Indirect, noninvasive evaluation of pressure wave transmission in essential hypertension

Behaviour of conduit arteries in hypertension

Through an increase in vascular resistance, changes of the small arteries are responsible for the evaluation of mean arterial pressure in hypertension. However, the amplitude of the pressure oscillation, i.e. pulse pressure, is influenced by other hemodynamic mechanisms, which involve large arteries through a decrease in compliance and an increase in wave reflections. Consequently, structural and functional alterations of the large arteries are responsible in hypertensive subjects for an increase in the amplitude of the pressure oscillation and a disproportionate increase in systolic pressure over diastolic blood pressure through arterial (and not arteriolar) changes. Such findings not only contribute to a better understanding of the relationships between vascular structure and function and the level of blood pressure but also to better interprate the hypertensive complications, particularly those related to the heart and larges vessels.