Division of Nephrology and Hypertension, Department of Medicine, University of Missouri School of Medicine, Columbia, MO, USA.
Harry S. Truman VA Hospital, Columbia, MO, USA.
Curr Hypertens Rep. 2018 Jul 4;20(8):72. doi: 10.1007/s11906-018-0867-x.
To update and review novel insights into the mechanisms, measurements, and therapeutic approaches to arterial stiffness.
Arterial (e.g., vascular) stiffness has been shown over time to prognosticate for cardiovascular and kidney outcomes. In this context, there has been increased interest behind the mechanisms that drive arterial stiffness beyond aging and interest in how to apply newer technologies in measurement of arterial stiffness. Pulse wave velocity has been the gold standard for measurement but industry has been innovating to improve measurement with use of single-point PWV as well as pharmacologic approaches with anti-hypertensives and oral hypoglycemic agents. Emerging data on the role of the mineralocorticoid receptor, the endothelial sodium channel (EnNaC), and uric acid in arterial stiffness are promising a number of potential therapies. Newer techniques of measuring PWV for arterial stiffness and novel therapies may soon lead to better outcomes from hypertension complications.
更新并综述动脉僵硬的机制、测量和治疗方法方面的新见解。
随着时间的推移,动脉(如血管)僵硬已被证明可预测心血管和肾脏结局。在这种情况下,人们对导致动脉僵硬的机制产生了更多的兴趣,这些机制除了与衰老有关外,人们还对如何应用新技术来测量动脉僵硬产生了兴趣。脉搏波速度一直是测量的金标准,但业界一直在创新,以改善单点脉搏波速度的测量,并利用抗高血压药物和口服降糖药物进行药理学方法。关于醛固酮受体、内皮钠通道(EnNaC)和尿酸在动脉僵硬中的作用的新数据为许多潜在的治疗方法带来了希望。用于动脉僵硬的脉搏波速度测量的新技术和新疗法可能很快会改善高血压并发症的治疗效果。