Hypertension and vascular aging

Hypertension syndrome is a complex set of hemodynamic maladaptations that include stiff central arteries with pressure amplification, arteriolar constriction, microcirculatory rarefaction, metabolic abnormalities, cardiac hypertrophy and increased blood pressure variability. Cardiovascular aging in hypertension is accompanied by isolated systolic hypertension and an increased pulse pressure due to the increased central arterial stiffness, and patients with this malady have higher cardiovascular morbidity and mortality rates. Systolic hypertension causes endothelial dysfunction and atherosclerosis/ arteriosclerosis, so that the aortic compliance is reduced and the small resistance arteries are constricted with inward eutrophic remodeling. Central arterial stiffness increases the SBP variability and also the blunt aortocarotid baroreflex, which can cause orthostatic hypotension.