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Arterial stiffening in hypertension: beyond blood pressure levels

Journal of Human Hypertension volume 24, pages 303–305 (2010)Cite this article

Uncontrolled hypertension confers a major risk factor of death worldwide with at least 25% of the world's adult population having elevated arterial blood pressure.1 Hypertension is strongly associated with damage of the vasculature and target organs, leading to cardiovascular and renal disease. Progressive remodelling and impairment of elastic properties of conduit arteries represent a characteristic feature of hypertension strongly associated with unfavourable prognosis. Not surprisingly, the results of the Conduit Artery Function Evaluation (CAFE) study suggest that arterial function may be a useful treatment target in hypertension.2

For decades, hypertension-related abnormalities of arterial compliance have been considered simply as a compensatory response of the arterial wall matrix to high sheer stress and axial pressure secondary to high blood pressure. However, certain observations and recent findings indicate that this process is much more complex. Indeed, the degree of impairment of elastic properties in hypertension varies substantially (with an extreme form represented by isolated systolic hypertension) thus indicating that factors other than blood pressure itself may determine vascular mechanical characteristics. For example, aging is a critical modality leading to arterial stiffening. It has been reported that ‘aortic’ pulse wave velocity increases twofold between the ages of 20 and 80 years resulting in about a 35–40 mm Hg increase in central (aortic) pressure and pulse pressure.3 Admittedly, the process of hypertension- and age-related stiffening of conduit arteries is strikingly heterogeneous among the population, and our knowledge on the mechanisms implicated in the modification of arterial elastic characteristics is very scarce.

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  1. Haemostasis Thrombosis and Vascular Biology Unit, University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK

    A Shantsila & E Shantsila

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Shantsila, A., Shantsila, E. Arterial stiffening in hypertension: beyond blood pressure levels. J Hum Hypertens 24, 303–305 (2010). https://doi.org/10.1038/jhh.2009.101

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