Recent Advances on Large Arteries in Hypertension

Abstract

Abstract-The most classic hemodynamic concept explaining the increased mean arterial pressure in hypertension reflects an increased total peripheral resistance dynamically and an increased wall-to-lumen ratio to suppress smaller arteries. However, a more current consideration takes into account not only that steady component but also the pulsatile component of blood pressure, a point that importantly modifies the traditional hemodynamic definition. Whereas mean arterial pressure is almost constant along the arterial tree, the pulse pressure increases markedly from the more central to the peripheral arteries, indicating that in vivo each artery should be characterized according to its own blood pressure curve. This important concept implies major modifications in the methods used to investigate the relationships between mechanical factors and large artery structure and function. It therefore seems reasonable that in hypertension the large arteries should no longer be considered as passive conduits but rather in terms of their active behavioral response to the mechanical forces to which they are subjected. New investigational aspects in hypertension therefore now involve not only genetic, cellular, and molecular mechanisms but also transductional hemodynamic mechanisms reflecting changing patterns in the extracellular matrix that influence structural remodeling of the vessels. (Hypertension. 1998;32:156-161.)

The metabolic syndrome in elderly individuals is associated with greater muscular, but not elastic arterial stiffness, independent of low-grade inflammation, endothelial dysfunction or insulin resistance—The Hoorn Study

“…It can, however, be speculated that increasing age plays an important role and (or) that different segments of the arterial tree respond differently to 'metabolic stress' as a consequence of important structural and functional differences between muscular and elastic arteries. 39,42 Our data would then support the hypothesis that the process of arterial remodelling may favour the preservation of (elastic) compliance, 43 which is in accordance with our observation that the carotid and brachial arterial diameter were significantly increased in the MetS (Table 4). Nevertheless, peripheral arterial stiffness may be clinically just as important as it has been shown to be closely associated with prevalent peripheral vascular disease, 44,45 which is a clinically important outcome in the (pre-) diabetic population.…”

A velocidade da onda de pulso em jovens: estudo do Rio de Janeiro

“…Hence the great interest of many researchers in the study of arterial stiffness through various methods, including the analysis of pulse wave velocity (PWV) [5][6][7] .…”

Association between genetic variants of the ADD1 and GNB3 genes and blood pressure response to the cold pressor test in a Chinese Han population: the GenSalt Study

“…SBP may be more related to aortic elasticity and pulse wave velocity, whereas DBP may be more closely associated with peripheral vascular resistance. 23 The magnitude of increase in SBP and DBP response to cold stimulus might be regulated by different genes. Such an influence may explain why certain SNPs were related to SBP, while others were associated with DBP.…”