Physiological network analysis of arterial stiffness, hemodynamic parameters and aortic architecture in patients with and without hypertension

Introduction Hypertension is associated with vascular remodeling and hemodynamic alterations; however, the global interaction of these processes remains insufficiently understood. Objective To analyze the structure of physiological networks integrating arterial stiffness, hemodynamic parameters, and aortic architecture in patients with and without hypertension. Materials and methods An analytical study based on a secondary dataset (n = 801) including clinical and hemodynamic measurements, arterial stiffness assessed by the left and right cardio-ankle vascular index (CAVI-L and CAVI-R), and aortic diameters measured by computed tomography. Physiological networks were estimated for hypertensive and non-hypertensive groups using the Extended Bayesian Information Criterion Graphical LASSO (EBIC-GLASSO). Centrality metrics (degree, strength, betweenness) and global network metrics (density, modularity, and communities) were computed. Networks were visualized using the Fruchterman–Reingold algorithm and compared through a permutation-based procedure reproducing the Network Comparison Test (NCT). Results Network analysis revealed topological differences between patients with hypertension and those without hypertension. In the hypertensive group, CAVI-L, body mass index, and diastolic blood pressure showed higher degree and strength values. Aortic segments such as the sinus of Valsalva, mid aortic arch, and proximal descending thoracic aorta exhibited higher betweenness values. The hypertensive network showed higher density and lower effective functional differentiation. Permutation analysis confirmed greater global network strength in the hypertensive group, with formal statistical significance observed only for diastolic blood pressure. Conclusions Hypertension is associated with global changes in vascular organization, characterized by increased arterial stiffness, higher network connectivity, and a functional predominance of diastolic blood pressure within the physiological network.