Is vascular stiffness an emerging target to prevent hypertension?

摘要

The age-associated increase in blood pressure (BP) combined with an aging worldwide population translates to an enormous emerging global public health problem. In addition to the well-ascribed risk factors of myocardial infarction and stroke, hypertension is an important risk factor for chronic kidney disease (CKD), atrial fibrillation, congestive heart failure, and cognitive impairment. In parallel with efforts directed toward enhanced awareness and control of hypertension, a better understanding of how to prevent the age-related increase in BP clearly is needed. Increased arterial stiffness, or a decrease in vascular compliance, is the predominant pathophysiologic characteristic of geriatric hypertension and explains the age-related increase in both systolic BP and pulse pressure. Recent studies have added to our understanding of the mechanisms that underlie the age-related increase in large artery stiffness and vascular aging; several of these are listed in Box 1.