SUMMARYWe performed simultaneous noninvasive measurements of common carotid artery and brachial artery hemodynamics in nine normal subjects and 10 subjects with sustained essential hypertension. In hypertensive subjects, brachial artery blood flow and forearm vascular resistance were in the normal range while carotid artery blood flow and carotid artery resistance were decreased and increased, respectively. The most important findings were the changes in the internal caliber of large arteries. Although the brachial and carotid artery diameters of hypertensive subjects were measured for the same level of mean arterial pressure, brachial artery diameter was significantly increased and carotid artery diameter was strictly normal as compared with values found in normal subjects. To assess whether carotid artery circulation could influence the baroreceptor reflex response to arteriolar vasodilation, carotid artery and brachial artery hemodynamics were measured in immediate succession in normotensive and hypertensive subjects before and after oral administration of cadralazine, a dihydralazine derivative. After cadralazine treatment, carotid artery tangential tension decreased in hypertensive subjects, and the changes were significantly correlated to the Increase in heart rate. A similar correlation was found in normal subjects, but it was reset toward higher heart rates. These results indicate that the carotid artery does not behave like the brachial artery in response to a chronic increase in blood pressure. This behavior indicates intrinsic alterations of the arterial wall and might be involved in the resetting of the carotid baroreceptor reflex. Carotid artery circulation could play a role in hypertension by modulating the carotid baroreceptor mechanisms involved in the response to drug-induced arteriolar vasodilation. Whether these findings represent a primary or a secondary event remains to be determined. (CCA) and the brachial artery (BA) to a chronic elevation of blood pressure may differ according to the regional circulation. Using a noninvasive pulsed Doppler system, we evaluated arterial diameter and blood flow of the straight superficial arteries. We measured simultaneously CCA and BA hemodynamics in normal and hypertensive subjects to assess the effect of essential hypertension on circulation in these arteries.The decrease in blood pressure and vascular resistance observed after treatment with dihydralazine or its derivative, cadralazine, was related to the dilation of small arteries, as has been shown extensively for dihyFrom the Diagnosis Center and the Hypertension Research Center, Broussais Hospital, Paris, France.Address for reprints: Prof. M. Safar, Centre de Diagnostic, H6pi-tal Broussais,