THE ARTERIAL SYSTEM IN HYPERTENSION - A PROSPECTIVE VIEW

Hypertension has long been considered a hemodynamic disorder, the hall mark of which is an increased total peripheral resistance that is more or less uniformly distributed in the arterioles of the component orga n circulations. In recent years, because of the introduction of innova tive technologies and methods, it is now possible to obtain a meaningf ul assessment of the physiological role of the larger arteries, thereb y providing an index of arterial distensibility and compliance and a n ew means to assess the role of pulsatile pressure and arterial stiffen ing in hypertension and its comorbid diseases (eg, arteriosclerosis, d iabetes mellitus). This discussion addresses these newer methodologica l aspects in assessing arterial stiffening in systemic hypertension an d other cardiovascular disorders. In addition, the epidemiological, th e molecular biological, and genetic, as well as certain therapeutic, a spects of pulse pressure in these circumstances are discussed.