Arterial stiffness in prehypertension: a possible vicious cycle.
The pathophysiological abnormalities associated with increased arterial stiffness and/or abnormal pressure wave reflection may play crucial roles in increasing the risk of development of cardiovascular events. On the other hand, prehypertension, defined as a systolic blood pressure of 120-139 and/or a diastolic blood pressure of 80-89 mmHg, is a "danger zone" for the later development of hypertension and is also associated with an increased incidence of cardiovascular diseases and cardiovascular mortality. We discuss the association among arterial stiffness/pressure wave reflection, prehypertension, and the later development of hypertension. Several prospective studies have demonstrated that increased arterial stiffness/abnormal pressure wave reflection are risk factors for the later development of hypertension in subjects with prehypertension. On the contrary, persistence of prehypertention accelerates the age-related increase of the arterial stiffness. Thus, arterial stiffness and prehypertension may be elements of a vicious cycle, and other cardiovascular risk factors, such as aging and abnormal glucose metabolism, may aggravate this cycle. In the future, development of a simple technique to assess large/small arterial stiffness and an effective strategy to reduce arterial stiffness in subjects with prehypertension is warranted.
Second Department of Internal Medicine, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Tokyo, Japan. tomiyama@tokyo-med.ac.jp
Hirofumi
H
Tomiyama
Akira
A
Yamashina
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001158:Arteries / Q000473:pathology* / Q000503:physiopathology; D001794:Blood Pressure; D003187:Compliance; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058246:Prehypertension / Q000473:pathology* / Q000503:physiopathology; D011673:Pulsatile Flow; D012307:Risk Factors