B031: Role of pulse pressure in determining structural vascular changes in hypertension

• Published in: American journal of hypertension Vol. 13; no. S2; p. 198A
• Main Authors: Stella, M.L., Vailati, S., Magnoni, M., Seravalle, G., Meloni, A., Grassi, G., Mancia, G.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01-04-2000
• Subjects: hypertension; Pulse pressure; target organ damage; vascular hypertrophy
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/S0895-7061(00)00692-0

Studies performed in animal models of hypertension have shown that an elevated pulse pressure (PP) adversely affects the mechanical properties of the arterial vessels. Whether this is also the case in essential hypertension is unknown, however. In 11 untreated essential hypertensives (HHT, age 46.8±1.7, mean±SEM) with PP values amounting to 60.4±1.4 mmHg (range 52–64 mmHg), and in 11 age-matched untreated essential hypertensives with PP values amounting to 44.9±1.0 mmHg (LHT, PP range 41–48 mmHg) without any other major cardiovascular risk factor, we evaluated systolic, diastolic and mean blood pressure (SBP, DBP and MBP, Finapres), heart rate (HR, EKG), forearm and calf blood flows (FBF and CBF, venous occlusion plethysmography) and forearm and calf vascular resistance (FVR: MBP/FBF and CVR:MBP/CBF, respectively). We also evaluated forearm and calf minimal vascular resistance (FVRmin and CVRmin) following 12 min of local ischaemia associated with 2 min of isometric exercise. SBP was significantly higher in HHT than in LHT (156.5±2.1 vs 146.0±3.4 mmHg, p<0.05), while other resting haemodynamic parameters were similar in the two groups (HHT vs LHT: MBP 115.4±1.8 vs 115.9±3.4, DBP 95.6±1.5 vs 100.9±3.4 mmHg, HR 77.1±2.9 vs 72.5±3.2 bpm, FVR 37.3±2.7 vs 38.3±3.1 U, CVR 55.2±3.9 vs 47.7±4.7 U). On the contrary FVRmin values were significantly higher in HHT as compared to LHT (3.6±0.6 vs 2.1±0.2 U, p<0.05), and 2) directly related to PP but not to SBP values (multiple stepwise regression analysis: r=0.45, p<0.03 and r=0.35, p<0.09, respectively). CVRmin values were not significantly different in the two groups and were not related to PP and SBP. These data provide evidence that 1) PP represents a haemodynamic variable which is directly involved in the development of vascular hypertrophy characterizing essential hypertension and 2) hypertension-related structural alterations of limb vascular district depend to a greater extent on hydrostatic influences rather than on haemodynamic factors.