Different Impact of Essential Hypertension on Structural and Functional Age-Related Vascular Changes.
We evaluated whether vascular remodeling is present in physiological aging and whether hypertension accelerates the aging process for vascular function and structure. Small arteries from 42 essential hypertensive patients (HT) and 41 normotensive individuals (NT) were dissected after subcutaneous biopsy. Endothelium-dependent vasodilation (pressurized myograph) was assessed by acetylcholine, repeated under the nitric oxide synthase inhibitor N-nitro-l-arginine methylester or the antioxidant tempol. Structure was evaluated by media-lumen ratio (M/L). Intravascular oxidative generation and collagen deposition were assessed. Inhibition by N-nitro-l-arginine methylester on ACh was inversely related to age in both groups (P<0.0001) and blunted in HT versus NT for each age range. In NT, tempol enhanced endothelial function in the oldest subgroup; in HT, the potentiating effect started earlier. HT showed an increased M/L (P<0.001) versus control. In both groups, M/L was directly related to age (P<0.0001). M/L was greater in HT, starting from 31 to 45 years range. A significant age-hypertension interaction occurred (P=0.0009). In NT, intravascular superoxide emerged in the oldest subgroup, whereas it appeared earlier among HT. Among NT, aged group displayed an increment of collagen fibers versus young group. In HT, collagen deposition was already evident in youngest, with a further enhancement in the aged group. In small arteries, ageing shows a eutrophic vascular remodeling and a reduced nitric oxide availability. Oxidative stress and fibrosis emerge in advanced age. In HT, nitric oxide availability is early reduced, but the progression rate with age is similar. Structural alterations include wide collagen deposition and intravascular reactive oxygen species, and the progression rate with age is steeper.
From the Histology Unit (C.I., C.S., N.B.), Internal Medicine Unit (R.M.B., E.D., S.T., A.V.) of Department of Clinical and Experimental Medicine, Emergency Surgery Unit (M.C.) of Department of Surgery, Medical, Molecular, and Critical Area Pathology, and General Surgery Unit (G.D.C.) of Department of Oncology Transplantation and New Technologies, University of Pisa, Italy.
Rosa Maria
RM
Bruno
From the Histology Unit (C.I., C.S., N.B.), Internal Medicine Unit (R.M.B., E.D., S.T., A.V.) of Department of Clinical and Experimental Medicine, Emergency Surgery Unit (M.C.) of Department of Surgery, Medical, Molecular, and Critical Area Pathology, and General Surgery Unit (G.D.C.) of Department of Oncology Transplantation and New Technologies, University of Pisa, Italy.
Emiliano
E
Duranti
From the Histology Unit (C.I., C.S., N.B.), Internal Medicine Unit (R.M.B., E.D., S.T., A.V.) of Department of Clinical and Experimental Medicine, Emergency Surgery Unit (M.C.) of Department of Surgery, Medical, Molecular, and Critical Area Pathology, and General Surgery Unit (G.D.C.) of Department of Oncology Transplantation and New Technologies, University of Pisa, Italy.
Chiara
C
Ippolito
From the Histology Unit (C.I., C.S., N.B.), Internal Medicine Unit (R.M.B., E.D., S.T., A.V.) of Department of Clinical and Experimental Medicine, Emergency Surgery Unit (M.C.) of Department of Surgery, Medical, Molecular, and Critical Area Pathology, and General Surgery Unit (G.D.C.) of Department of Oncology Transplantation and New Technologies, University of Pisa, Italy.
Cristina
C
Segnani
From the Histology Unit (C.I., C.S., N.B.), Internal Medicine Unit (R.M.B., E.D., S.T., A.V.) of Department of Clinical and Experimental Medicine, Emergency Surgery Unit (M.C.) of Department of Surgery, Medical, Molecular, and Critical Area Pathology, and General Surgery Unit (G.D.C.) of Department of Oncology Transplantation and New Technologies, University of Pisa, Italy.
Nunzia
N
Bernardini
From the Histology Unit (C.I., C.S., N.B.), Internal Medicine Unit (R.M.B., E.D., S.T., A.V.) of Department of Clinical and Experimental Medicine, Emergency Surgery Unit (M.C.) of Department of Surgery, Medical, Molecular, and Critical Area Pathology, and General Surgery Unit (G.D.C.) of Department of Oncology Transplantation and New Technologies, University of Pisa, Italy.
Giulio
G
Di Candio
From the Histology Unit (C.I., C.S., N.B.), Internal Medicine Unit (R.M.B., E.D., S.T., A.V.) of Department of Clinical and Experimental Medicine, Emergency Surgery Unit (M.C.) of Department of Surgery, Medical, Molecular, and Critical Area Pathology, and General Surgery Unit (G.D.C.) of Department of Oncology Transplantation and New Technologies, University of Pisa, Italy.
Massimo
M
Chiarugi
From the Histology Unit (C.I., C.S., N.B.), Internal Medicine Unit (R.M.B., E.D., S.T., A.V.) of Department of Clinical and Experimental Medicine, Emergency Surgery Unit (M.C.) of Department of Surgery, Medical, Molecular, and Critical Area Pathology, and General Surgery Unit (G.D.C.) of Department of Oncology Transplantation and New Technologies, University of Pisa, Italy.
Stefano
S
Taddei
From the Histology Unit (C.I., C.S., N.B.), Internal Medicine Unit (R.M.B., E.D., S.T., A.V.) of Department of Clinical and Experimental Medicine, Emergency Surgery Unit (M.C.) of Department of Surgery, Medical, Molecular, and Critical Area Pathology, and General Surgery Unit (G.D.C.) of Department of Oncology Transplantation and New Technologies, University of Pisa, Italy. agostino.virdis@med.unipi.it.
Agostino
A
Virdis
D000328:Adult; D000368:Aged; D000375:Aging; D001158:Arteries / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D001706:Biopsy; D003094:Collagen / Q000378:metabolism; D003430:Cross-Sectional Studies; D018450:Disease Progression; D004730:Endothelium, Vascular / Q000473:pathology* / Q000503:physiopathology; D000075222:Essential Hypertension; D005260:Female; D006801:Humans; D006973:Hypertension / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D017382:Reactive Oxygen Species / Q000378:metabolism; D066253:Vascular Remodeling; D014664:Vasodilation / Q000502:physiology*; D055815:Young Adult
D017382:Reactive Oxygen Species; D003094:Collagen
endothelial dysfunction; microcirculation; nitric oxide; oxidant stress; remodeling