In silico hemodynamical simulations show additional benefits of artery wall softening induced by antihypertensive drugs

• Published in: Computer methods and programs in biomedicine Vol. 245; p. 108016
• Main Authors: Jagoš, Jiří, Kohút, Jiří, Novotný, Tomáš, Křivka, Tomáš, Hájek, Petr, Formánek, Martin, Lisický, Ondřej, Burša, Jiří
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.03.2024
• Subjects: Antihypertensive Agents - pharmacology; Antihypertensives; Atherosclerosis; Atherosclerosis - drug therapy; Blood Flow Velocity; Carotid Arteries; Carotid artery; Computer Simulation; Hemodynamics - physiology; Humans; Models, Cardiovascular; Multiscale flow simulations; Parameter optimization; Patient-specific model; Pulse Wave Analysis; Multiscale flow simulations; Carotid artery; Patient-specific model; Parameter optimization; Antihypertensives; Atherosclerosis
• ISSN: 0169-2607; 1872-7565; 1872-7565
• DOI: 10.1016/j.cmpb.2024.108016

•Five patient-specific model of carotid arteries from old individuals.•Comparison of blood flow between the young and old archetypal waveforms.•The old flow waveform shows significantly lower TAWSS compared to young one.•Antihypertensives or regular aerobic exercise may decelerate the atherosclerotic process. Age-related arterial stiffening increases peripheral resistance and decreases arterial distensibility, thus contributing to hypertension, an important risk factor of atherosclerosis. It causes abnormal blood flow, endothelial dysfunction, higher pulse wave velocity, and consequently elevated pressure wave amplitude. This paper presents the influence of these changes via multiscale 3D-0D transient computational fluid dynamics simulations of blood flow in five patient-specific geometries of human carotid bifurcation using archetypal flow waveforms for young and old subjects. The proposed model shows a significant decrease in the time-averaged wall shear stress (TAWSS) for the old archetypal flow waveform. This is in good agreement with clinical data on a straight segment of common carotid arteries available for young and old subjects. Moreover, our study showed that the decrease of area-averaged TAWSS related to the old flow waveform is much more pronounced (2.5 ÷ 4.5 times higher) at risk areas (areas showing TAWSS below its threshold value of 0.48 Pa) than in straight segments commonly considered in clinical studies. Since arterial stiffness can be lowered through long-term usage of any of the five basic groups of antihypertensives, possible benefits of such medical therapy could be not only lowering blood pressure and peripheral resistance but also in increasing the TAWSS and thus attenuating an important mechanism of the atherosclerotic process.