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Hemodynamics of Prehypertension

  • Peter W. de Leeuw
  • Barry van Varik
  • Daan J. L. van Twist
  • Abraham A. Kroon
Chapter
Part of the Updates in Hypertension and Cardiovascular Protection book series (UHCP)

Abstract

Hemodynamic investigations in prehypertensive people have revealed that already at this early stage of hypertension, total peripheral resistance is increased. This is true even in situations where cardiac output is elevated. Heart rate and arterial stiffness are clearly higher as well in prehypertensives as compared to normotensives. As far as the peripheral circulation has been studied, this shows abnormalities in prehypertension which are also consistent with an increased resistance to flow. Altogether, there is not enough evidence to conclude that hypertension evolves from a high-output to a high-resistance state. Rather, the increase in resistance is a primary phenomenon.

Keywords

Cardiac output Heart rate Prehypertension Autonomic control Renal Arterial stiffness 

References

  1. 1.
    Birkenhäger WH, De Leeuw PW, Schalekamp MADH. Control mechanisms in essential hypertension. Amsterdam: Elsevier Biomedical Press; 1982.Google Scholar
  2. 2.
    Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The seventh report of the joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003;289(19):2560–72.CrossRefGoogle Scholar
  3. 3.
    Vasan RS, Larson MG, Leip EP, Kannel WB, Levy D. Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study: a cohort study. Lancet. 2001;358(9294):1682–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Vasan RS, Larson MG, Leip EP, Evans JC, O’Donnell CJ, Kannel WB, et al. Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med. 2001;345(18):1291–7.CrossRefGoogle Scholar
  5. 5.
    Birkenhager WH. A critical interpretation of juvenile borderline hypertension. J Hypertens. 1991;9(Suppl 6):S2–9.Google Scholar
  6. 6.
    Omvik P, Lund-Johansen P. Hemodynamics of hypertension. In: Mancia G, Grassi G, Redon J, editors. Manual of hypertension of the European Society of Hypertension. 2nd ed. Boca Raton, FL: CRC Press; 2014. p. 101–14.CrossRefGoogle Scholar
  7. 7.
    Julius S, Esler M. Autonomic nervous cardiovascular regulation in borderline hypertension. Am J Cardiol. 1975;36(5):685–96.CrossRefPubMedGoogle Scholar
  8. 8.
    Drukteinis JS, Roman MJ, Fabsitz RR, Lee ET, Best LG, Russell M, et al. Cardiac and systemic hemodynamic characteristics of hypertension and prehypertension in adolescents and young adults: the Strong Heart Study. Circulation. 2007;115(2):221–7.CrossRefGoogle Scholar
  9. 9.
    De Marco M, de Simone G, Roman MJ, Chinali M, Lee ET, Russell M, et al. Cardiovascular and metabolic predictors of progression of prehypertension into hypertension: the Strong Heart Study. Hypertension. 2009;54(5):974–80.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Zhu H, Yan W, Ge D, Treiber FA, Harshfield GA, Kapuku G, et al. Cardiovascular characteristics in American youth with prehypertension. Am J Hypertens. 2007;20(10):1051–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Davis JT, Rao F, Naqshbandi D, Fung MM, Zhang K, Schork AJ, et al. Autonomic and hemodynamic origins of pre-hypertension: central role of heredity. J Am Coll Cardiol. 2012;59(24):2206–16.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Pal GK, Adithan C, Ananthanarayanan PH, Pal P, Nanda N, Thiyagarajan D, et al. Association of sympathovagal imbalance with cardiovascular risks in young prehypertensives. Am J Cardiol. 2013;112(11):1757–62.CrossRefPubMedGoogle Scholar
  13. 13.
    De Leeuw PW, Kho TL, Birkenhäger WH. Pathophysiologic features of hypertension in young men. Chest. 1983;83(2 Suppl):312–4.CrossRefPubMedGoogle Scholar
  14. 14.
    Gedikli O, Kiris A, Ozturk S, Baltaci D, Karaman K, Durmus I, et al. Effects of prehypertension on arterial stiffness and wave reflections. Clin Exp Hypertens. 2010;32(2):84–9.CrossRefPubMedGoogle Scholar
  15. 15.
    Davis JT, Pasha DN, Khandrika S, Fung MM, Milic M, O'Connor DT. Central hemodynamics in prehypertension: effect of the beta-adrenergic antagonist nebivolol. J Clin Hypertens (Greenwich). 2013;15(1):69–74.CrossRefGoogle Scholar
  16. 16.
    Birkenhäger WH, De Leeuw PW, Derkx FHM. The kidney in hypertension-background and practical implications. Hypertens Res. 1993;16(1):3–15.Google Scholar
  17. 17.
    Messerli FH, De Carvalho JG, Christie B, Frohlich ED. Systemic and regional hemodynamics in low, normal and high cardiac output borderline hypertension. Circulation. 1978;58(3 Pt 1):441–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Schmieder RE, Schachinger H, Messerli FH. Accelerated decline in renal perfusion with aging in essential hypertension. Hypertension. 1994;23(3):351–7.CrossRefPubMedGoogle Scholar
  19. 19.
    Bianchi G, Cusi D, Gatti M, Lupi GP, Ferrari P, Barlassina C, et al. A renal abnormality as a possible cause of “essential” hypertension. Lancet. 1979;1(8109):173–7.CrossRefPubMedGoogle Scholar
  20. 20.
    Hollenberg NK, Borucki LJ, Adams DF. The renal vasculature in early essential hypertension: evidence for a pathogenetic role. Medicine (Baltimore). 1978;57(2):167–78.CrossRefGoogle Scholar
  21. 21.
    Erdogan D, Yildirim I, Ciftci O, Ozer I, Caliskan M, Gullu H, et al. Effects of normal blood pressure, prehypertension, and hypertension on coronary microvascular function. Circulation. 2007;115(5):593–9.CrossRefPubMedGoogle Scholar
  22. 22.
    Grassi G, Buzzi S, Dell'Oro R, Mineo C, Dimitriadis K, Seravalle G, et al. Structural alterations of the retinal microcirculation in the “prehypertensive” high-normal blood pressure state. Curr Pharm Des. 2013;19(13):2375–81.CrossRefPubMedGoogle Scholar
  23. 23.
    Guyton A. Arterial pressure and hypertension. Philadelphia: WB Saunders Company; 1980.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Peter W. de Leeuw
    • 1
    • 2
  • Barry van Varik
    • 2
  • Daan J. L. van Twist
    • 2
  • Abraham A. Kroon
    • 1
  1. 1.Department of MedicineMaastricht University Medical CentreMaastrichtThe Netherlands
  2. 2.Department of MedicineZuyderland Medical CenterGeleen/HeerlenThe Netherlands

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