Structural changes of large arteries in sustained essential hypertension.
Structural changes of large arteries in sustained essential hypertension.
复制标题
持续性原发性高血压中大动脉的结构变化。
作者：
M. Safar;A. Simon;J. Levenson
通过使用原始的脉冲多普勒系统可以研究人类完整浅动脉的物理特性。与同龄对照相比，可以获得高血压患者肱动脉的直径、血流速度、容量流量和顺应性的测量结果。在持续性原发性高血压中，动脉顺应性降低，其降低方式与年龄和血压水平无关。根据药理学研究，可以排除自主神经系统激活的主要作用。正如在单纯收缩期高血压和下肢动脉硬化闭塞症中所观察到的，动脉顺应性的降低可能是由于动脉壁的结构改变导致收缩压不成比例的升高。硝酸甘油能够逆转顺应性下降和收缩压升高。结论是，大动脉的适应性变化参与高血压血流的结构性自动调节，并导致老年受试者收缩压显着升高。
The physical properties of intact superficial arteries can be studied in humans by using original pulsed Doppler systems. Measurements of the diameter, blood flow velocity, volumic flow, and compliance of the brachial artery can be obtained in hypertensive humans in comparison with controls of the same age. In sustained essential hypertension, arterial compliance is decreased, in a manner that is not related exclusively to age and to the level of blood pressure. On the basis of pharmacological studies, the predominant role of activation of the autonomic nervous system can be excluded. As observed in isolated systolic hypertension and in arteriosclerosis obliterans of the lower limbs, the reduction in arterial compliance is probably due to structural alterations of the arterial wall, which produce a disproportionate increase in systolic pressure. Nitroglycerine is able to reverse both the decreased compliance and the increased systolic pressure. The conclusion follows that adaptive changes of large arteries participate in the structural autoregulation of blood flow in hypertension and lead to a predominant elevation of systolic pressure in older subjects.