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Arterial Stiffness and Hypertension in the Elderly
Stéphane Laurent1,2,3, Pierre Boutouyrie1,2,3
1Assistance-Publique Hôpitaux de Paris, Université de Paris, Paris, France.
Frontiers in Cardiovascular Medicine
|December 17, 2020
Summary
Arterial stiffness increases with age and hypertension, predicting cardiovascular events in the elderly. Understanding cellular mechanisms and applying concepts like Early Vascular Aging can help prevent complications.
Area of Science:
- Cardiovascular Medicine
- Gerontology
- Vascular Biology
Background:
- Hypertension prevalence and arterial stiffness significantly increase with age.
- Arterial stiffness and wave reflections are key determinants of cardiovascular events in elderly hypertensive patients.
- Existing evidence covers epidemiology, pathophysiology, and pharmacology of large arteries in hypertension across age groups.
Purpose of the Study:
- To review cellular and molecular mechanisms of arterial stiffening in elderly hypertensives.
- To examine the consequences of arterial stiffening on central pressures and target organs.
- To discuss methodologies for measuring arterial stiffness, pulse pressure, and wave reflection, and apply concepts of Early Vascular Aging (EVA) and Supernormal Vascular Aging (SUPERNOVA) for prevention.
Main Methods:
- Review of existing literature on arterial stiffness in hypertension and aging.
- Analysis of epidemiological data and pharmacological interventions.
- Discussion of measurement methodologies and conceptual frameworks like EVA and SUPERNOVA.
Main Results:
- Arterial stiffening in elderly hypertensives leads to increased central systolic and pulse pressures due to wave reflections.
- Arterial stiffness and wave reflections are established predictors of cardiovascular events.
- Concepts like EVA and SUPERNOVA offer insights into managing determinants of arterial stiffness.
Conclusions:
- Arterial stiffening is a critical factor in cardiovascular complications among the elderly hypertensive population.
- Accurate measurement of arterial stiffness and pulse pressure is essential for risk assessment.
- Targeting determinants of arterial stiffness through pharmacological and conceptual approaches like EVA can aid in preventing target organ damage and cardiovascular events.
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