Early vascular ageing as a new model to understand hypertension and arterial disease

Abstract

Hypertension is a major cardiovascular risk factor and can be treated. The cardiovascular risk associated with hypertension, however, cannot be fully reversed by treatment with blood pressure-lowering drugs. One reason could be that not all risk factors are addressed at the same time, but another reason could well be that structural changes and remodelling of the arterial wall are not diminished nor normalized. One component that has attracted considerable research efforts in recent years is arterial stiffness, primarily involving the arteria media (elastin, collagen), but also the arterial intima and adventitia. Arterial stiffness in large elastic arteries can be measured by aortic pulse wave velocity from the carotid artery to the femoral artery and is considered to be both a cause and a consequence of hypertension. The treatment of arterial stiffness involves traditional antihypertensive drugs such as renin–angiotensin blocking agents, but new experimental drugs are under development such as the angiotensin-II agonist compound 21 currently being tested in humans.