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A b s t r a c tThe cardiovascular diseases are still the leading cause of mortality and impaired quality of life worldwide. This fact implies the necessity of appropriate screening markers for focusing primary prevention on the individuals at higher cardiovascular risk.The relevance of arterial stiffness as a predictor of future cardiovascular events is due to the fact it is a manifestation of the cumulative effect of all the harmful factors acting on the vascular wall, their duration and intensity, as well as of the genetic background of the individual.The major structure of the vascular wall of the large "conduit" arteries is reviewed and the organization of the basic unit, the lamellar unit, is discussed in relation to the normal aging process and the concomitant alterations in arterial stiffness.A review of the modern non-invasive methods for arterial stiffness evaluation is carried out: imaging of the relationship between vascular size and distending pressure; pulse wave analysis; measurement of pulse wave velocity (PWV).A comparison of the resting brachial-ankle PWV (ba-PWV) is performed between two groups of young healthy adults: offspring of parents with cardiovascular pathology (N+) and their age matched controls (N-). Brachial-ankle PWV was significantly higher (8.72 ± 0.35 m/s) in N+ as compared to N-(6.72 ± 0.66 m/s) (P < 0.01). We consider the increased PWV as a consequence to an autonomic dysbalance and to an elevated sympathetic stimulation of the vascular smooth muscle in the healthy young adults with positive family history for cardiovascular pathology. We can conclude that measurement of ba-PWV is a relevant and cost-effective method for screening the individuals at higher cardiovascular risk.

Summary Vascular-ventricular coupling is a major determinant of left ventricular load. The aim of our study was to assess non- invasively left ventricular load and its dependency on central hemodynamics. Sixty-five healthy and gender-matched individuals were divided in two groups according to their age: 20y/o and 50y/o. Applanation tonometry was performed using the Sphygmocor device. Central pressures and pulse wave analysis indices were computed. Central systolic (120±3 vs. 98±2 mm Hg) and pulse pressures (43±3 vs. 29±1 mm Hg) as well as the augmentation index (AIx75) (23±3 vs. 6±2%) were significantly higher in the 50y/o group (p<0.01). These parameters are relevant markers of arterial stiffness and evidenced the development of central arterial morphological and functional alterations in the older subjects. The time-tension index (TTI) computed from the systolic pressure area was significantly higher in the 50y/o subjects as compared to the 20y/o group (2378±66 vs. 1954±73 mmHg×s, p<0.01). Moreover, we have shown the presence of significant correlation between TTI and AIx75 (p<0.01) in both age groups. This finding confirmed the contribution of arterial stiffness for the impaired vascular-ventricular coupling. In conclusion, applanation tonometry might be utilized for non-invasive evaluation of the left ventricular load, which is an important parameter of cardiovascular risk.