Cholesterol, lipids and arterial stiffness.
Arterial stiffness and pulse pressure are important determinants of cardiovascular risk. Patients with hypercholesterolaemia have a higher central pulse pressure and stiffer blood vessels than matched controls, despite similar peripheral blood pressures. These haemodynamic changes may contribute to the increased risk of cardiovascular disease associated with hypercholesterolaemia and their assessment may improve risk stratification. Lipid-lowering therapy, particularly with statins, generally leads to a reduction in arterial stiffness, re-enforcing the concept that stiffness is a modifiable parameter and risk factor. There are a number of potential mechanisms linking arterial stiffness and plasma lipids, including atherosclerosis, changes in the elastic elements of the arterial wall, endothelial dysfunction and inflammation. This review will focus on the current evidence linking cholesterol to larger artery stiffening, potential therapies and mechanisms.
Wilkinson
Ian
I
Clinical Pharmacology Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
Cockcroft
John R
JR
D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D008076:Cholesterol, HDL / Q000097:blood* / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood* / Q000187:drug effects; D004730:Endothelium, Vascular / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008077:Lipoproteins, LDL / Q000097:blood / Q000187:drug effects; D014655:Vascular Resistance / Q000187:drug effects
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein