Do arterial effects of antihypertensive drugs depend on subject's serum cholesterol?

Quantitative Vascular Evaluation: From Laboratory Experiments to Point-of-Care Patient (Clinical Approach)

To enhance the efficiency of patient-specific risk stratification and diagnosis, an assessment of arterial structural and functional changes associated to a vascular disease in both early and advanced stages have been proposed, with the objective of limiting the progression or revert vascular alterations. In this connection, an interdisciplinary international partnership made up by research institutions from France, Argentina, Uruguay and Spain was established, with the objective of contributing to the evaluation and follow-up of factors involved in the physiopathology of cardiometabolic diseases and human aging. Several studies, such as the effect of hypertension in large arteries, alterations in arterial wall viscosity, stiffness and inertia, endothelial function and vascular reactivity, cardiovascular risk improvement, vascular age assessment and cryografts vascular response evaluation were carried out as a result of this international collaboration during the last twenty-five years.

Smart Damping Modulation of Carotid Wall Energetics in Human Hypertension

Damping is the conversion of mechanical energy of a structure into thermal energy, and it is related to the material viscous behavior. To evaluate the role of damping in the common carotid artery (CCA) wall in human hypertension and the possible improvement of angiotensin-converting enzyme (ACE) inhibition, we used noninvasive CCA pressure (tonometry) and diameter (B-mode echography) waveforms in normotensive subjects (NT group; n=12) and in hypertensive patients (HT group; n=22) single-blind randomized into HT–placebo (n=10) or HT-treated (ramipril, 5 to 10 mg/d during 3 months; n=12). Vascular smooth muscle (VSM) null tonus condition was achieved from in vitro pressure and diameter waveforms (Konigsberg microtransducer and sonomicrometry) measured in explanted human CCA (n=14). Arterial wall dynamics was described by viscous (η), inertial ( M ), and compliance ( C ) parameters, mean circumferential wall stress, viscous energy dissipation ( W D ), peak strain energy ( W St ), damping ratio (ξ= W D / W St ), and modeling isobaric indexes C Iso and W St(Iso) . The lack of VSM tonus isobarically increased wall stress and reduced η, C Iso , and damping ( P <0.01). Wall stress, η, and W D were greater in HT than in NT ( P <0.015) and arrived near normal in HT-treated ( P <0.032 respect to HT), with no changes in HT–placebo. Whereas C Iso increased in HT-treated ( P <0.01) approaching the NT level, ξ did not vary among groups. During hypertension, because of the W St increase, the arterial wall reacts increasing W D to maintain ξ. ACE inhibition modulates VSM activation and vessel wall remodeling, significantly improving wall energetics and wall stress. This protective vascular action reduces extra load to the heart and maintains enhanced arterial wall damping.