Second Department of Internal Medicine, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Tokyo, Japan.
J Cardiovasc Transl Res. 2012 Jun;5(3):280-6. doi: 10.1007/s12265-011-9345-4. Epub 2012 Jan 6.
The pathophysiological abnormalities associated with increased arterial stiffness and/or abnormal pressure wave reflection may play crucial roles in increasing the risk of development of cardiovascular events. On the other hand, prehypertension, defined as a systolic blood pressure of 120-139 and/or a diastolic blood pressure of 80-89 mmHg, is a "danger zone" for the later development of hypertension and is also associated with an increased incidence of cardiovascular diseases and cardiovascular mortality. We discuss the association among arterial stiffness/pressure wave reflection, prehypertension, and the later development of hypertension. Several prospective studies have demonstrated that increased arterial stiffness/abnormal pressure wave reflection are risk factors for the later development of hypertension in subjects with prehypertension. On the contrary, persistence of prehypertention accelerates the age-related increase of the arterial stiffness. Thus, arterial stiffness and prehypertension may be elements of a vicious cycle, and other cardiovascular risk factors, such as aging and abnormal glucose metabolism, may aggravate this cycle. In the future, development of a simple technique to assess large/small arterial stiffness and an effective strategy to reduce arterial stiffness in subjects with prehypertension is warranted.
与动脉僵硬度增加和/或压力波反射异常相关的病理生理异常可能在增加心血管事件发展风险方面发挥关键作用。另一方面，高血压前期定义为收缩压 120-139mmHg 和/或舒张压 80-89mmHg，是高血压后期发展的“危险地带”，也与心血管疾病和心血管死亡率的增加相关。我们讨论了动脉僵硬度/压力波反射、高血压前期与高血压后期发展之间的关系。一些前瞻性研究表明，在高血压前期患者中，动脉僵硬度/异常压力波反射增加是高血压后期发展的危险因素。相反，高血压前期的持续存在加速了与年龄相关的动脉僵硬度的增加。因此，动脉僵硬度和高血压前期可能是一个恶性循环的因素，其他心血管危险因素，如衰老和异常葡萄糖代谢，可能会加重这种循环。未来，开发一种评估大/小动脉僵硬度的简单技术和在高血压前期患者中降低动脉僵硬度的有效策略是必要的。
