O'Rourke Michael F, Hashimoto Junichiro
St Vincent's Clinic/University of New South Wales, Darlinghurst, New South Wales, Australia.
J Cardiopulm Rehabil Prev. 2008 Jul-Aug;28(4):225-37. doi: 10.1097/01.HCR.0000327179.21498.38.
The subject of arterial stiffness as a modifiable risk factor is controversial and difficult to understand. The best approach here will be to assist readers to understand the issue and the basis of controversy. We also hope to show that the subject is not as overwhelming as it might appear. We believe that new blood is required in this field and that a basic understanding is necessary for researchers to be induced to take on such investigations. Our approach sets out a historic and pathophysiologic background on which modern studies can be based; describes measures and indices of arterial stiffness including pulse wave velocity, augmentation index, ambulatory arterial stiffness index, aortic impedance, and carotid elastic modulus; and finally, addresses the specifics of this interesting and important question. Although aortic stiffening with age is attributable to fracture of elastin lamellae and is largely irreversible, stiffening of muscular arteries can be modified by vasodilator drugs, and by improved endothelial function such as induced by exercise training.
动脉僵硬度作为一个可改变的风险因素这一主题存在争议且难以理解。这里最好的方法是帮助读者理解这个问题以及争议的基础。我们还希望表明这个主题并不像它可能看起来那么难以应对。我们认为这个领域需要新的活力，并且对于吸引研究人员进行此类研究来说，基本的理解是必要的。我们的方法阐述了现代研究可以基于的历史和病理生理背景；描述了动脉僵硬度的测量方法和指标，包括脉搏波速度、增强指数、动态动脉僵硬度指数、主动脉阻抗和颈动脉弹性模量；最后，阐述了这个有趣且重要问题的具体细节。尽管随着年龄增长主动脉变硬归因于弹性蛋白层的断裂且在很大程度上是不可逆的，但肌性动脉的硬化可以通过血管扩张药物以及改善内皮功能（如运动训练所诱导的）来改变。
