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Modeling Forearm Vascular Mechanics in Hypertension

An emerging hypothesis states that vascular disease is initiated within the microvasculature. Using a modified Windkessel model, lumped mechanical properties of the forearm vascular bed were examined to determine the effect of chronic hypertension on the blood supply to skeletal muscle. Systemic pulse pressure (PP; Finometer), brachial artery radius (BAR; Ultrasound), vascular bed compliance (C), and resistance (R) were measured in (I), Hypertensive (HT) patients with controlled blood pressure (CBP) and high glucose (HG)(n=8), (II) HT patients with CBP and normal glucose (NG)(n=10), (III) HT patients with uncontrolled blood pressure (UBP) and HG (n=18), (IV) HT patients with UBP and NG (n=16), and (V) age‐matched, healthy controls (n=27). R was decreased and BAR was increased in UBP groups with HG levels compared to all other groups (p<0.05). PP was found to vary across groups, but was unrelated to C. These findings support a model of systolic HT which is consistent with the PP results. UBP with high glucose appears to initiate hypertrophic remodelling leading to reduced vascular R. However, from a vascular mechanics perspective, hypertension, with or without high glucose, does not modify microvascular compliance in skeletal muscle. Supported by Canadian Institutes of Health Research, NSERC, and the Canadian Diabetes Association.