Reversibility of Vascular Hypertrophy in Pharmacologically Treated Patients

Established essential hypertension is characterized by raised vascular resistance and, in most cases, normal cardiac output. Both in human and animal models of hypertension, structural vascular changes have been demonstrated. Such morphologic changes are at least to some extent reversible in hypertensive animals if prolonged normotension is induced. In humans, however, results are conflicting. In some vascular beds (hand and forearm), plethysmographic studies have indicated partial regression during antihypertensive treatment, whereas available studies have been negative as regards the calf muscle vascular bed. Some recent studies suggest that reversibility of structural vascular changes may not only be related to blood pressure reduction per se, but that effects on sympathetic tone and/or trophic neurohormonal influences also may be of importance.