DIFFERENCES IN AORTIC AUGMENTATION PRESSURE BETWEEN NORMOTENSIVE AND HYPERTENSIVE SUBJECTS MEASURED IN COMMUNITY PHARMACIES IN SPAIN

Association of Local Arterial Stiffness and Windkessel Model Parameters with Ageing in Normotensives and Hypertensives

Computation of arterial stiffness is a well-established, widely accepted method for estimating vascular age. Although carotid-femoral pulse wave velocity is typically used for vascular age assessment, most recent studies have reported the need to consider a combination of local and regional stiffness indices possessing distinct association with the vascular structure and/or function for better prediction of early vascular ageing syndrome. In this work, we investigate the association of clinically validated local stiffness (obtained using biomechanical relations), global stiffness (obtained from 3-element Windkessel modelling), and pulse contour indices from the aorta with ageing and their distribution in normotensives and hypertensives. The analysis was performed on 420 (virtual) subjects (age: 65 ± 11 years) with an equal proportion of hypertensive (age: 65 ± 11 years) and normotensive (age: 65 ± 11 years) subjects. Multivariate linear regression analysis revealed an independent association of each of the indices with age (Adjusted r = 0.75 p < 0.01). Specific stiffness index (r = 0.67, p < 0.001), Augmentation index (r = 0.55, p< 0.001) and total arterial compliance (r = -0.50, p < 0.001) depicted highest correlation with age. There was a significant difference (> 16%, p < 0.001) in mean values of the measured indices between hypertensive and normotensive subjects. The study findings further emphasize the need to combine multiple non-invasive vascular markers to capture the unique aspects of age-induced arterial wall remodelling for reliable monitoring and management of the early vascular ageing syndrome. Clinical Relevance- This study demonstrates an independent and combined predictive role of local/global stiffness and pulse contour indices in ageing.

Beneficial Effect of Statin Therapy on Arterial Stiffness

Arterial stiffness describes the increased rigidity of the arterial wall that occurs as a consequence of biological aging and several diseases. Numerous studies have demonstrated that parameters to assess arterial stiffness, especially pulse-wave velocity, are predictive of those individuals that will suffer cardiovascular morbidity and mortality. Statin therapy may be a pharmacological strategy to improve arterial elasticity. It has been shown that the positive benefits of statin therapy on cardiovascular disease is attributable not only to their lipid-lowering capacity but also to various pleiotropic effects, such as their anti-inflammatory, antiproliferative, antioxidant, and antithrombotic properties. Additionally, statins reduce endothelial dysfunction, improve vascular and myocardial remodeling, and stabilize atherosclerotic plaque. The aim of the present review was to summarize the evidence from human studies showing the effects of statins on arterial stiffness.