Cardiovascular Division, Medical School, University of Minnesota, VCRC Room 270, 420 Delaware St SE, MMC 508, Minneapolis, MN 55455, USA.
Cardiovasc Drugs Ther. 2010 Aug;24(4):305-10. doi: 10.1007/s10557-010-6250-z.
Early cardiovascular disease starts in the endothelium leading to functional changes in the vasculature. These changes can be depicted by assessment of arterial stiffness or elasticity. There are several techniques to assess arterial stiffness. Increased arterial stiffness or decreased arterial elasticity has been associated with cardiovascular risk factors. There is now evidence that small artery elasticity is a strong predictor for arterial hypertension. Moreover arterial elasticity provides extra prognostic information beyond arterial blood pressure measurement. Arterial stiffness attenuation may reflect the true reduction of arterial wall damage.
ACE-inhibitors, angiotensin II receptor blockers, aldosterone antagonists and calcium antagonists have favorable effects in improving arterial elasticity, while beta-blockers have an inverse effect. Diuretics have not been evaluated. Lipid lowering therapy, some antidiabetic therapy have shown to reduce arterial stiffness. Inflammatory and infectious diseases have been associated with vascular inflammation and consequently increase in arterial stiffness. The effect of anti-inflammatory agents and antiretroviral therapy on arterial stiffness is under investigation.
Measurement of arterial stiffness will not only be helpful in the detection of early vascular disease but also as a tool in the selection and follow-up monitoring of therapeutic strategies aimed at preventing or delaying progression of vascular disease.
早期心血管疾病始于血管内皮，导致血管功能发生变化。这些变化可以通过评估动脉僵硬度或弹性来描述。有几种技术可以评估动脉僵硬度。动脉僵硬度增加或弹性降低与心血管危险因素有关。现在有证据表明，小动脉弹性是动脉高血压的强有力预测因子。此外，动脉弹性提供了超越动脉血压测量的额外预后信息。动脉僵硬度的降低可能反映了动脉壁损伤的真正减少。
血管紧张素转换酶抑制剂、血管紧张素 II 受体阻滞剂、醛固酮拮抗剂和钙通道阻滞剂在改善动脉弹性方面具有有利影响，而β受体阻滞剂则具有相反的影响。利尿剂尚未得到评估。降脂治疗、一些糖尿病治疗已显示可降低动脉僵硬度。炎症和传染病与血管炎症有关，因此会增加动脉僵硬度。抗炎药和抗逆转录病毒疗法对动脉僵硬度的影响正在研究中。
测量动脉僵硬度不仅有助于检测早期血管疾病，而且还可以作为一种工具，用于选择和监测旨在预防或延缓血管疾病进展的治疗策略。
