Arterial dynamics, cardiac hypertrophy, and antihypertensive treatment.

The relationship between cardiac hypertrophy, ventricular function, and aortic volume distensibility was studied in men with sustained essential hypertension by echocardiography and determination of pulse-wave velocity. The more reduced the aortic distensibility, the higher was the blood pressure response to exercise and the greater were the degree of cardiac hypertrophy and the modifications in systolic time intervals. Changes in cardiac performance as determined by vasodilators equipotent in relation to blood pressure reduction were found to have markedly different effects on aortic distensibility; volume distensibility was unchanged by cadralazine but was improved by calcium entry blockers and isosorbide dinitrate. Our findings suggest that alterations in the buffering function of the large arteries, as indicated by decreased volume distensibility, participate in the increased afterload in patients with essential hypertension and thus influence the degree of cardiac hypertrophy and changes in cardiac function and selective use of antihypertensive drugs may influence cardiovascular morbidity and mortality by their differential effect on large-vessel distensibility.