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Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness
05:51

Measuring the Carotid to Femoral Pulse Wave Velocity (Cf-PWV) to Evaluate Arterial Stiffness

Published on: May 3, 2018

Decreasing arterial aging by controlling blood pressure levels and hypertension: a step forward

Angelo Scuteri1, Pedro Guimarães Cunha

  • 1UOC Geriatria, INRCA / IRCCS, Via Cassia 1167, 00189 Rome, Italy. angeloelefante@interfree.it

Current Vascular Pharmacology
|December 25, 2012
PubMed

Insights

Arterial aging and stiffening increase risks for cardiovascular events and cognitive decline. Lowering blood pressure (BP) is key, but aggressive BP reduction may harm older adults, potentially worsening cognitive impairment.

Area of Science:

  • Cardiovascular Science
  • Gerontology
  • Neuroscience

Background:

  • Arterial aging, marked by stiffening and increased aortic pulse wave velocity, is a significant risk factor for cardiovascular events, disability, and cognitive dysfunction.
  • Current strategies to mitigate arterial aging primarily focus on blood pressure (BP) reduction.

Purpose of the Study:

  • To evaluate the impact of antihypertensive medications on arterial health beyond BP reduction.
  • To explore the risks associated with aggressive BP lowering in older adults, particularly concerning cognitive function.

Main Methods:

  • Review of clinical evidence on selective antihypertensive drug classes.
  • Analysis of the effects of calcium channel blockers, converting enzyme inhibitors, and angiotensin type 1 receptor antagonists on arterial walls.
  • Assessment of the 'lower the better' BP paradigm in elderly populations.

Main Results:

  • Certain antihypertensive drug classes demonstrate beneficial effects on arterial walls and vessels, independent of BP reduction.
  • The "lower the better" approach to BP management in older individuals may increase side effects like hypotension.
  • Hypotension can lead to transient organ hypoperfusion, potentially exacerbating cognitive impairment and dementia.

Conclusions:

  • While reducing BP is crucial for managing arterial aging, a nuanced approach is needed for older adults.
  • The potential for side effects from aggressive BP lowering necessitates careful consideration to avoid detrimental impacts on cerebral perfusion and cognitive health.

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