Anti-inflammatory drugs and statins for arterial stiffness reduction

Arterial stiffness is a powerful predictor of cardiovascular outcome in various patient groups as well as in general population, and can directly accelerate the atherosclerotic process. Arterial stiffness is regulated by numerous factors. Traditionally, mean arterial pressure and structural changes in the components of arterial wall were thought to be main determinants of arterial stiffness, however it is now recognized that arterial stiffness is also regulated by the smooth muscle tone and that endothelium derived mediators, such as NO, contribute to the functional regulation of arterial stiffness. It has also become apparent that inflammation has an important role in the stiffening of the large arteries, possibly via changes in the composition of the arterial wall due to inflammatory cell infiltration or via endothelial dysfunction. Recently, numerous small scale interventional studies have looked into the possibility of using anti-inflammatory and cholesterol-reduction therapies with anti-inflammatory properties as a means to reduce arterial stiffness and therefore cardiovascular risk. Anti-inflammatory therapies, such as corticosteroids and anti-TNF alpha therapy have been shown to reduce arterial stiffness in patients with chronic inflammatory conditions. In addition, statins and other cholesterol-reducing agents have been shown to have beneficial effects on wave reflection and aortic stiffness reduction in several patient groups. This review aims to explore the studies investigating the role of inflammation on arterial stiffening and to review the results from the studies investigating the effect of anti-inflammatory drugs and statins for arterial stiffness reduction and finally, to discuss the potential mechanisms by which these drugs may reduce arterial stiffness.