ARTERIOSCLEROSIS OBLITERANS OF THE LOWER-LIMBS AS A MODEL OF PERIPHERAL VASCULAR-DISEASE WITH HYPERTENSION

In patients with arteriosclerosis obliterans of the lower limbs, hypertension is often characterized by a disproportionate increase in systolic pressure whereas diastolic blood pressure remains normal or even low. This hemodynamic pattern is associated with a reduction in systemic and forearm arterial compliance, whereas cardiac output and peripheral vascular resistance remains within the normal range in the absence of complications. The reduced arterial compliance is influenced not only by structural modifications of the arterial wall but also by changes in vasomotor tone. Whereas increased sodium intake and beta-blockade by propranolol reduce arterial compliance, nitrate derivatives increase arterial compliance with a resulting selective decrease in systolic pressure.