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The hemodynamic mechanisms of hypertension are often limited to the
study of three dominant parameters: blood pressure, cardiac output
and vascular resis tance. Accordingly, the development of
hypertension is usually analyzed in terms of a 'struggle' between
cardiac output and vascular resistance, resulting in the classical
pattern of normal cardiac output and increased vascular resistance,
thus indicating a reduction in the caliber of small arteries.
However, during the past years, the clinical management of
hypertension has largely modified these simple views. While an
adequate control of blood pressure may be obtained with
antihypertensive drugs, arterial complications may occur, involving
mainly the coronary circulation and suggesting that several parts
of the cardiovascular system are altered in hypertension. Indeed,
disturbances in the arterial and the venous system had already been
noticed in animal hypertension. The basic assumption in this book
is that the overall cardiovascular system is involved in the
mechanisms of the elevated blood pressure in patients with
hypertension: not only the heart and small arteries, but also the
large arteries and the venous system. For that reason, the
following points are emphasized. First, the cardiovascular system
in hypertension must be studied not only in terms of steady flow
but also by taking into account the pulsatile components of the
heart and the arterial systems. Second, arterial and venous
compliances are altered in hypertension and probably reflect
intrinsic alterations of the vascular wall."
The hemodynamic mechanisms of hypertension are often limited to the
study of three dominant parameters: blood pressure, cardiac output
and vascular resisĀ tance. Accordingly, the development of
hypertension is usually analyzed in terms of a 'struggle' between
cardiac output and vascular resistance, resulting in the classical
pattern of normal cardiac output and increased vascular resistance,
thus indicating a reduction in the caliber of small arteries.
However, during the past years, the clinical management of
hypertension has largely modified these simple views. While an
adequate control of blood pressure may be obtained with
antihypertensive drugs, arterial complications may occur, involving
mainly the coronary circulation and suggesting that several parts
of the cardiovascular system are altered in hypertension. Indeed,
disturbances in the arterial and the venous system had already been
noticed in animal hypertension. The basic assumption in this book
is that the overall cardiovascular system is involved in the
mechanisms of the elevated blood pressure in patients with
hypertension: not only the heart and small arteries, but also the
large arteries and the venous system. For that reason, the
following points are emphasized. First, the cardiovascular system
in hypertension must be studied not only in terms of steady flow
but also by taking into account the pulsatile components of the
heart and the arterial systems. Second, arterial and venous
compliances are altered in hypertension and probably reflect
intrinsic alterations of the vascular wall.
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