ABSTRACT
In patients with essential hypertension, arterial stiffness is elevated in response to the increased loading of stiff wall materials, such as collagen. Indeed, when blood pressure (BP) increases during the cardiac cycle from diastole to systole, distensibility decreases. These short-term changes should not be confounded with long-term changes in structure and function. Particularly, whether the decrease in large artery distensibility observed in middle age hypertensive patients is due primarily to an increase in distending pressure or to hypertensioninduced changes in structural properties has been much debated (24). We recently reviewed the various mechanisms explaining that the changes in arterial wall material, which accompany arterial wall hypertrophy in animal models of
essential hypertension, are not necessarily associated with an increased isobaric stiffness and mechanical strength, and concluded that the increase in arterial stiffness observed in patients with essential hypertension was primarily due to an increase in distending pressure (28). Later, age, metabolic disorders, renal failure may modify this hemodynamic pattern (49).
