Aortic stiffness: Current understanding and future directions

João L. Cavalcante, João A.C. Lima, Alban Redheuil, Mouaz H. Al-Mallah

Research output: Contribution to journalReview article

513 Scopus citations

Abstract

The aorta stiffens with aging, a process that is accelerated by arterial hypertension. Decreased arterial compliance is one of the earliest detectable manifestations of adverse structural and functional changes within the vessel wall. The use of different imaging techniques optimized for assessment of vascular elasticity and quantification of luminal and vessel wall parameters allows for a comprehensive and detailed view of the vascular system. In addition, several studies have also documented the prognostic importance of arterial stiffness (AS) in various populations as an independent predictor of cardiovascular morbidity and all-cause mortality. Measurement of AS by applanation tonometry with pulse-wave velocity has been the gold-standard method and is well-validated in large populations as a strong predictor of adverse cardiovascular outcomes. Because aortic stiffness depends on the prevailing blood pressure, effective antihypertensive treatment is expected to reduce it in proportion to the blood pressure reduction. Nevertheless, drugs lowering blood pressure might differ in their effects on structure and function of the arterial walls. This review paper not only will discuss the current understanding and clinical significance of AS but also will review the effects of various pharmacological and nonpharmacological interventions that can be used to preserve the favorable profile of a more compliant and less stiff aorta.

Original languageEnglish (US)
Pages (from-to)1511-1522
Number of pages12
JournalJournal of the American College of Cardiology
Volume57
Issue number14
DOIs
StatePublished - Apr 5 2011

Keywords

  • aortic distensibility
  • aortic stiffness
  • applanation tonometry
  • pulse wave velocity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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