Heterogeneity of the arterial tree in essential hypertension: a noninvasive study of the terminal aorta and the common carotid artery.
The diameter and the stiffness of the distal portion of the abdominal aorta and of the common carotid artery were evaluated noninvasively in 72 subjects with mild to moderate hypertension by comparing 39 normotensive controls of same age and sex distribution. For each arterial segment, pulsatile changes of diameter were determined by a newly described echotracking technique and pulse pressure was evaluated by applanation tonometry and oscillometric methods. In both territories, distensibility of hypertensive subjects was significantly reduced but compliance was reduced only at the aortic level. Diastolic diameter was increased at the carotid but not at the aortic site. Multiple regression analysis indicated that whereas compliance and distensibility were strongly influenced by BP in the terminal aorta, age was the predominant factor influencing carotid arterial stiffness. Following 30 days of converting enzyme inhibition, the decrease of BP was associated with a normalisation of aortic compliance and distensibility whereas no change was observed at the site of the carotid artery. The study provides evidence that the response of the arteries to the changes of BP differ in the various parts of the arterial tree. This factor may influence the drug effect produced by chronic converting enzyme inhibition.
Benetos
A
A
Department of Internal Medicine, Broussais Hospital, Paris, France.
Asmar
R
R
Gautier
S
S
Salvi
P
P
Safar
M
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D001011:Aorta / Q000187:drug effects / Q000503:physiopathology*; D001794:Blood Pressure / Q000187:drug effects; D017536:Carotid Artery, Common / Q000503:physiopathology*; D003187:Compliance / Q000187:drug effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D017257:Ramipril / Q000627:therapeutic use
D017257:Ramipril