Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 74, Issue 9, Pages 1237-1263Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2019.07.012
Keywords
arterial stiffness; dementia; heart failure; liver disease; matrix gla protein; pre-eclampsia; renal disease; systolic hypertension; vascular calcification
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Funding
- NIH [R01 HL 121510-01A1, R61-HL-146390, R01-AG058969, 1R01HL104106, P01HL094307, R56 HL136730]
- National Institutes of Health
- American College of Radiology Network
- Fukuda-Denshi
- Bristol-Myers Squibb
- Microsoft
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A healthy aorta exerts a powerful cushioning function, which limits arterial pulsatility and protects the microvasculature from potentially harmful fluctuations in pressure and blood flow. Large-artery (aortic) stiffening, which occurs with aging and various pathologic states, impairs this cushioning function, and has important consequences on cardiovascular health, including isolated systolic hypertension, excessive penetration of pulsatile energy into the microvasculature of target organs that operate at low vascular resistance, and abnormal ventricular-arterial interactions that promote left ventricular remodeling, dysfunction, and failure. Large-artery stiffness independently predicts cardiovascular risk and represents a high-priority therapeutic target to ameliorate the global burden of cardiovascular disease. This paper provides an overview of key physiologic and biophysical principles related to arterial stiffness, the impact of aortic stiffening on target organs, noninvasive methods for the measurement of arterial stiffness, mechanisms leading to aortic stiffening, therapeutic approaches to reduce it, and clinical applications of arterial stiffness measurements. (C) 2019 by the American College of Cardiology Foundation.
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