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Published on: October 19, 2016
Arterial stiffness as a risk factor for coronary artery disease
1Department of Medicine, Peter Bent Brigham Hospital, Harvard Medical School, Boston, MA, USA.
Insights
Hypertension management is crucial for reducing cardiovascular risks. Arterial stiffness is an emerging risk factor, providing prognostic insights beyond traditional measures like blood pressure.
Area of Science:
- Cardiovascular Physiology
- Vascular Biology
- Hypertension Research
Background:
- Hypertension is a significant modifiable risk factor for cardiovascular diseases.
- The arterial system's role extends beyond passive blood transport, involving endothelial function and structural integrity.
- Arterial stiffness markers are increasingly recognized for their prognostic value.
Purpose of the Study:
- To highlight the expanded understanding of the arterial system's role in cardiovascular physiology.
- To emphasize the significance of arterial stiffness as an emerging cardiovascular risk factor.
- To discuss how arterial stiffness measurements offer prognostic information beyond standard risk stratification.
Main Methods:
- Review of clinical trials and epidemiologic studies.
- Correlation of arterial stiffness markers (e.g., pulse-wave velocity, augmentation index, pulse pressure) with cardiovascular outcomes.
- Analysis of how arterial stiffness measurements clarify clinical trial results.
Main Results:
- Successful blood pressure reduction decreases risks for coronary artery disease, stroke, heart failure, and renal failure.
- Markers of arterial stiffness correlate with cardiovascular outcomes and provide prognostic information.
- Arterial stiffness measurements help explain differing clinical trial outcomes despite similar blood pressure reductions.
Conclusions:
- Arterial stiffness is a critical factor in cardiovascular health, offering prognostic insights.
- Understanding arterial stiffness enhances cardiovascular risk assessment and stratification.
- Further research into arterial stiffness can refine clinical trial interpretation and patient management.
Abstract:
Hypertension is a major modifiable risk factor, and clinical trials have demonstrated that successful reduction of elevated blood pressure to target levels translates into decreased risk for the development of coronary artery disease, stroke, heart failure, and renal failure. The arterial system had previously been regarded as a passive conduit for the transportation of arterial blood to peripheral tissues. The physiologic role the arterial system was greatly expanded by the recognition of the central role of the endothelial function in a variety of physiologic processes. The role of arterial function and structure in cardiovascular physiology was expanded with the development of a variety of parameters that evaluate arterial stiffness. Markers of arterial stiffness have been correlated with cardiovascular outcomes, and have been classified as an emerging risk factor that provides prognostic information beyond standard stratification strategies involving hypertension, diabetes, obesity, dyslipidemia and smoking. Multiple epidemiologic studies have correlated markers of arterial stiffness such as pulse-wave velocity, augmentation index and pulse pressure with risk for the development of fatal and nonfatal cardiovascular events. Additionally, measurements of arterial stiffness had clarified the results of clinical trials that demonstrated differing impacts on clinical outcomes, despite similar reductions in blood pressure, as measured by brachial and sphygmomanometry.
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