US EPA

1685469 

Journal Article 

Atherosclerosis and arteriosclerosis in hypertension 

Klaus, D 

2000 

1 

Nieren- und Hochdruckkrankheiten
ISSN: 0300-5224 

29 

1 

1-16 

WOS:000085326000001 

Atherosclerosis and arteriosclerosis, mostly used as synonymous terms, are both aggravated by arterial hypertension, bur atherosclerosis and arteriosclerosis are different in structural and physiological alterations. Atherosclerosis is primarily located in the intima and disturbs the conduit function of the arteries by segmentary lesions. Arteriosclerosis is a diffuse disease of the media and increases arterial stiffness. Endothelial dysfunction is early present in both diseases. On a molecular basis atherosclerosis is characterized by an imbalance in the bioavailability of nitric oxide and reactive oxygen species. An imbalance is also found for vasoconstricting vs vasodilating mediators and substances. The interrelationship between angiotensin II and oxydation of lipids reinforces the cascade of events. As a therapeutic consequence even moderate increased LDL-cholesterol levels in hypertensive patients should be treated and a supplementation with antioxydant agents is to be recommended. Arterial hypertension facilitates the establishment and progression of arteriosclerosis in large central arteries, whereas ageing promotes arteriosclerosis in the small peripheral vessels as well. Arteriosclerosis increases arterial stiffness and therefore - in a given stroke volumen - both systolic blood pressure and pulse pressure. As a consequence of the positive feedback mechanism hypertension will be become more pronounced. Arteriosclerosis furthermore leads to an increase of pulse wave velocity. The earlier wave reflexion from the lower limbs increases systolic aortic blood pressure in the late systole. Late systolic blood pressure peak in the ascending aorta is considered as an independent rise factor for coronary artery disease. Measurement of pulse wave velocity should be used as a clinical method for determination of arterial stiffness. Drugs that mainly decrease systolic pressure and pulse pressure like nitrates have a more pronounced effect on large arteries than on resistance vessels, but the relevance of arterial stiffness in diagostic and therapeutic aspects needs further evaluation. 

age and arteriosclerosis; arterial compliance; arterial distensibility; arterial stiffness; bioavailability of nitric oxide; blood pressure augmentation; hypertension and arteriosclerosis; hypertension and atherosclerosis; hypertension and endothelial dysfunction; mechanotransduction; pulse wave velocity; superoxiddismutase in hypertension