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Does hyperkinetic circulation constitute a pre‐hypertensive stage? A 5‐year follow‐up of haemodynamics in young men with mild blood pressure elevation
Author(s) -
ANDERSSON O. K.,
BECKMANSUURKÜLA M.,
SANNERSTEDT R.,
MAGNUSSON M.,
SIVERTSSON R.
Publication year - 1989
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1989.tb01415.x
Subject(s) - medicine , blood pressure , hemodynamics , vascular resistance , cardiology , hyperaemia , cardiac index , cardiac output , plethysmograph , blood flow
Abstract Andersson OK, Beckman‐Suurküla M, Sannerstedt R, Magnusson M, Sivertsson R (Departments of Internal Medicine and Clinical Physiology, Sahlgrenska Hospital and Department of Clinical Physiology, Östra Hospital, Gothenburg University, Gothenburg, Sweden.) Does hyperkinetic circulation constitute a pre‐hypertensive stage? A 5‐year follow‐up of haemodynamics in young men with mild blood pressure elevation. Journal of Internal Medicine 1989; 226 : 401–08. In a previous haemodynamic examination, 44 young men (18–22 years) with blood pressure elevation above the 98th percentile, mean arterial blood pressure (MAP) ≥ 95 ± 6 mm Hg, showed an increased cardiac index (dye‐dilution) and an enhanced resistance at maximal vasodilation of the hand (venous occlusion plethysmography during hyperaemia). This latter finding suggested arteriolar wall hypertrophy. However, the subgroup with the highest cardiac index (≥ 3.86 1 min −1 × m 2 ) ( n = 18) displayed normal vascular resistance at maximal dilation in comparison with the normotensive control group ( n = 29). Consequently, functional signs of arteriolar hypertrophy were restricted to individuals with normal or low cardiac index. At the re‐investigation 5 years later, a significant reduction in blood pressure was observed in the normotensive control group (MAP: from 88 ± 7 to 85 ± 7 mm Hg, P < 0.05). There was no change in individuals with initially elevated blood pressure. Furthermore, cardiac index fell significantly with time in this latter group. Thus, the blood pressure elevation in the hypertensive group, previously mainly dependent on high blood flow was, 5 years later, more related to an increased total peripheral resistance, (Δ total peripheral resistance = 8%). However, no definite evidence indicating development of hypertrophy of the resistance vessels of the hand was observed during the follow‐up period. Since the hyperkinetic subgroup did not display a concomitant fall in blood pressure with cardiac output, our results do not support the theory that the hyperkinetic form of borderline hypertension is a temporary phenomenon, explained by the inclusion of anxious individuals afraid of the experimental situation. Hyperkinetic hypertension may be the initial phase of sustained hypertension in a subgroup of the future hypertensive population.