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Assessment of arterial distensibility by automatic pulse wave velocity
measurement. Validation and clinical application studies. Hypertension,
1995. 26:485-490.
- Low molecular weight heparins : a guide to their optimum use in pregnancy.
Drugs, 2002. 62:463-477.
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Influence of L-NAME, acetylcholine
and adenosine on mean blood pressure, pulse pressure and pulse pressure amplification
in rats. Journal of Cardiovascular Pharmacology, 2003.
41:210-8.
- Heart rate and pulse pressure
amplification in hypertensive subjects. American Journal of Hypertension
2003. May;16(5):363-70.
- Gender influence on the relation
between heart rate and aortic stiffness. Journal of Hypertension
2003. 21:555-562
- Pulse pressure and arterial
stiffness in rats: comparison with humans. American Journal of
Physiology - Heart and Circulatory Physiology, 2003. 285(4):H1363-9.
Laurent P, Albaladejo
P, Blacher J, Rudnichi A, Smulyan H, Safar M.E.
Heart rate and pulse pressure amplification
in hypertensive subjects.
Am J Hypertens 2003. May;16(5):363-70.
Abstract :
Although mean blood pressure (MBP) remains unmodified along the arterial
tree, pulse pressure (PP) increases physiologically from the central
to the peripheral arteries. Amplification of PP is known to be influenced
by heart rate (HR), but the impact of this alteration has never been
tested in patients with hypertension.
METHODS : A total
of 712 hypertensive subjects, either treated or untreated, were divided
into three classes of HR level. Carotid and brachial systolic blood
pressure (SBP), carotid augmentation index, a marker of wave reflections,
and carotid-brachial PP amplification were measured using applanation
tonometry.
RESULTS : Independent
of age, sex, and antihypertensive drugs, subjects with HR >80 beats/min
were characterized, in comparison with those with lower HR, by reduced
carotid SBP, PP, and augmentation index, resulting in a significant
increase in PP amplification. In men but not in women, this pattern
was associated with higher values of brachial SBP and DBP and by higher
incidences of elevated glycemia and atherosclerotic alterations. In
the male population, PP amplifications was, independent of HR, associated
with the presence of beta blocking agents (negative association) and
elevated plasma glucose.
CONCLUSIONS :
Hypertensive men and women with high HR have significant PP amplifications,
principally because of reduced central SBP and disturbed wave reflections.
beta-blocking agents and plasma glucose independently alter PP amplification
in men but not in women. Whether these opposite patterns influence
the gender difference in cardiovascular risk should be prospectively
studied.
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last modified on : 25 oct 2005 |
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