Hypertension III: Flow-Induced Vascular Remodeling

Flow-induced remodeling and flow-induced vasodilatation

Jo De Mey

Dear Dr Prewitt,

In your introduction you suggest a direct relationship between between endothelium-dependent flow-induced vasodilatation and flow-induced remodeling. I wonder what the direct experimental proof for this may be.
1. To my knowledge endothelium-dependency has only been demonstrated for the structural response of (juvenile) rabbit carotid arteries to blood flow reduction. What justifies to extrapolate this finding to arterioles and to chronic hyperperfusion?
2. Is there any evidence against a parallel (rather than a series) relationship between dilatation and outward remodeling. Outward remodeling may be an alternative pathway to normalise shear stress, rather than a consequence of dilatation. To put it differently, outward remodeling may develop in those conditions where dilatation is not (or no longer) capable of normalizing of shear stress.

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