Vascular Stiffness and Increased Pulse Pressure in the Aging Cardiovascular System

Abstract

Aging leads to a multitude of changes in the cardiovascular system, including systolic hypertension, increased central vascular stiffness, and increased pulse pressure. In this paper we will review the effects of age-associated increased vascular stiffness on systolic blood pressure, pulse pressure, augmentation index, and cardiac workload. Additionally we will describe pulse wave velocity as a method to measure vascular stiffness and review the impact of increased vascular stiffness as an index of vascular health and as a predictor of adverse cardiovascular outcomes. Furthermore, we will discuss the underlying mechanisms and how these may be modified in order to change the outcomes. A thorough understanding of these concepts is of paramount importance and has therapeutic implications for the increasingly elderly population.

ABCA1-dependent serum cholesterol efflux capacity inversely correlates with pulse wave velocity in healthy subjects

“…Our new observation that ABCA1-dependent serum CEC is the fi rst strong parameter that follows those well known to be predictive of PWV (age, blood pressure, and BMI) ( 38,39 ) is consistent with the idea that functionally conserved HDL, infl uencing cholesterol traffi cking in the arterial wall, may contribute to limit vessel stiffness. A very recent work showed that arterial stiffness, evaluated as PWV, correlates with circulating oxidized LDL in healthy subjects, pointing to the importance of lipid metabolism on this parameter ( 40 ).…”

Fixed-Dose Triple Combination of Antihypertensive Drugs Improves Blood Pressure Control: From Clinical Trials to Clinical Practice

“…The increase of pulse pressure (the pulsatile component of blood pressure) is an age-related phenomenon and the common belief is that it is an indicator of large artery stiffness [18] and an established marker of cardiovascular risk in different clinical settings [19,20]. High pulse pressure may derive both from a rise in systolic values and from a decrease in diastolic values.…”

Efeitos Da Restrição Calórica Sobre a Histomorfometria Da Aorta Torácica De Ratos Envelhecidos

“…Complementando, Steppan et al (2011) descrevem que a espessura da íntima-média em humanos triplica entre os 20 e os 90 anos de idade. Para Collins et al (2014) o aumento da espessura aórtica ocorre com predomínio do incremento intimal, enquanto a túnica média permanece praticamente constante com a idade.…”