MECHANICAL PRESSURE VERSUS INTRINSIC EFFECTS OF HYPERTENSION ON LARGE ARTERIES IN HUMANS
MECHANICAL PRESSURE VERSUS INTRINSIC EFFECTS OF HYPERTENSION ON LARGE ARTERIES IN HUMANS
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DOI：
10.1161/01.hyp.18.5.657
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发表时间：
1991-11-01
期刊：
影响因子：
8.3
通讯作者：
PICHEL, R
中科院分区：
文献类型：
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作者：
ARMENTANO, R;SIMON, A;PICHEL, R
对23例正常血压者和49例高血压患者的肱动脉直径和顺应性进行了测量。在等压条件下，通过从动脉中的压力-直径和压力-顺应性曲线的测量数据外推的建模分析来比较结果。使用对数直径-压力函数以及测量肱动脉血压和管腔直径（通过脉冲多普勒）和肱桡动脉脉搏波速度（通过机械图）。高血压患者的直径和顺应性的测量值分别为对照组值的109%和63%。在所有受试者的相同压力水平（两组平均血压的平均水平）下，通过模型外推数据，高血压患者的直径和顺应性的等压值分别为对照组值的107%和81%。总的来说，测量的等压直径和测量的顺应性与收缩压、舒张压和平均血压值相关（p < 0.001），而等压顺应性仅与收缩压（p < 0.05）和脉压（p < 0.01）值相关。因此，在高血压人群中观察到的肱动脉直径增加和顺应性降低不能仅仅归因于血压升高的拉伸效应，还归因于动脉壁的内在改变。这些可能代表继发于动脉压慢性升高的适应性结构或功能变化，或血管壁的原发性异常。
Brachial artery diameter and compliance were measured in 23 normotensive control subjects and 49 hypertensive patients. The results were compared in isobaric conditions by a modeling analysis extrapolating from the measured data a short segment of the pressure-diameter and pressure-compliance curves in the artery. A logarithmic diameter-pressure function was used as well as measurements of brachial artery blood pressure and lumen diameter (by pulsed Doppler), and of brachial-to-radial pulse wave velocity (by mechanography). The measured values of diameter and compliance in the hypertensive patients were 109% and 63%, respectively, of the control group values. By extrapolating the data via the model at the same pressure level in all subjects (the average level of mean blood pressure of the two groups), the isobaric values of diameter and compliance in the hypertensive patients were 107% and 81%, respectively, of the control group values. Overall, measured isobaric diameters and measured compliance correlated with systolic, diastolic, and mean blood pressure values (p < 0.001), whereas isobaric compliance correlated only with systolic (p < 0.05) and pulse (p < 0.01) pressure values. Thus, the increased diameter and reduced compliance of the brachial artery observed in hypertensive humans cannot be attributed solely to the stretching effect of elevated blood pressure, but also to intrinsic alteration of the arterial walls. These could represent either adaptative structural or functional changes secondary to the chronic increase in arterial pressure, or primary abnormalities of the vessel wall.