Influence of aging on arterial compliance

With aging, pulse pressure increases. A high pulse pressure has been recognised as an important cardiovascular risk factor. The increase in pulse pressure with aging is mainly due to a decrease in large artery compliance. Compliance and distensibility are large artery wall properties. Compliance is the buffering capacity of the vessel. Distensibility reflects much more the elasticity of the artery. Compliance is related to distensibility and arterial diameter. These large artery wall properties can be measured non-invasively using new echo-tracking techniques. With these techniques it has been shown that the elasticity (distensibility) and the buffering capacity (compliance) of the common carotid artery is decreasing with aging, while diameter of the artery increases. This increase in diameter might be a compensating mechanism to limit the decrease in compliance. There are indications that the effect of aging on large artery wall properties may not be similar at all vascular territories. A decrease in compliance leads to a high pulse pressure and isolated systolic hypertension. The drug of choice for the treatment of isolated systolic hypertension should increase large artery compliance with no, or only minor effect on resistance vessels. This would lead to a decrease in pulse pressure without decreasing mean blood pressure. As a result, systolic but not diastolic blood pressure decreases. It appears that nitrates better than other anti-hypertensive drugs can decrease pulse pressure. They therefore have been advocated for the treatment of isolated systolic hypertension.

[1]  M. Alderman,et al.  Isolated diastolic hypertension. A favorable finding among young and middle-aged hypertensive subjects. , 1995, Hypertension.

[2]  D L McGee,et al.  Systolic blood pressure, arterial rigidity, and risk of stroke. The Framingham study. , 1981, JAMA.

[3]  J. Coope,et al.  LOWERING BLOOD PRESSURE , 1987, The Lancet.

[4]  H. S. Struijker Boudier,et al.  Effects of antihypertensive agents on local arterial distensibility and compliance. , 1995, Hypertension.

[5]  A. Guyton,et al.  Textbook of Medical Physiology , 1961 .

[6]  S. Laurent,et al.  Arterial alterations with aging and high blood pressure. A noninvasive study of carotid and femoral arteries. , 1993, Arteriosclerosis and thrombosis : a journal of vascular biology.

[7]  M. Safar.  Pulse pressure in essential hypertension: clinical and therapeutical implications. , 1989, Journal of hypertension.

[8]  L. Bortel,et al.  Vessel Wall Properties of Large Arteries in Uncomplicated IDDM , 1995, Diabetes Care.

[9]  H. Struijker‐Boudier,et al.  Introduction to large artery properties as a target for risk reduction by antihypertensive therapy , 1992, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[10]  M Arditi,et al.  Non-invasive estimate of the mechanical properties of peripheral arteries from ultrasonic and photoplethysmographic measurements. , 1991, Clinical physics and physiological measurement : an official journal of the Hospital Physicists' Association, Deutsche Gesellschaft fur Medizinische Physik and the European Federation of Organisations for Medical Physics.

[11]  W. L. Ooi,et al.  Relation of pulse pressure and blood pressure reduction to the incidence of myocardial infarction. , 1994, Hypertension.

[12]  C. Bulpitt,et al.  Lead Exposure and Conventional and Ambulatory Blood Pressure: A Prospective Population Study , 1996 .

[13]  M. Safar,et al.  Carotid artery tonometry: an accurate non-invasive method for central aortic pulse pressure evaluation. , 1991, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[14]  A. Simon,et al.  Structural changes of large arteries in sustained essential hypertension. , 1984, Hypertension.

[15]  A. Hoeks.  Non-invasive study of the local mechanical arterial characteristics in humans , 1993 .

[16]  H. Smulyan,et al.  Forearm arterial distensibility in systolic hypertension. , 1984, Journal of the American College of Cardiology.

[17]  G. Bettelli,et al.  [Isolated systolic hypertension in the elderly]. , 1989, Medicina.

[18]  H. Petrovitch,et al.  ISOLATED SYSTOLIC HYPERTENSION : LOWERING THE RISK OF STROKE IN OLDER PATIENTS , 1992 .

[19]  M. O'Rourke,et al.  Arterial stiffness, systolic blood pressure, and logical treatment of arterial hypertension. , 1990, Hypertension.

[20]  M. Safar,et al.  Influence of diuretics on brachial artery diameter and distensibility in hypertensive patients , 1990, Fundamental & clinical pharmacology.

[21]  R S Reneman,et al.  Flow velocity patterns in and distensibility of the carotid artery bulb in subjects of various ages. , 1985, Circulation.

[22]  R. Nakayama,et al.  Noninvasive measurements of digital arterial pressure and compliance in man. , 1977, The American journal of physiology.

[23]  R S Reneman,et al.  Assessment of the distensibility of superficial arteries. , 1990, Ultrasound in medicine & biology.

[24]  A. Hoeks,et al.  Effect of perindopril and amiloride/hydrochlorothiazide on haemodynamics and vessel wall properties of large arteries , 1993, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[25]  B Waeber,et al.  Isobaric compliance of the radial artery is increased in patients with essential hypertension , 1993, Journal of hypertension.

[26]  M. Karamanoglu,et al.  An analysis of the relationship between central aortic and peripheral upper limb pressure waves in man. , 1993, European heart journal.