Savoia Carmine, Battistoni Alleggra, Calvez Valentin, Cesario Vincezo, Montefusco Giulio, Filippini Antonio
Clinical and Molecular Medicine Department, Cardiology Unit, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Department of Anatomical Sciences, Histological, Legal Medical and Locomotor Sapienza University of Rome, Rome, Italy.
Curr Hypertens Rev. 2017;13(1):16-23. doi: 10.2174/1573402113666170505115010.
Hypertension and aging are characterized by vascular remodelling and stiffness as well as endothelial dysfunction. Endothelial function declines with age, since aging is associated with senescence of the endothelium due to increased rate of apoptosis and reduced regenerative capacity of the endothelium. Different phenotypes of hypertension have been described in younger and adult subjects with hypertension. In younger patients, functional and structural alterations of resistance arteries occur as the earliest vascular alterations which have prognostic significance and may contribute to stiffness of large arteries through wave reflection. In individuals above age of 50 years as well as in subjects with long-lasting elevated blood pressure, vascular changes occur predominantly in conduit arteries which become stiffer. Activation of renin-angiotensin-aldosterone and endothelin systems plays a key role in endothelial dysfunction, vascular remodelling, and aging by inducing reactive oxygen species production, and promoting inflammation and cell growth.
高血压和衰老的特征是血管重塑、僵硬以及内皮功能障碍。内皮功能随年龄下降，因为衰老与内皮细胞衰老相关，这是由于细胞凋亡率增加和内皮细胞再生能力降低所致。在患有高血压的年轻和成年受试者中，已描述了不同类型的高血压。在年轻患者中，阻力动脉的功能和结构改变是最早出现的血管改变，具有预后意义，并可能通过波反射导致大动脉僵硬。在50岁以上的个体以及血压长期升高的受试者中，血管变化主要发生在变得更僵硬的传导动脉中。肾素-血管紧张素-醛固酮系统和内皮素系统的激活通过诱导活性氧产生、促进炎症和细胞生长，在内皮功能障碍、血管重塑和衰老中起关键作用。
