title: Pulse pressure, arterial stiffness, and end-organ damage.
abstract: Whereas larger arteries participate in the dampening of blood pressure (BP) oscillations resulting from intermittent ventricular ejection, smaller arteries steadily deliver an adequate supply of blood from the heart to the peripheral organs. Numerous active mechanisms are involved in this process. Cyclic stress acts differently from steady stress, inducing stronger and stiffer material of the vessel wall than under static conditions. Cyclic strain participates in the phenotypic plasticity of smooth muscle cells, initiates transduction mechanisms and induces the transcriptional profile of mechanically induced genes. Finally, the autoregulatory mechanism protecting the brain, heart and kidney from cardiovascular (CV) damage differ markedly according to their localization. Whereas the heart is dependent on pulsatile forces, owing to the diastolic perfusion of coronary arteries, the brain and the kidney are rather influenced by steady mechanical forces. For the kidney, the transmission of pulsatile pressure may greatly contribute to glomerular sclerosis in the elderly.
authors.affiliation: Paris Descartes University; AP-HP; Diagnosis and Therapeutic Center, Hôtel-Dieu, 1, place du Parvis Notre-Dame, 75181, Paris Cedex 04, France. michel.safar@htd.aphp.fr
authors.forename: Michel E
authors.initials: ME
authors.lastname: Safar
authors.forename: Peter M
authors.initials: PM
authors.lastname: Nilsson
authors.forename: Jacques
authors.initials: J
authors.lastname: Blacher
authors.forename: Albert
authors.initials: A
authors.lastname: Mimran
mesh_terms: D001158:Arteries / Q000473:pathology*; D001794:Blood Pressure / Q000502:physiology*; D004730:Endothelium, Vascular / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000473:pathology; D051437:Renal Insufficiency / Q000209:etiology / Q000473:pathology; D012306:Risk; D013312:Stress, Physiological; D014655:Vascular Resistance / Q000502:physiology*; D059289:Vascular Stiffness / Q000502:physiology*