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Pathophysiology of Hypertension in the Elderly Laurent S, Boutouyrie P, Benetos A 70 AJGC2002 11 34-39 Translated with permission in 2002, Stéphane Laurent, Pierre Boutouyrie, Athanase Benetos

1 Pathophysiology of Hypertension in the Elderly Laurent S, Boutouyrie P, Benetos A 70 AJGC Translated with permission in 2002, Stéphane Laurent, Pierre Boutouyrie, Athanase Benetos Pathophysiology of hypertension in the elderly. Am J Geriatr Cardiol 2002 ; Copyright 2002 LE JACQ. All right reserved. ISHISH isolated systolic hypertension ISH arterial stiffness /03/ 400//JCLS

2 PWV , medionecrosis 3,11,12 13 O Rouke 3 MAP

3 14 3arterial stiffness PWV Kelly PWV PWV10.1m PWV 23 atherosclerosis arteriosclerosis Avolio 24 PWV PWV , 25 3, 26 3, 27 PWV 28, 29 16

4 16, 30, 31 P VC VP 32, Boutouyrie 28 Segers 35 3NT13 NT13 NT13 HT34 HT34 HT34 Means SEM NT HT p 0.001HT NT HT NTHTNT p

5 35 2 Grassi , Laogun AA, Gosling RG. In vivo arterial compliance in man. Clin Phys Physiol Meas Relf IR, Lo CS, Myers KA, et al. Risk factors for changes in aorto-iliac arterial compliance in healthy men. Arteriosclerosis O Rourke MF. Arterial Function in Health and Disease. London, UK Churchill Livingstone ,153,196. Rushmer RF. Cardiovascular Dynamics. Philadelphia, PA W.B. Saunders Randall OS, van den Bos GC, Westerhof N. Systemic compliance does it play a role in the genesis of essential hypertention? Cardiovasc Res Milnor WR. Hemodynamics. Baltimore, MD Williams and Wilkins ,211. O Rourke MF. Arterial stiffness, systolic blood pressure and logical treatment of arterial hypertension. Hypertension Wolinski H. Long-term effects of hypertension on rat aortic wall and their relation to concurrent aging changes morphological and chemical studies. Circ Res Lakatta EG, Mitchell JH. Pomerance A, et al. Human aging changes in structure and function. J Am Coll Cardiol A-47A. 10 Carlson RG, Lillehei CW, Edwards J. Cystic medical necrosis of the ascending aorta in relation to age and hypertension. Am J Cardiol Dobrin PB. Vascular mechanics. In Sheperd JT, Abboud FM, Geiger SR, eds. Handbook of Physiology. Section 2 The Cardiovascular System. Peripheral Circulation and Organ Blood Flow, Part 1. Vol 3. Bethesda, MD American Physiological Society Cox RH. Basis for the altered arterial wall mechanics in the spontaneously hypertensive rat. Hypertension Rucker RB, Tinker D. Structure and metabolism of arterial elastin. Int Rev Exp Pathol Roach MR, Burton AC. The effect of age on the elasticity of human iliac arteries. Can J Biochem Bramwell JC, Hill AV. Velocity of transmission of the pulse wave and elasticity of arteries. Lancet Benetos A, Laurent S, Hoeks AP, et al. Arterial alterations with aging and high blood pressure. A noninvasive study of carotid and femoral arteries. Arterioscler Thromb Nichols WV, O Rourke MF. McDonald s Blood Flow in Arteries Theoretical, Experimental and Clinical Principles. 3rd ed. London, UK Arnold , , , Asmar R, Benetos A, London G, at el. Aortic distensibility in normotensive, untreated and treated hypertensive patients. Blood Press Avolio AP. Pulse wave velocity and hypertension. In Safar ME, ed. Arterial and Venous Systems in Essential Hypertension. The Hague, Netherlands Martinus Nijhoff Kelly R, Hayward C, Avolio A, et al. Noninvasive determination of age-related changes in the human arterial pulse. Circulation

6 21 Nagai Y, Fleg JL, Kemper MK, et al. Carotid arterial stiffness as a surrogate for aortic stiffness relationship between carotid artery pressure-strain elastic modulus and aortic pulse wave velocity. Ultrasound Med Biol Franklin SS, Gustin WT, Wong ND. Hemodynamic patterns of age-related changes in blood pressure. The Framingham Heart Study. Circulation Avolio A. Genetic and environmental factors in the function and structure of the arterial wall. Hypertension Avolio AP, Deng FQ, Li W-Q, et al. Effects of aging on arterial distensibility in populations with high and low prevalence of hypertension comparison between urban and rural communities in China. Circulation Folkow B, Svanborg A. Physiology of cardiovascular aging. Physiol Rev Safar ME. Pulse pressure in essential hypertension clinical and therapeutical implications. J Hypertens Folkow B. Physiological aspects of primary hypertension. Physiol Rev Boutouyrie P, Laurent S, Girerd X, et al. Common carotid artery stiffness and patterns of left ventricular hypertrophy in hypertensive patients. Hypertension Roman MJ, Pickering TG, Pini R, et al. Prevalence and determinants of cardiac and vascular hypertrophy in hypertension. Hypertension Arcaro G, Laurent S, Jondeau G, et al. Stiffness of the common carotid artery in treated hypertensive patients. J Hypertens Boutouyrie P, Laurent S, Benetos A, et al. Opposing effects of aging on distal and proximal large arteries in hypertensives. J Hypertens suppl Laurent S, Caviezel B, Beck L, et al. Carotid artery distensibility and distending pressure in hypertensive humans. Hypertension Laurent S. Arterial wall hypertrophy and stiffness in essential hypertensive patients. Hypertension Bussy C, Boutouyrie P, Lacolley P, et al. Intrinsic stiffness of the carotid arterial wall material in essential hypertensives. Hypertension Segers P, Stergiopulos N, Westerhof N. Quantification of the contribution of cardiac and arterial remodeling to hypertension. Hypertension Grassi G, Seravalle G, Bertinieri G, et al. Sympathetic and reflex alterations in systo-diastolic and systolic hypertension of the elderly. J Hypertens Benetos A, Safar M, Rudnichi A, et al. Pulse pressure a predictor of long-term cardiovascular mortality in a French male population. Hypertension Mitchell GF, Moye LA, Braunwald E, et al. for the SAVE Investigators. Sphygmomanometric determined pulse pressure is a powerful independent predictor of recurrent events after myocardial infarction in patients with impaired left ventricular function. Circulation Lee MT, Rosner BA, Weiss ST. Relationship of blood pressure to cardiovascular death the effect of pulse pressure in the elderly. Ann Epidemiol Kannel WB, Stokes JLL. Hypertension as a cardiovascular risk factor. In Bulpitt CJ, ed. Handbook of Hypertension Epidemiology of Hypertension. Vol 6. Amsterdam, Netherlands Elsevier Science Kannel WB, Gordon T, Schwartz MJ. Systolic versus diastolic blood pressure and risk of coronary heart disease the Framingham Study. Am J Cardiol Laurent S, Boutouyrie P, Asmer R, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension

Noninvasive estimation of pulmonary capillary wedge pressure and cardiac output by the analysis of pulmonary venous flow velocity patterns in patients

Noninvasive estimation of pulmonary capillary wedge pressure and cardiac output by the analysis of pulmonary venous flow velocity patterns in patients with acute congestive heart failure Jung-Myung Lee,