Elastic modulus of the radial artery wall material is not increased in patients with essential hypertension.

Laurent, Stéphane; Girerd, Xavier; Mourad, Jean‐Jacques; Lacolley, Patrick; Beck, L; Boutouyrie, Pierre; Mignot, J; Safar, Michel E.

doi:10.1161/01.atv.14.7.1223

Cited by 202 publications

(159 citation statements)

References 40 publications

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“…This measure is independent of the actual BP in normotensive subjects (18,19). Finally, the incremental modulus of elasticity (E inc ) provides direct information about the arterial wall material, independent of its geometry (20). We found low arterial wall distensibility, a high arterial stiffness parameter, and a high incremental modulus of elasticity in all patients compared with age-matched and gender matched healthy controls.…”

Section: Discussionmentioning

confidence: 73%

Increased Arterial Stiffness in Young Adults with End-Stage Renal Disease since Childhood

Groothoff

Gruppen²,

Offringa³

et al. 2002

Journal of the American Society of Nephrology

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Abstract. Increased arterial stiffness is a risk factor for mortality in adults over 40 yr of age with end-stage renal disease (ESRD). As no data exist on vascular changes in young adults with ESRD since childhood, a long-term outcome study was performed. All living Dutch adult patients with onset of ESRD between 1972 and 1992 at age 0 to 14 yr were invited for carotid artery and cardiac ultrasound and BP measurements. Data on clinical characteristics were collected by review of all medical charts. Carotid ultrasound data were compared with those of 48 age-matched and gender-matched healthy controls. Carotid artery and cardiac ultrasound was performed in 130 out of 187 eligible patients. Mean age was 29.0 (20.7 to 40.6) yr. Compared with controls, patients had a similar intima media thickness but a reduced mean arterial wall distensibility DC (40.0 versus 45.0 kPa Ϫ1 · 10 Ϫ3 ; 95% CI, Ϫ9.1 to Ϫ0.8; P Ͻ 0.001), an increased stiffness parameter ␤ (4.2 versus 3.8; 95% CI, 0.05 to 0.68; P ϭ 0.02), an increased elastic incremental modulus E inc (0.35 versus 0.27 kPa · 10 3 ; 95% CI, 0.02 to 0.12; P Ͻ 0.001). Multiple regression analyses in all subjects revealed that ESRD was associated with an increase in ␤ and E inc . Arterial wall properties of patients currently on dialysis and transplanted patients were comparable. In all patients, current systolic hypertension was associated with increased E inc and decreased DC. In conclusion, carotid arterial wall stiffness is increased in young adult patients with pediatric ESRD. Hypertension is a main determinant and might be a target for treatment of these potentially lethal arterial wall changes.Cardiovascular disease is the main cause of death in adults with end-stage renal disease (ESRD) (1-4). Cardiovascular causes of death are relatively uncommon under the age of 40 yr in the general population. Yet, cardiovascular diseases also account for most deaths in patients with ESRD aged between 25 and 44 yr (1). There are indications that even in children and young adults with ESRD since childhood, cardiovascular disease is the main cause of death, similar to older ESRD patients. We performed a long-term follow up study on the somatic, social, and psychologic outcome of children with ESRD. Over 25% of all patients had died, all of them under the age of 36 yr. We found cardiovascular disease to be the most important cause of death in the whole group, and cardiac death most prominent in those patients who died more than 10 yr after beginning renal replacement therapy (RRT) (5).Clinical studies have shown that increased stiffness of the large arteries independently contributes to the high mortality in dialysis patients over 40 yr of age (6 -8). Recently, studies performed with electron beam CT have shown coronary calcifications in adolescents and young adults with ESRD (9 -11). However, these studies concern only a few patients; to date, no data exist on arterial wall distensibility in young adult patients with ESRD since childhood. The purpose of this study was to assess the pre...

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Section: Discussionmentioning

confidence: 73%

Increased Arterial Stiffness in Young Adults with End-Stage Renal Disease since Childhood

Groothoff

Gruppen²,

Offringa³

et al. 2002

Journal of the American Society of Nephrology

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“…22,23 The effects of sympathetic stimulation on arterial mechanical properties are complex and depend on passive effects of the increased arterial pressure and of changes in vessel geometry and smooth muscle tone due to active vasoconstriction. Increasing blood pressure stretches vessel walls and reduces their compliance by increasing wall stiffness (represented by the incremental modulus) and the radius-to-wall thickness ratio.…”

Section: Discussionmentioning

confidence: 99%

Studies on cardiac sympathovagal balance and large artery distensibility in patients with untreated essential hypertension

et al. 1999

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Background: Power spectral analysis of heart rate variability and arterial distensibility are non-invasive measures of cardiac autonomic modulation and mechanical vessel wall properties, respectively. The aim of the present study was to assess cardiac sympathovagal balance, carotid and brachial artery distensibility and a possible relation between these parameters in mildly hypertensive patients as compared to normotensive controls. Methods: Total power (TP, 0.01 to 0.5 Hz) and spectral components (low frequency 0.04 -0.15 Hz, mainly sympathetic cardiac modulation; high frequency 0.15-0.4 Hz, mainly vagal cardiac modulation) and cardiac sympathovagal balance (LF/LH ratio) of short term heart rate variability (ECG-recording) were calculated in 15 untreated essential hypertensive patients (HYP) and 15 age-and sex-matched healthy controls (CON). Brachial and carotid artery distensibility coefficient (DC) was measured with a multigate doppler system (echotracking).

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“…2,11 Recent studies indicate that differences in distending pressure account for arterial stiffness in essential hypertension. 18,19 Laurent et al 19 have shown that the decrease in arterial distensibility was primarily due to higher distending BP rather than to structural modifications, and when adjusted for differences in BP, hypertrophied arteries of essential hypertensive subjects were more distensible than those of normotensive controls. In contrast to the results in essential hypertensive subjects, arterial stiffness in hypertensive patients with end-stage renal failure appear to be related to structural vessel wall changes.…”

Section: Discussionmentioning

confidence: 99%

A longitudinal study of vessel wall properties in normotensive and hypertensive renal transplant recipients

et al. 1998

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The mechanisms responsible for reduced arterial distensibility in renal transplant recipients remain to be evaluated. The present longitudinal study was aimed to evaluate the effect of hypertension on the evolution of vessel wall properties in renal transplant recipients. The mechanical properties of the common carotid artery were determined in 24 normotensive and 24 treated hypertensive renal transplant recipients 6-12 weeks after transplantation. The measurements were repeated after 2 years. Arterial distension was determined by using a multigate pulsed Doppler system, blood pressure (BP) was measured by a mercury sphygmomanometer. BP was 127 ؎ 3/80 ؎ 2 mm Hg at entry and 133 ؎ 3/82 ؎ 2 mm Hg after 2 years in the normotensive group, 146 ؎ 4/90 ؎ 3 mm Hg at entry and 145 ؎ 3/87 ؎ 2 mm Hg after 2 years in the hypertensive group (P Ͻ 0.01, normotensives vs hypertensives). The distens-

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Elastic modulus of the radial artery wall material is not increased in patients with essential hypertension.

Cited by 202 publications

References 40 publications

Increased Arterial Stiffness in Young Adults with End-Stage Renal Disease since Childhood

Increased Arterial Stiffness in Young Adults with End-Stage Renal Disease since Childhood

Studies on cardiac sympathovagal balance and large artery distensibility in patients with untreated essential hypertension

A longitudinal study of vessel wall properties in normotensive and hypertensive renal transplant recipients

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