Saul G D
Med Hypotheses. 1999 Apr;52(4):349-51. doi: 10.1054/mehy.1999.0660.
Pressure-induced arterial stress is probably the principle factor in the localization of atherosclerotic disease. The occurrence of lesions at the bifurcations and ostia of arteries seems to be caused by the concentration of stress at these locations. Other puzzles and paradoxes regarding the distribution of atherosclerosis can be explained by dynamic extra-arterial pressure (DEAP): fluctuations in tissue pressure that occur with movement, body position, and the beating of the heart. These tissue pressures, both above and below atmospheric pressure, change the transmural pressures in arteries and thereby either retard or accelerate atherogenesis. The DEAP hypothesis predicts that physical fitness increases extra-arterial tissue pressure, which protects important arteries from high transmural pressure. Deconditioning is expected to have the exact opposite effect, producing the equivalent of localized hypertension in the cerebral, internal carotid, coronary, abdominal aorta, and lower extremity arteries.
压力诱导的动脉应力可能是动脉粥样硬化疾病定位的主要因素。动脉分叉处和开口处病变的发生似乎是由这些部位的应力集中所致。关于动脉粥样硬化分布的其他谜题和矛盾现象可以用动态动脉外压力（DEAP）来解释：随着运动、身体姿势和心脏跳动而发生的组织压力波动。这些高于和低于大气压的组织压力会改变动脉的跨壁压力，从而延缓或加速动脉粥样硬化的发生。DEAP假说预测，身体健康会增加动脉外组织压力，从而保护重要动脉免受高跨壁压力的影响。而身体机能下降预计会产生完全相反的效果，在脑动脉、颈内动脉、冠状动脉、腹主动脉和下肢动脉中产生相当于局部高血压的情况。
