Arterial aging: a review of the pathophysiology and potential for pharmacological intervention

This review begins with a perspective on the effects of arterial aging on society and world events over the past century. Until recently, the use of just one technique to measure blood pressure non-invasively limited progress in understanding the mechanisms involved and the potential of antihypertensive drug therapies. New methods for extracting information from the arterial waveform have followed the (re)introduction of arterial tonometry into clinical practice, together with mathematical analysis in the frequency and time domains. These new methods have exposed the phenomenon of aortic stiffening with age, and early wave reflection arising therefrom, and identified it as the major cause of cardiovascular degeneration. Such findings point to arterial aging as a logical target for the treatment and prevention not only of cardiac, aortic and large artery disease, but also of damage to microvessels in the brain and kidney, which in turn leads insidiously to dementia and renal failure, respectively.