Large Artery Stiffness: A Companion to the 2015 AHA Science Statement on Arterial Stiffness

Area of Science:

• Cardiology
• Vascular Medicine
• Hypertension Research

Background:

• Large artery stiffness (LAS) is an independent predictor of cardiovascular disease and mortality.
• Current hypertension guidelines present differing recommendations on the routine assessment of LAS.
• Pulse wave velocity (PWV) is recognized as a marker of target organ damage, though its systematic use is debated globally.

Purpose of the Study:

• To provide an updated review of large artery stiffness (LAS).
• To discuss the varying guideline positions on assessing LAS via pulse wave velocity (PWV).
• To summarize recent advances in treatments impacting LAS.

Main Methods:

• Literature review of current guidelines and recent studies on LAS.
• Analysis of the role of pulse wave velocity (PWV) in cardiovascular risk stratification.
• Evaluation of therapeutic interventions affecting LAS, including dietary, pharmacological, and procedural approaches.

Main Results:

• Guideline recommendations for assessing LAS using PWV differ significantly between European, Asian, and North American authorities.
• PWV demonstrates value in predicting cardiovascular events and refining risk classification, particularly in intermediate-risk individuals.
• Interventions like sodium restriction, exercise, statins, mineralocorticoid blockers, and renal denervation show varied effects on LAS.

Conclusions:

• Despite guideline discrepancies, PWV is a valuable tool for cardiovascular risk assessment.
• Therapeutic strategies targeting LAS show promise, with ongoing research into their efficacy.
• Further research is needed to standardize LAS assessment and optimize treatment strategies.