MEASUREMENT OF ARTERIAL AGING IN HYPERTENSIVE PATIENTS*

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Abstract
The ratio of the fall in pulse pressure to the fall in diastolic pressure following the inhalation of amyl nitrite is an indirect clinical index of the effect of aging on arterial walls. (Jour. Clin. Invest. 40 933-939, 1961). This index is not directly related to distensibility of the large arteries but it represents the differential of their stiffness with respect to pressure. The purpose of this study was to re-examine the relationship between hypertension and aging of the arteries by means of the amyl nitrite test. The hypothesis that in the majority of patients with essential hypertension the elevated diastolic pressure is the consequence of aging of arteries is evaluated. Our findings in 100 hypertensive patients revealed no evidence of premature arterial aging in 71 of them when they were compared with normal subjects of the same age. The clinical feature of the 29 hypertensives with abnormal rigidity indices suggested that arteriosclerosis and hypertension developed as two separate entities possibly potentiating each other. We found no evidence to suggest that hypertension might have been caused by arteriosclerosis extending to the peripheral vascular system. If structural changes in the peripheral vascular bed play a major role in the etiology of essential hypertension, they do not appear to be related to premature arterial aging as determined by this test.