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KMID : 0648320030090020145
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Journal of The Korean Society of Hypertension
2003 Volume.9 No. 2 p.145 ~ p.152
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Contribution of Vascular Stiffness to Peripheral Resistance in Patient with Essential Hypertension
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Park Sung-Bae
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Abstract
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Background: To assess the relationship between the overall and local vascular stiffness and other traditional
hemodynamic indexes in relatively young and uncomplicated essential hypertensive patients.
Methods: We examined the relations of vascular stiffness to hemodynamic and humoral variables and to total peripheral resistance (TPR) in 53 asymptomatic, non-medicated, relatively young adults (mean age; 48 years old) with uncomplicated essential hypertension. Cardiac and carotid ultrasonography was used to measure TPR, stroke index, and carotid intima-media thickness (IMT). Overall vascular stiffness (pulse pressure/stroke index) and aortic and carotid beta index (pressure-independent measures of vascular stiffness) were calculated. Plasma transforming growth factor b (TGF-β1) was measured by ELISA.
Results: The mean blood pressure was 165/105 mmHg in hypertensives (vs 116/82 mmHg of normotensives, p<0.01 both). In hypertensives, echocardiographic LV mass index and carotid IMT were significantly larger (104 g/m2 and 0.62 mm) than those of normotensives (87 g/m2 and 0.5 mm). TGF-β1 did not differ in either group. Vascular stiffness (beta) of aorta and carotid artery was similar in 2 groups. In contrast, overall vascular stiffness were significantly increased to 1.24 ml.mmHg-2.m-2 in hypertensives (p<0.001) compared to normotensive subjects (0.98 ml.mmHg-2.m-2). Overall vascular stiffness correlated with blood cholesterol level and carotid IMT, but not with cardiac hypertrophy. There was no relationship between overall stiffness and local stiffness at aorta and carotid artery. By multivariate analysis, overall arterial stiffness strongly related with total peripheral resistance (standardized coefficient β=0.785, p<0.003),
in contrast to the lack of relations to traditional hemodynamic indexes, sex, and age.
Conclusions: In conclusion, overall vascular stiffness, rather than either aorta or carotid stiffness, contributes to
the increase of total peripheral resistance in young-aged, uncomplicated patients with essential hypertension.
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KEYWORD
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Total peripheral resistance, Vascular stiffness, Hypertension
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