Atherogenic Vascular Stiffness and Hypertension

Mukherjee, Debabrata

doi:10.1001/2012.jama.10931

Cited by 13 publications

(10 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A key implication from these observations is that arterial stiffness, when used as a measure of cardiovascular risk, may identify novel therapeutic approaches to prevent the onset or progression of hypertension. 2 These findings are profound because commonly used antihypertensive medications are based largely on their vasodilating effects on smaller resistance vessels and have little effect on arterial stiffness. 3 Traditional vasodilatory drugs lower mean central pressures but do not have significant effects on pressure dy-namics or so-called pulsation.…”

mentioning

confidence: 99%

Vascular Stiffening in Pulmonary Hypertension: Cause or Consequence? (2013 Grover Conference Series)

et al. 2014

View full text Add to dashboard Cite

Recent studies have indicated that systemic arterial stiffening is a precursor to hypertension and that hypertension, in turn, can perpetuate arterial stiffening. Pulmonary artery (PA) stiffening is also well documented to occur in pulmonary hypertension (PH), and there is evidence that pulmonary vascular stiffness (PVS) may be a better predictor of outcome than pulmonary vascular resistance (PVR). We have hypothesized that the decreased flow-damping function of elastic PAs in PH likely initiates and/or perpetuates dysfunction of pulmonary microvasculature. Recent studies have shown that large-vessel stiffening increases flow pulsatility in the distal pulmonary vasculature, leading to endothelial dysfunction within a proinflammatory, vasoconstricting, and profibrogenic environment. The intricate role of stiffening-stimulated high pulsatile flow in endothelial cell dysfunction includes stepwise molecular events underlying PA hypertrophy, inflammation, endothelial-mesenchymal transition, and fibrosis. In addition to contributing to microenvironmental alterations of the distal vasculature, disordered proximal-distal PA coupling likely also plays a role in increasing ventricular afterload, ultimately causing right ventricle (RV) dysfunction and death. Current therapeutic treatments do not provide a realistic approach to destiffening arteries and, thus, to potentially abrogating the effects of high pulsatile flow on the distal pulmonary vasculature or the increased work imposed by stiffening on the RV. Scrutinizing the effect of PA stiffening on high pulsatile flow-induced cellular and molecular changes, and vice versa, might lead to important new therapeutic options that abrogate PA remodeling and PH development. With a clear understanding that PA stiffening may contribute to the progression of PH to an irreversible state by contributing to chronic microvascular damage in lungs, future studies should be aimed first at defining the underlying mechanisms leading to PA stiffening and then at improved treatment approaches based on these findings.Keywords: pulmonary hypertension, arterial stiffening, wave reflection, smooth muscle cell, endothelial cell, inflammation, right ventricle, treatment. Arterial stiffening is increasingly recognized as a risk factor of cardiovascular events as well as a guide for pharmacological treatment of cardiovascular diseases. Yet its exact role in the development and progression of cardiovascular diseases such as hypertension remains elusive. A recent study, however, presented convincing data supporting the possibility of a cause-effect relationship between arterial stiffness and systemic hypertension: higher levels of arterial stiffness and central pressures preceded and were associated with an increased risk of hypertension, but hypertension did not cause arterial stiffness. 1This work demonstrated that increased vascular stiffness could be a precursor to hypertension. A key implication from these observations is that arterial stiffness, when used as a measure of cardiovascula...

show abstract

mentioning

confidence: 99%

Vascular Stiffening in Pulmonary Hypertension: Cause or Consequence? (2013 Grover Conference Series)

et al. 2014

View full text Add to dashboard Cite

show abstract

“…The difference in kurtosis is due to the deleterious effect of hypertension on compliance by the stiffening of vessels. 27 Age, sex and the covariates of study participants…”

Section: Discussionmentioning

confidence: 99%

“…In aHT+ group, compliance is modified due to impairment of the vascular wall leading to the failure of protective mechanisms because of the stiffening effect. 27 …”

Section: Discussionmentioning

confidence: 99%

“…The protocol consisted of phase-contrast velocimetry sequences with retrospective cardiac gating (through a peripheral pulse sensor) performed as in previous studies. 16,24,2519,27,28 The main parameters were as follows: TE (echo time): 6-9 milliseconds (ms); TR (repetition time): 20 ms; the flip angle: 25°; the number of stages: 32; the field of view: 160 × 120 mm; the matrix: 256 × 128; slice thickness: 5 mm encoding speed (Venc): 80 cm/s for cervical and intracranial vascular flow. The acquisition planes were selected perpendicularly to the assumed direction of cervical and intracranial vascular flow with angiography sequence (Figure 1).…”

Section: Imagingmentioning

confidence: 99%

See 1 more Smart Citation

Arterial hypertension impact on cerebral blood flow in patients with Alzheimer’s disease

Zmudka¹,

Bouzerar²,

Gondry³

et al. 2017

Geriatr., Gerontol. Aging

View full text Add to dashboard Cite

BACKGROUND: Studies show the potential deterioration of brain vascularization and probable involvement of hypertension in Alzheimer disease (AD). OBJECTIVE: The objective was to evaluate the potential impact of hypertension on cerebral vascular flows in a sample of Alzheimer's patients. METHODS: 19 patients with AD, including 10 with hypertension (aHT+) and 9 without hypertension (aHT-) were recruited. They underwent clinical evaluation and phase-contrast MRI protocol for flow assessment. Cerebral arterial flow distributions were evaluated using kurtosis and skewness indices at the intracranial and extracranial levels. RESULTS: No significant differences were found in the mean arterial flow, pulse flow and kurtosis between the levels in the AD aHT+ population. There was a significant difference in skewness between extra-and intracranial levels (p = 0.01). No significant differences were found in the mean arterial flow between the levels in the AD aHT-population. A significant difference was observed in the pulse flow (p = 0.03), kurtosis (p = 0.02) and skewness (p = 0.008) between the levels. At the extracranial level we did not find any significant differences in the mean arterial flow, pulse flow or skewness between aHT+ and aHT-. There was a significant difference in kurtosis at the extracranial level between the aHT+ and aHT-(p = 0.03). At the intracranial level, there were no significant differences in all parameters. CONCLUSION: Results showed a difference between cerebral vasculature in AD for aHT+ and aHT-groups. This is probably related to the loss of arterial compliance induced by the degradation of the vascular system.

show abstract

“…Esse achado reforça a importância da patologia como fator causal em hipertensos não transplantados mas também em transplantados de coração, o que foi encontrado neste grupo. As outras comorbidades também tem importância para o aumento do risco, como já visto por outros autores (42,54,55) .…”

Section: Monitorização Ambulatorial Da Pressão Arterial E Iaraunclassified

Avaliação do índice de rigidez arterial em pacientes transplantados de coração, hipertensos e não hipertensos

Neto¹,

de²

View full text Add to dashboard Cite

Atherogenic Vascular Stiffness and Hypertension

Cited by 13 publications

References 17 publications

Vascular Stiffening in Pulmonary Hypertension: Cause or Consequence? (2013 Grover Conference Series)

Vascular Stiffening in Pulmonary Hypertension: Cause or Consequence? (2013 Grover Conference Series)

Arterial hypertension impact on cerebral blood flow in patients with Alzheimer’s disease

Avaliação do índice de rigidez arterial em pacientes transplantados de coração, hipertensos e não hipertensos

Contact Info

Product

Resources

About