Skip to main page content
U.S. flag

An official website of the United States government

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011:2011:263585.
doi: 10.4061/2011/263585. Epub 2011 Aug 2.

Vascular stiffness and increased pulse pressure in the aging cardiovascular system

Affiliations

Vascular stiffness and increased pulse pressure in the aging cardiovascular system

Jochen Steppan et al. Cardiol Res Pract. 2011.

Abstract

Aging leads to a multitude of changes in the cardiovascular system, including systolic hypertension, increased central vascular stiffness, and increased pulse pressure. In this paper we will review the effects of age-associated increased vascular stiffness on systolic blood pressure, pulse pressure, augmentation index, and cardiac workload. Additionally we will describe pulse wave velocity as a method to measure vascular stiffness and review the impact of increased vascular stiffness as an index of vascular health and as a predictor of adverse cardiovascular outcomes. Furthermore, we will discuss the underlying mechanisms and how these may be modified in order to change the outcomes. A thorough understanding of these concepts is of paramount importance and has therapeutic implications for the increasingly elderly population.

PubMed Disclaimer

Figures

Figure 1
Figure 1
This figures illustrates the composition of the arterial pressure waveform from a combination of a forward pressure wave created by ventricular contraction and a reflected wave. MAP: mean arterial pressure; SBP: systolic blood pressure (see [13]).
Figure 2
Figure 2
Schematic representation of pulse pressure amplification. Pressure tracings from the brachial artery and central aorta are shown, from a young individual with a highly compliant vasculature tree (left) and from an old one with stiff vessels (right). Despite similar brachial blood pressures, central blood pressures vary considerably. In young individuals, P1 (which coincides with systolic blood pressures) marks the outward traveling blood pressure wave, while P2 represents the arrival of the reflected pressure wave in diastole, augmenting diastolic blood pressure, and coronary filling. Pulse pressure augmentation in old, stiff vessels leads to a significant increase in P2 as compared to P1, as wave reflection occurs earlier and faster, leading to an augmentation in systolic blood pressure. Augmentation index is calculated as the difference between the second (P2) and first (P1) systolic peaks (delta P) as a percentage of pulse pressure (see [23]).
Figure 3
Figure 3
This figure shows pooled RR and 95% CI for aortic PWV and total CV events (a), CV mortality (b), and total mortality (c), according to baseline risk and disease state. Data are provided for high versus low aortic pulse wave velocity (PWV) (left column), increase in aortic PWV by 1 m/s (middle column), and increase in aortic PWV by 1 SD (right column) (see [46]).

Similar articles

Cited by

References

    1. Franklin SS. Hypertension in older people: part 1. Journal of Clinical Hypertension. 2006;8(6):444–449. - PMC - PubMed
    1. Watanabe M, Sawai T, Nagura H, Suyama K. Age-related alteration of cross-linking amino acids of elastin in human aorta. Tohoku Journal of Experimental Medicine. 1996;180(2):115–130. - PubMed
    1. Cattell MA, Anderson JC, Hasleton PS. Age-related changes in amounts and concentrations of collagen and elastin in normotensive human thoracic aorta. Clinica Chimica Acta. 1996;245(1):73–84. - PubMed
    1. Kass DA. Age-related changes in venticular-arterial coupling: pathophysiologic implications. Heart Failure Reviews. 2002;7(1):51–62. - PubMed
    1. Mitchell GF. Effects of central arterial aging on the structure and function of the peripheral vasculature: implications for end-organ damage. Journal of Applied Physiology. 2008;105(5):1652–1660. - PMC - PubMed

LinkOut - more resources