INFLUENCE OF THE ARTERIAL BLOOD-PRESSURE AND NONHEMODYNAMIC FACTORS ON REGIONAL ARTERIAL-WALL PROPERTIES IN MODERATE ESSENTIAL-HYPERTENSION

Structural and functional abnormalities may occur at the left ventricl e and in different large arteries in essential hypertension. Noninvasi ve high resolution pulsed doppler echo-tracking technique allows calcu lation of regional arterial wall properties, which might be determined by either hemodynamic or non-hemodynamic factors. Therefore we aimed to study regional arterial wall properties in three different vascular territories and examined whether hemodynamic and non-hemodynamic para meters were significantly associated to a specific vascular territory. In 30 patients (mean age 47 +/- 2 years) with newly diagnosed and unt reated essential arterial hypertension, arterial wall properties were determined at the carotid (common, external and internal), femoral, an d brachial artery using a noninvasive ultrasound wall movement detecto r system, The study parameters were arterial diameter, relative diamet er change, arterial distensibility (DC) and cross-sectional compliance (CC) coefficient. On the day of the experiments office blood pressure (BP) was measured as well as an ambulatory 24 h BP profile performed on an outpatient basis. Blood samples were taken on the day of the vas cular examination for the determination of plasma renin activity (PRA) , aldosterone, intact (1-84) parathyroid hormone (PTH), insulin and pl asma noradrenaline and adrenaline. Among the studied vascular territor ies, only DC and CC of the common carotid artery were significantly (P < 0.01) correlated with office and ambulatory systolic BP. Intact PTH was significantly correlated with the diameter (r = 0.61, P = 0.005) and DC (r = -0.53, P = 0.01) of the internal carotid artery. Noradrena line was inversely correlated with DC of the femoral artery (r = -0.55 , P < 0.01). All correlations remained significant after adjustment fo r age and body mass index as confounding variables. In conclusion, in mild to moderate arterial essential hypertension there is a heterogene ity of vascular wall properties and their relationship to BP and humor al factors between brachial, femoral and carotid (common, external and internal) arteries. Our findings might renew interest in the old conc ept of the 'circulatory paradox'.