Impact of hypertension and arterial wall expansion on transport properties and atherosclerosis progression

Abstract

This study explored the impact of hypertension on atheroma plaque formation through a mechanobiological model. The model incorporates blood flow via the Navier–Stokes equation. Plasma flow through the endothelium is determined by Darcy’s law and the Kedem-Katchalsky equations, which consider the three-pore model utilized for substance flow across the endothelium. The behavior of these substances within the arterial wall is described by convection–diffusion-reaction equations, while the arterial wall itself is modeled as a hyperelastic material using Yeoh’s model. To accurately evaluate hypertension’s influence, adjustments were made to incorporate wall compression-induced wall compaction by radial compression. This compaction impacts three key variables of the transport phenomena: diffusion, porosity, and permeability. Based on the obtained findings, we can conclude that hypertension significantly augments plaque growth, leading to an over 400% increase in plaque thickness. This effect persists regardless of whether wall mechanics are considered. Tortuosity, arterial wall permeability, and porosity have minimal impact on atheroma plaque growth under normal arterial pressure. However, the atheroma plaque growth changes dramatically in hypertensive cases. In such scenarios, the collective influence of all factors—tortuosity, permeability, and porosity—results in nearly a 20% increase in plaque growth. This emphasizes the importance of considering wall compression due to hypertension in patient studies, where elevated blood pressure and high cholesterol levels commonly coexist.