Therapeutic modification of arterial stiffness: An update and comprehensive review

Area of Science:

• Cardiovascular Medicine
• Vascular Biology
• Clinical Therapeutics

Background:

• Arterial stiffness is a key indicator of cardiovascular disease risk and predicts adverse clinical outcomes.
• Traditional vascular risk factors (age, hypertension, smoking, dyslipidemia), diabetes, obesity, and inflammation contribute to atherosclerosis and arterial stiffness.
• Effective management strategies focus on addressing multiple modifiable risk factors in high-risk individuals.

Purpose of the Study:

• To provide a comprehensive review of the pathogenesis, measurement, and management of arterial stiffness.
• To detail therapeutic options for arterial stiffness across diverse patient populations.
• To aid physicians in clinical decision-making for managing arterial stiffness.

Main Methods:

• Review of current literature on arterial stiffness pathogenesis and risk factors.
• Analysis of therapeutic interventions for arterial stiffness in various conditions (hypertension, diabetes, obesity, inflammatory diseases).
• Discussion of emerging treatments and ongoing clinical trials.

Main Results:

• Lifestyle modifications and ω-3 fatty acids can improve arterial stiffness in hypertension and metabolic syndrome.
• Pharmacological agents (RAAS inhibitors, metformin, statins) benefit patients with hypertension and diabetes.
• Weight reduction, exercise, CPAP, and anti-TNF-alpha therapy show promise in specific populations.
• Renal sympathetic nerve denervation is under investigation for resistant hypertension.

Conclusions:

• A multifaceted approach targeting modifiable risk factors is crucial for managing arterial stiffness.
• Therapeutic strategies should be tailored to specific patient populations and underlying conditions.
• Physicians can utilize this comprehensive knowledge to optimize clinical management of arterial stiffness.