the elastic arteries. Group I consisted of healthy young individuals (27 f 4 years); Group II of healthy adults (46 f 9 years); Group IU of normotensive hypercholesterolemic adults (45 f 12 years and serum cholesterol >239 mg/dl); Group IV of hypertensive normocholesterolemic adults (56 f 13 years); and Group V of hypertensive hypercholesterolemic adults (56 f 9 years). The differential arterial pressure was estimated and divided by the volume change (delta P/delta V) of the aorta and the carotid and brachial arteries. The volume change was calculated using the "cylinder formula," measuring the radius from the ultrasonographic vessel image and assigning the cylinder a height of 1 cm. The A/E index of the Doppler transmitral spechum and the maximum velocity flow using Doppler in the above arteries were calculated. The presence of carotid atherosclerosis was observed and given an arbitrary scoring grade of 0, 1 , or 2. A higher arterial and ventricular stiffness was found in the hypertensive patients regardless of the presence of hypercholesterolemia. A higher fall in Doppler velocity and an increase in atherosclerosis lesions were found in Group V. Based on the results of this study, it was concluded that vascular and left ventricular stiffness have a close relationship with arterial hypertension but not with hypercholesterolemia. The hypercholesterolemic patients had a higher prevalence of carotid atherosclerosis and a higher scoring grade of severity.

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Summary:With a growing elderly population, the incidence ol' isolated systolic hypertension (ISH) has increased. This study characterizes dynamic vascular changes that occur with achnnced age and with ISH. Fifty-the healthy individuals and seven with ISH were distributed in seven age groups from the second to the seventh decade. An index of aortic stiffness (AWAV) was derived using a mercury sphygmomanometer to oht;lin pulse pressure, and ultrasonographic measurements were iiaed to estimate aortic volumes applying the "cylinder formula." The mathematic derivation of this formula is explairied in detail. Pulse pressure showed no significant change with age, but showed a significant increase with ISH. A decretisc in volume change from systole to diastole was found with advanced age. Norinotensive subjects aged 6.5 -t 2 years hut1 ;I %-fold increase in aortic stiffness compared with young individuals. Elderly patients with ISH had a 7-fold increase in aoilic stiffness compared with Group 1 (15 -t 2 years) (p <: 0.001 ) rind a 2.7-fold increase compared with Group 6 (normotensive subjects aged 65 -t 2 years). A strong correlation between systolic pressure and arterial stiffness was observed (r = 0.953) (p < 0.001 ). The proposed stiffness index was compared with the one described by Hirai, obtaining a high correlation, that is. r = 0.989 (p < 0.001 ). When compared with Stefanadis's index of distensibility, our index showed a coi-rclation ofr = 0.932 (p < 0,003). It is concluded that while systolic pressure is a main detenninant of arterial stiffness, the AWAV is a more sensitive method to estimate dynamic chnnges in elastic arteries such as the aorta.

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