Hemodynamic Patterns in Essential Hypertension

Abstract

Hemodynamic studies, including cardiac output, arterial blood pressure, run-off index, flow cessation pressure, and blood volume, were performed in 20 normotensive control subjects, 17 labile hypertensive patients and 20 patients with fixed hypertension, 10 of them with a mild elevation of the diastolic pressure and 10 classified as severe because of a diastolic blood pressure above 110 mm. Hg. In labile hypertension cardiac output was elevated, whereas blood volume, peripheral resistance, run-off index and flow cessation pressure were normal when blood pressure was high. This hemodynamic pattern was interpreted as due to an enhanced myocardial contractile energy or a restriction of the capacity vascular bed. In mild fixed hypertension total peripheral resistance and flow cessation pressure were uniformly increased, but cardiac output and run-off index were normal. This pattern may be explained by the influence of flow autoregulation and the barostatic mechanism. In severe fixed hypertension blood volume, cardiac output, and peripheral resistance were found to be high. Renal ischemia and secondary hyperaldosteronism may determine the development of this last stage of hypertension.