Henry Ford Heart and Vascular Institute, Detroit, Michigan, USA.
J Am Coll Cardiol. 2011 Apr 5;57(14):1511-22. doi: 10.1016/j.jacc.2010.12.017.
The aorta stiffens with aging, a process that is accelerated by arterial hypertension. Decreased arterial compliance is one of the earliest detectable manifestations of adverse structural and functional changes within the vessel wall. The use of different imaging techniques optimized for assessment of vascular elasticity and quantification of luminal and vessel wall parameters allows for a comprehensive and detailed view of the vascular system. In addition, several studies have also documented the prognostic importance of arterial stiffness (AS) in various populations as an independent predictor of cardiovascular morbidity and all-cause mortality. Measurement of AS by applanation tonometry with pulse-wave velocity has been the gold-standard method and is well-validated in large populations as a strong predictor of adverse cardiovascular outcomes. Because aortic stiffness depends on the prevailing blood pressure, effective antihypertensive treatment is expected to reduce it in proportion to the blood pressure reduction. Nevertheless, drugs lowering blood pressure might differ in their effects on structure and function of the arterial walls. This review paper not only will discuss the current understanding and clinical significance of AS but also will review the effects of various pharmacological and nonpharmacological interventions that can be used to preserve the favorable profile of a more compliant and less stiff aorta.
主动脉随着年龄的增长而变硬，动脉高血压会加速这一过程。动脉顺应性降低是血管壁内不良结构和功能变化最早可检测到的表现之一。使用不同的成像技术进行优化，以评估血管弹性和量化管腔和血管壁参数，可以全面详细地观察血管系统。此外，多项研究还记录了动脉僵硬度 (AS) 在各种人群中的预后重要性，作为心血管发病率和全因死亡率的独立预测因子。应用脉搏波速度的平板张力测量法测量 AS 一直是金标准方法，并且在大型人群中得到了很好的验证，是不良心血管结局的有力预测因子。由于主动脉僵硬度取决于当前的血压，因此预计有效的降压治疗会使其与血压降低成比例地降低。然而，降低血压的药物在其对动脉壁结构和功能的影响方面可能存在差异。这篇综述文章不仅将讨论 AS 的当前认识和临床意义，还将回顾各种可用于保持更顺应性和更少僵硬的主动脉有利特征的药理学和非药理学干预措施的效果。
