Arterial Hemodynamics in Prehypertensives

Compared to age-matched normotensive adults, those with essential hypertension have been shown to have distinct arterial hemodynamic abnormalities consisting of increased peripheral resistance, pulse wave velocity, and wave reflection magnitude as well as decreased wave reflection time and aortic co...

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Main Authors: Chih-Tai Ting, Jaw-Wen Chen, Mau-Song Chang, Frank Chi-Pong Yin
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:International Journal of Hypertension
Online Access:http://dx.doi.org/10.1155/2019/3961723
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author Chih-Tai Ting
Jaw-Wen Chen
Mau-Song Chang
Frank Chi-Pong Yin
author_facet Chih-Tai Ting
Jaw-Wen Chen
Mau-Song Chang
Frank Chi-Pong Yin
author_sort Chih-Tai Ting
collection DOAJ
description Compared to age-matched normotensive adults, those with essential hypertension have been shown to have distinct arterial hemodynamic abnormalities consisting of increased peripheral resistance, pulse wave velocity, and wave reflection magnitude as well as decreased wave reflection time and aortic compliance. These abnormalities are further exacerbated by beta-adrenergic blockade. To see if there are similar hemodynamic abnormalities that antedate the onset of fixed hypertension, we compared age-matched normotensives with prehypertensives selected from patients undergoing diagnostic cardiac catheterization. Ascending aortic pressure and flow were measured with a micromanometer and flow velocity sensor in the baseline state and after beta-adrenergic blockade. In the baseline state the prehypertensive compared to the normotensive group had elevated blood pressure, resistance, left ventricular end-diastolic pressure (LVEDP), and wave reflections. Beta-adrenergic blockade increased resistance, LVEDP, and wave reflections in both groups. Some of these findings are the same as those we previously reported in young persons with established, essential hypertension. The differences in LVEDP and wave reflections, both in the baseline state and after beta-blockade, were still present in subgroups with no differences in blood pressure. Hence, the elevated wave reflections in prehypertensives do not appear to be directly related to the level of blood pressure. These results support the notion that the elevated blood pressure in hypertension may represent a later manifestation of an already abnormal vascular system rather than the vascular abnormalities resulting from hypertension. Consequently, even before blood pressure becomes elevated, early diagnosis and treatment of the vascular abnormalities in prehypertensives may be warranted.
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spelling doaj-art-b33fb2bb2e11428eb2c4d3454d453bc02025-02-03T05:50:59ZengWileyInternational Journal of Hypertension2090-03842090-03922019-01-01201910.1155/2019/39617233961723Arterial Hemodynamics in PrehypertensivesChih-Tai Ting0Jaw-Wen Chen1Mau-Song Chang2Frank Chi-Pong Yin3Cardiovascular Center, Taichung Veterans General Hospital, Taichung, TaiwanDepartment of Medical Research, Veterans General Hospital, Taipei, TaiwanCardiology Division, Department of Medicine, Veterans General Hospital, Taipei, TaiwanDepartment of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USACompared to age-matched normotensive adults, those with essential hypertension have been shown to have distinct arterial hemodynamic abnormalities consisting of increased peripheral resistance, pulse wave velocity, and wave reflection magnitude as well as decreased wave reflection time and aortic compliance. These abnormalities are further exacerbated by beta-adrenergic blockade. To see if there are similar hemodynamic abnormalities that antedate the onset of fixed hypertension, we compared age-matched normotensives with prehypertensives selected from patients undergoing diagnostic cardiac catheterization. Ascending aortic pressure and flow were measured with a micromanometer and flow velocity sensor in the baseline state and after beta-adrenergic blockade. In the baseline state the prehypertensive compared to the normotensive group had elevated blood pressure, resistance, left ventricular end-diastolic pressure (LVEDP), and wave reflections. Beta-adrenergic blockade increased resistance, LVEDP, and wave reflections in both groups. Some of these findings are the same as those we previously reported in young persons with established, essential hypertension. The differences in LVEDP and wave reflections, both in the baseline state and after beta-blockade, were still present in subgroups with no differences in blood pressure. Hence, the elevated wave reflections in prehypertensives do not appear to be directly related to the level of blood pressure. These results support the notion that the elevated blood pressure in hypertension may represent a later manifestation of an already abnormal vascular system rather than the vascular abnormalities resulting from hypertension. Consequently, even before blood pressure becomes elevated, early diagnosis and treatment of the vascular abnormalities in prehypertensives may be warranted.http://dx.doi.org/10.1155/2019/3961723
spellingShingle Chih-Tai Ting
Jaw-Wen Chen
Mau-Song Chang
Frank Chi-Pong Yin
Arterial Hemodynamics in Prehypertensives
International Journal of Hypertension
title Arterial Hemodynamics in Prehypertensives
title_full Arterial Hemodynamics in Prehypertensives
title_fullStr Arterial Hemodynamics in Prehypertensives
title_full_unstemmed Arterial Hemodynamics in Prehypertensives
title_short Arterial Hemodynamics in Prehypertensives
title_sort arterial hemodynamics in prehypertensives
url http://dx.doi.org/10.1155/2019/3961723
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AT jawwenchen arterialhemodynamicsinprehypertensives
AT mausongchang arterialhemodynamicsinprehypertensives
AT frankchipongyin arterialhemodynamicsinprehypertensives