Hemodynamics of Primary Hypertension

Hypertension is the most common condition predisposing to cardiovascular disease, with a recent estimate that it affects approximately 1.39 billion people worldwide. From a hemodynamic standpoint, hypertension can arise as a result of altered ventricular ejection dynamics, for example, increased cardiac output, and/or an increase in impedance of the proximal or distal arterial tree, for example, increased aortic stiffness or peripheral vascular resistance. However, patients with hypertension are diagnosed and treated based on elevated blood pressure alone, without consideration of their underlying cardiovascular physiology. Understanding how this contributes to an individual’s hypertension could help in identifying the dominant aetiology and in tailoring treatment to an individual. For example, hypertension caused by increased cardiac output is likely to be due to a neurohormonal cause and might best be treated by an intervention known to reduce cardiac output. Conversely, hypertension that is due mainly to an increase in aortic stiffness might best be treated by an intervention that has a direct effect on aortic stiffness.

The goal is to understand how cardiovascular properties: cardiac properties, vascular properties and the coupling between these contribute to different hypertension sub-phenotypes and how this varies with age and other biological characteristics including gender, body mass and specific cardiac and vascular conditions. This will be done by commissioning articles that examine the contribution of one or more cardiovascular properties to hypertension in the general population or in specific sub-groups.

We welcome contributions that address the primary question (contribution of individual cardiovascular properties to hypertension) across a wide range of methodologies will be welcome: In vivo measurements in population studies or specific groups, in-silico simulations and in-vitro studies. Also important will be methodological developments designed to facilitate measurements of cardiovascular properties that can be applied to answer the primary question in future large scale studies.