Abstract
Vascular stiffening, a process responsible for the development of isolated systolic hypertension, depends on dysregulation of collagen–elastine production and arrangement, yet it is not known whether the effect is uniform throughout wide blood pressure (BP) range. To check whether arterial stiffness is similarly related to increased fibrotic remodelling, in patients with systolic blood pressure (SBP) above and below 160 mmHg. Consecutive peri- and postmenopausal female outpatients treated for hypertension and free from other disorders interfering with fibrotic processes, had their BP, pulse wave velocity (PWV), and collagen (N-terminal procollagen type III propeptide (PIIINP); C-terminal procollagen type I propeptide—(PICP)) measured. The average age of 100 women was 71.8±10.5 years, BP was 145/83±25/15 mmHg, pulse pressure 63±17 mmHg, and mean blood pressure (MBP) 104±17 mmHg. PWV was 12.9±3.6 m/s and was significantly higher among 30 patients with SBP of ⩾160 mmHg. PIIINP averaged 4.6±1.6 ng/ml and PICP 142.2±47.0 ng/ml. In the low SBP (<160 mmHg) group there was no relationship between PWV and collagen concentrations. However, in the ⩾160 mmHg group there was significant correlation between PWV and PIIINP concentration. The relationship held significant after adjustment for age, and BP components. Our result can help explaining the results of recent intervention trials where older patients tended to benefit more from potentially antifibrotic drugs (ACE-I), whereas those with compliant arteries tend to benefit from diuretics.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 digital issues and online access to articles
$119.00 per year
only $9.92 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Bonow RO, Udelson JE . Left ventricular diastolic dysfunction as a cause of congestive heart failure: mechanisms and management. Ann Intern Med 1992; 117: 502–510.
de Simone G, Pasanisi F, Contaldo F . Link of nonhemodynamic factors to hemodynamic determinants of left ventricular hypertrophy. Hypertension 2001; 38: 13–18.
Arnett DK, Evans GW, Riley WA . Arterial stiffness: a new cardiovascular risk factor? Am J Epidemiol 1994; 140: 669–682.
Bots ML, Dijk JM, Oren A, Grobbee DE . Carotid intima-media thickness, arterial stiffness and risk of cardiovascular disease: current evidence. J Hypertens 2002; 20: 2317–2325.
Fernández-Llama P et al. Angiotensin converting enzyme I/D polymorphism in essential hypertension and nephroangiosclerosis. Kidney Intern 1998; 53: 1743–1747.
O'Rourke MF et al. Clinical applications of arterial stiffness: definitions and reference values. Am J Hypertens 2002; 15: 426–444.
Gasowski J et al. Pulsatile blood pressure component as predictor of mortality in hypertension: a meta-analysis of clinical trial control groups. J Hypertens 2002; 20: 145–151.
O'Brien E et al. European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. J Hypertens 2003; 21: 821–848.
Ooshima A et al. Increased collagen synthesis in blood vessels of hypertensive rats and its reversal by antihypertensive agents. Proc Natl Acad Sci USA 1974; 71: 3019–3023.
Gilligan JP, Spector S . Synthesis of collagen in cardiac and vascular walls. Hypertension 1984; 6 (Suppl III): iii-44–iii-49.
Safar ME, Blacher J, Mourad JJ, London GM . Stiffness of carotid artery wall material and blood pressure in humans. Stroke 2000; 31: 782–790.
Gasowski J . Czynniki warunkujace strukture i funkcje mechaniczna duzych tetnic (Factors influencing structure and mechanical function of large arteries). Collegium Medicum UJ: Kraków, 2001.
Staessen JA et al. Risks of untreated and treated isolated systolic hypertension in the elderly: meta-analysis of outcome trials. Lancet 2000; 355: 865–872.
Blacher J et al. Pulse pressure not mean pressure determines cardiovascular risk in older hypertensive patients. Arch Intern Med 2000; 160: 1085–1089.
Dzau VJ, Safar ME . Large conduit arteries in hypertension: role of the vascular renin–angiotensin system. Circulation 1988; 77: 947–954.
Laviades C et al. Abnormalities of the extarcellular degradation of collagen type I in essential hypertension. Circulation 1998; 98: 535–540.
Scott DM, Harwood R, Grant ME, Jackson DS . Characterisation of the major collagen species preseent in porcine aortae and the synthesis of their precursors by smooth muscle cells in culture. Connective Tissue Res 1977; 5: 7–13.
Rauterberg J et al. Characterization of the collagen synthesized by cultured human smooth muscle cells from fetal and adult aorta. Hoppe-Seyler's Z Physiol Chem 1977; 358: 401–407.
Timms PM et al. Plasma tissue inhibitor of metalloproteinase-1 levels are elevated in essential hypertension and related to left ventricular hypertrophy. Am J Hypertens 2002; 15: 269–272.
Diez J et al. Increased serum concentrations of procollagen peptides in essential hypertension. Circulation 1995; 91: 1450–1456.
Chamiot Clerc P et al. Collagen I and III and mechanical properties of conduit arteries in rats with genetic hypertension. J Vasc Res 1999; 36: 139–146.
Blacher J et al. Pulse pressure not mean pressure determines cardiovascular risk in older hypertensive patients. Arch Intern Med 2000; 160: 1085–1089.
O'Rourke M . Mechanical properties in arterial disease. Hypertension 1995; 26: 2–9.
Gasowski J, Wang JG, Staessen JA . Clinical trials in isolated systolic hypertension. Curr Hypertens Rep 1999; 1: 387–393.
SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 1991; 265: 3255–3264.
Staessen JA et al. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension (correction published in The Lancet 1997, volume 350, November 29, p 1636). Lancet 1997; 350: 757–764.
Wing LMH et al on behalf of the ANBP2 Management Committee and Investigators. ‘Reverse white-coat hypertension’ in older hypertensives. J Hypertens 2002; 20: 639–644.
Heart Outcomes Prevention Evaluation Study Investigators. Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 2000; 355: 253–259.
Rajzer MW et al. Aortic pulse wave velocity in young normotensives with a family history of hypertension. J Hypertens 1999; 17: 1821–1824.
Author information
Authors and Affiliations
Corresponding author
Additional information
Conflict of interests: None declared.
Rights and permissions
About this article
Cite this article
Skalska, A., Gąsowski, J., Cwynar, M. et al. The relationship between pulse wave velocity and indexes of collagen synthesis in hypertensive patients, according to the level of systolic blood pressure. J Hum Hypertens 19, 731–735 (2005). https://doi.org/10.1038/sj.jhh.1001892
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.jhh.1001892
Keywords
This article is cited by
-
Targeting the arterial wall, but what is the target?
Journal of Human Hypertension (2009)
-
Matrix metalloproteinase-9 polymorphism contributes to blood pressure and arterial stiffness in essential hypertension
Journal of Human Hypertension (2007)