Pulsatile diameter and elastic modulus of the aortic arch in essential hypertension: A noninvasive study

• Published in: Journal of the American College of Cardiology Vol. 13; no. 2; pp. 399 - 405
• Main Authors: Isnard, Richard N., Pannier, Bruno M., Laurent, Stéphane, London, Gérard M., Diebold, Benoît, Safar, Michel E.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.1989; Elsevier Science
• Subjects: Adult; Aorta, Thoracic - pathology; Aorta, Thoracic - physiopathology; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Flow Velocity; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Echocardiography; Elasticity; Female; Humans; Hypertension - pathology; Hypertension - physiopathology; Male; Medical sciences; Middle Aged; Pulse; Human; Hypertension; Aorta arch; Pulsatile; Elasticity; Cardiovascular disease; Essential; Diameter
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/0735-1097(89)90518-4

A noninvasive evaluation of the aortic arch diameter was performed in 16 subjects with sustained essential hypertension and in 15 normal subjects of similar age, gender and boyy surface area. In all subjects, measurements were obtained of brachial mean arterial pressure and pulse pressure, cardiac mass (judged on echocardiography) and carotid-femoral pulse wave velocity together with ultrasound determinations of aortic arch diastolic and systolic diameter (suprasternal window). For each subject, pulsatile change in aortic diameter, strain and aortic arch elastic modulus were calculated. Compared with normal subjects, the hypertensive subjects showed an increase in aortic arch diameter (diastolic diameter 29.6 ± 1.0 versus 25.4 ± 1.0 mm, p < 0.01), in elastic modulus (1.071 ± 0.131 versus 0.526 ± 0.045 105N·m−2, p < 0.001) and pulse wave velocity (11.8 ± 0.5 versus 8.90.3 m/s, p < 0.001). In the study group, a positive correlation was observed between diastolic aortic arch diameter and mean arterial pressure (r = 0.54, p < 0.01) and between elastic modulus and cardiac mass (r = 0.60, p < 0.01). Elastic modulus and age were positively correlated (r = 0.73, p < 0.01) in hypertensive but not in normal subjects (r = 0.08, NS). This study is the first to demonstrate noninvasively that both the aortic arch diameter and the elastic modulus are increased in patients with sustained uncomplicated essential hypertension. These findings suggest that the increase in elastic modulus could influence the development of cardiac hypertrophy, and that both age and blood pressure act independently as factors that alter the arterial wall of subjects with sustained essential hypertension.