Hypertension, Antihypertensive Drugs and Atherosclerosis

Hollander, William

doi:10.1161/01.cir.48.5.1112

Cited by 50 publications

(14 citation statements)

References 77 publications

(15 reference statements)

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“…8 From the Bramwell and Hill 10 equation, which relates pulse wave velocity (C) to pressure (/>), volume (V), and volume change {dV) in an artery (C = \JVdPledV), the arterial compliance {dVldP) per unit length can be calculated as dVldP = n D 2 /4 e C 2 . Characteristic impedance and the compliance per unit length were determined from measurements of pulse wave velocity and diameter in brachial artery (expressed in dyn-sec-cm~5 and in cm 4 -dyn~', respectively, according to the centimeter-gram-second [CGS] system of units).…”

Section: Methodsmentioning

confidence: 99%

“…Although not directly caused by hypertension per se, it is accelerated by high arterial pressure and not always reduced by antihypertensive treatment. 4 Recent progress in noninvasive techniques for the assessment of arterial function allows early screening for detection of damage in large arteries in hypertension. 5 In this study, the forearm arteries were chosen for investigation because they are the site of clinical and epidemiological blood pressure measurements.…”

mentioning

confidence: 99%

“…4 tive expression of the accelerating effect of pressure on this aging phenomenon. 21 Accordingly, the increased diameter of the brachial artery in hypertension can be considered to be a consequence of aging, simply accelerated by pressure elevation.…”

mentioning

confidence: 99%

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Evidence of early degenerative changes in large arteries in human essential hypertension.

et al. 1985

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SUMMARY Noninvasive evaluation of brachial artery diameter (pulsed Doppler velocimetry) and pulse wave velocity (strain gauge mechanography) was performed in 23 normal subjects and 49 patients with uncomplicated essential hypertension. Pulsatile arterial function was described in terms of derived characteristic impedance and arterial compliance. Compared with normal controls, hypertensive patients had greater arterial diameter (p < 0.01) and pulse wave velocity (p < 0.001). Two nomograms obtained from normal subjects relating the product of age and diastolic pressure to diameter and pulse wave velocity were used for analysis of the hypertensive group; 35 patients were inside the 95% confidence limits of the diameter and pulse wave velocity nomograms (Group 1), while 14 patients were outside the pulse wave velocity nomogram (Group 2). Age and mean pressure were similar, but pulse wave velocity was higher (p < 0.001), arterial compliance lower (p < 0.001), and characteristic impedance higher (p < 0.001) in Group 2 than in Group 1. The amplitude of pulse pressure was higher in Group 2 than in Group 1 (p < 0.001), and a negative correlation was found between pulse pressure and arterial compliance in Group 2, but not in Group 1. Thus, in the majority of hypertensive patients, arterial modifications could be related to the normal influence of age and pressure. In contrast, other patients exhibited features suggesting excessive arterial stiffness, manifested by abnormally high pulse wave velocity, decreased arterial compliance, and increased characteristic impedance. (Hypertension 7: 675-680, 1985) KEY WORDS • large arteries • essential hypertension • pulsed Doppler • brachial artery diameter • pulse wave velocity • arterial compliance D AMAGE of large arteries is a major contributing factor to the high cardiovascular morbidity and mortality observed in hypertension.1 Moreover, it has been established recently that even in treated hypertensive patients, ischemic lesions continue to develop as a consequence of the injury to the large arteries. 2 Such arterial damage is nonuniform. Arteriosclerotic lesions represent the direct effect of increased intraluminal pressure on the arterial wall. However, this effect is not specific to hypertension but appears as a consequence of arterial aging caused by

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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Evidence of early degenerative changes in large arteries in human essential hypertension.

et al. 1985

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“…The increased inotropic performance was proportional to increased left ventricular mass and indicated that the hypertrophied heart can maintain a given cardiac output at a higher pressure, that is against a greater output impedance, than can the normal heart. While this is clearly true for Korner and Broughton's experimental preparation, it may not be so in the hypertensive patient with associated coronary artery disease in whom the increased myocardial work may precipitate myocardial ischaemia and consequent impaired contractile function (Hollander, 1973 (Lund-Johansen, 1980). This redistribution is essential for the maintenance of cardiac output as the hypertrophied left ventricle of the hypertensive patient is more dependent on the Frank-Starling mechanism to maintain its performance (Folkow, 1978;Tarazi, 1982, Tarazi andLevy, 1982).…”

Section: Adrenergic and Other Pathophysiological Mechanisms In Hypertmentioning

confidence: 99%

Anaesthesia and Hypertension

Prys-Rroberts

1984

British Journal of Anaesthesia

113

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“…Arterial hypertension is one of the commonest causes of cardiovascular deaths, mainly from myocardial infarction and cerebrovascular accidents (Hollander 1973, Bulpitt et al 1979. Mild hypertension, whether treated or not, does not appear to be a significant determinant of the cardiac risk of anaesthesia (Goldman & Caldera 1979).…”

Section: Coronary Artery Diseasementioning

confidence: 99%

Implications for Anaesthesia of New Concepts in Cardiovascular Diseases: Discussion Paper

Foëx

1983

J R Soc Med

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Hypertension, Antihypertensive Drugs and Atherosclerosis

Cited by 50 publications

References 77 publications

Evidence of early degenerative changes in large arteries in human essential hypertension.

Evidence of early degenerative changes in large arteries in human essential hypertension.

Anaesthesia and Hypertension

Implications for Anaesthesia of New Concepts in Cardiovascular Diseases: Discussion Paper

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