Increase in Opening Angle in Hypertension Off-Loads the Intimal Stress: A Simulation Study

Abstract

The stress distribution in the vessel wall has important bearing on vascular function including intima, media, and adventitia. The residual strain in the vessel wall has been thought to largely normalize the transmural stress distribution with slightly higher values at the intima. In hypertension, the compensatory increase in opening angle is thought to maintain a uniform stress distribution. We have recently shown that the circumferential stress at adventitia may exceed that at intima at physiological loading due to large opening angle (OA) in normal porcine coronary arteries. The objective of this study was to show that increases in opening angle subsequent hypertension can further shift the stress from the intima to the adventitia. The change in stress distribution during acute hypertension was calculated using available data on the changes in vessel geometry, material property, and internal pressure during hypertension. It was found that the increase in OA following acute hypertension off-loads the stress from intima to adventitia, therefore, relieving some of the stress increase in the intimal layer induced by the sudden pressure increase. This has important implications for hypertension where it may shift the excessive stress from the inner layer to the outer layer. This may be a protective mechanism for the intima layer in hypertension.