P41 Increased Stiffness in the Digital Arteries of Essential Hypertensive Women: The Fuchsia Study

Abstract

Rationale and Aim

Essential hypertension is characterized by extensive alterations of arterial geometry and mechanical properties: increased stiffness, dilation and wall of large arteries, increased thickness in muscular arteries, small artery remodeling. This study is aimed at exploring function and structure of the digital arteries of the hand, muscular arteries with an internal diameter of 500–1000 mm, easily accessible by ultrahigh frequency ultrasound.

Methods

24 hypertensive women (HT) and 37 healthy controls (C) were recruited. 5’-videoclips of left palmar digital arteries were obtained by VevoMD (FUJIFILM, VisualSonics, Toronto, Canada), by means of a 70 MHz probe (axial-lateral resolution 30–65 mm). An automatic system (Cvsuite, Quipu srl; Pisa, Italy) was used to measure intima-media thickness (IMT) and diameter. Distensibility and stiffness were then calculated using left brachial pulse pressure (PP - oscillometric)

Results

HT and C had similar age (57 ± 11 vs 53 ± 11 years, p = 0.22), BMI (24.9 ± 4.6 vs 24.5 ± 4.2 vs kg/m², p = 0.80) and mean blood pressure (BP, 95 ± 12 vs 91 ± 12 mmHg, p = 0.24); HT showed slighlty higher PP (54 ± 14 vs 47 ± 10, p = 0.07). Palmar digital lumen tended to be higher in HT (804 ± 201 vs 696 ± 191 mm, p = 0.10), while IMT was similar (120 ± 23 vs 125 ± 36 mm, p = 0.81). Distensibility was reduced (21.4 ± 18.2 vs 29.0 ± 18.8 kPa ¹, p < 0.05), while stiffness was increased (7.95 ± 2.22 vs 6.72 ± 2.11 m/s, p < 0.005).

Conclusions

This is the first report of the presence of altered mechanical properties (i.e. increased stiffness) in muscular arteries with lumen <1000 mm of essential hypertensive women. These findings suggest that increased hemodynamic load characterizing hypertension lead to a different vascular phenotype in each arterial segment.