Pedrinelli R, Dell'Omo G, Catapano G, Talarico L, Di Bello V, Petrucci R, Napoli V
Istituti di I Clinica Medica, Universita di Pisa, Italy.
Coron Artery Dis. 1995 Nov;6(11):845-50.
The development of a reduced forearm blood flow reserve and an increased carotid intima media thickness is a well known consequence of the structural adaptation of arterioles and large arteries in response to hypertension. It is unknown, however, how those two processes relate to each other in the individual hypertensive patient.
Minimal forearm vascular resistances (Rmin, the ratio of mean blood pressure to postischemic plethysmographic peak forearm blood flow), common carotid intima media thickness (IMT, high-resolution ultrasonography), blood pressure (indirect method), left ventricular mass, posterior wall and septum thickness (by echocardiography) and lipids were measured in 15 men with mild-to-moderate essential hypertension without evidence of atherosclerotic involvement of the carotid arteries, and in 14 normotensive controls with a similar age range.
Rmin and IMT were greater in hypertensives, and a statistically significant positive correlation existed between the two variables. Both Rmin and IMT correlated with left ventricular structure indices and blood pressure. Age showed a positive correlation with IMT, while lipids were unrelated to either parameter.
The micro- and macrovascular segments of the hypertensive circulation readapt in parallel in response to elevated blood pressure, possibly through the commensurate development of medial hypertrophy.
前臂血流储备减少和颈动脉内膜中层厚度增加是小动脉和大动脉因高血压而发生结构适应性变化的一个众所周知的后果。然而，在个体高血压患者中，这两个过程如何相互关联尚不清楚。
对15名无颈动脉粥样硬化累及证据的轻度至中度原发性高血压男性以及14名年龄范围相似的血压正常对照者，测量其最小前臂血管阻力（Rmin，平均血压与缺血后体积描记法测量的前臂血流峰值之比）、颈总动脉内膜中层厚度（IMT，高分辨率超声检查）、血压（间接法）、左心室质量、后壁和室间隔厚度（超声心动图检查）以及血脂。
高血压患者的Rmin和IMT更高，且这两个变量之间存在统计学显著正相关。Rmin和IMT均与左心室结构指标和血压相关。年龄与IMT呈正相关，而血脂与这两个参数均无关。
高血压循环的微血管和大血管段可能通过相应的中层肥厚发展，对血压升高做出平行的重新适应。
