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Vascular Aging and Disease of the Small Vessels
Damiano Rizzoni1,2, Marco Rizzoni3, Matteo Nardin4
1Clinica Medica, Department of Clinical and Experimental Sciences, University of Brescia, c/o 2a Medicina Spedali Civili di Brescia, Piazza Spedali Civili 1, 25100, Brescia, Italy. damiano.rizzoni@unibs.it.
Insights
Large artery stiffening and microvascular disease are linked, potentially worsening cardiovascular events. Hypertension and aging share vascular dysfunction mechanisms, impacting organs like the heart, brain, and kidneys.
Area of Science:
- Cardiovascular science
- Vascular biology
- Gerontology
Background:
- Cardiovascular events stem from macro and microcirculatory vascular damage.
- Arterial stiffening and microvascular disease may have a bidirectional relationship.
- Hypertension and aging share common vascular dysfunction mechanisms.
Purpose of the Study:
- To explore the interplay between large artery stiffening and microvascular disease.
- To investigate shared mechanisms of vascular dysfunction in hypertension and aging.
- To understand how these vascular changes contribute to organ damage.
Main Methods:
- Analysis of vascular remodelling and endothelial function.
- Assessment of vascular stiffness in large and small arteries.
- Examination of pressure wave transmission and reflection dynamics.
Main Results:
- Vascular remodelling, endothelial dysfunction, and stiffness are common in hypertension and aging.
- Structural and functional changes in small arteries are observed with aging, potentially exacerbated by hypertension.
- A cross-talk between large and small artery changes influences pressure wave dynamics.
Conclusions:
- The bidirectional relationship between large artery stiffening and microvascular disease contributes to cardiovascular events.
- Shared vascular dysfunction mechanisms in hypertension and aging accelerate organ damage.
- Interactions between macro and microvascular changes exacerbate cardiac, brain, and kidney complications.
Abstract:
Cardiovascular events are the consequence of vascular damage at both the macro and microcirculatory level. The relationship between large stiffening artery and microvascular disease may be bidirectional, since wave reflection from microvascular sites could increase systolic blood pressure and pulse pressure, while transmission of increased arterial pulsatility to microvessels could represent a mechanism of damage. Hypertension and aging share similar mechanisms of vascular dysfunction. In fact, vascular remodelling, endothelial dysfunction and vascular stiffness are common features in hypertension and aging. Structural and functional changes in small arteries occur during normal and accelerated aging, possibly triggered by hypertension. A cross-talk may be present between large and small artery changes, interacting with pressure wave transmission and reflection, exaggerating cardiac, brain and kidney damage, and finally leading to cardiovascular and renal complications.
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