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Acta Pharmacologica Sinica (2010) 31: 12671276 2010 CPS and SIMM All rights reserved 1671-4083/10 $32.00 www.nature.com/aps
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Review
Arterial stiffness: a brief review
Najeeb A SHIRWANY, Ming-hui ZOU
Division of Endocrinology and Diabetes, Department of Medicine, University of Oklahoma Health Science Center, Oklahoma City, OK 73104, USA
Physical stiffening of the large arteries is the central paradigm of vascular aging. Indeed, stiffening in the larger central arterial system, such as the aortic tree, signicantly contributes to cardiovascular diseases in older individuals and is positively associated with systolic hypertension, coronary artery disease, stroke, heart failure and atrial brillation, which are the leading causes of mortality in the developed countries and also in the developing world as estimated in 2010 by World Health Organizations. Thus, better, less invasive and more accurate measures of arterial stiffness have been developed, which prove useful as diagnostic indices, pathophysiological markers and predictive indicators of disease. This article presents a review of the structural determinants of vascular stiffening,its pathophysiologic determinants and its implications for vascular research and medicine. A critical discussion of new techniques for assessing vascular stiffness is also presented.
Keywords: aortic stiffness; cardiovascular diseases; pathophysiology; clinical relevance
Acta Pharmacologica Sinica (2010) 31: 12671276; doi: 10.1038/aps.2010.123; published online 30 Aug 2010
Introduction
While generalized stiffening of the vasculature as a hallmark of normal aging has been recognized even in ancient medical texts, systematic scientic evaluation of arterial stiffening and particularly the type that affects the central arterial axis (ie the aortic system and its central branches) has only matured as a clinical and research discipline in recent decades. Stiffening in the larger central arterial system, such as the aortic tree, significantly contributes to cardiovascular diseases in older individuals and is positively associated with systolic hypertension[1],
coronary artery disease[2], stroke[2], heart failure[3] and atrial brillation[4]. Central arterial stiffening is now fully recognized as an important consequence of aging that has been shown to provoke deleterious vascular phenotypes in diseases such as diabetes, atherosclerosis and renal disease among others[5].
Therefore predictably, there is a consistent increase in the incidence and prevalence of the surrogate markers of vascular stiffening in these conditions and these are typically pulse pressure and isolated systolic hypertension[69].
Arteries deliver blood at high pressure to peripheral vascular beds. The arterial...