Vascular ageing and interventions: lessons and learnings.
This review discusses the relationship between elevated blood pressure, hypertension, arterial stiffness and hence vascular ageing. This is a complex process and the majority of treatments target the consequences of this, rather than the pathophysiology of ageing itself. This is because preventing vascular ageing from occurring is complex and would require very early intervention and lifelong treatment. The process of arteriosclerosis is known to result from reversible and irreversible functional components, and, together, these are responsible for the increased systolic and decreased diastolic blood pressure seen with advancing age. Indeed, hypertension develops as it becomes more difficult for the heart to drive blood flow around the body, as a result of poor ventricular coupling and increased arterial stiffness. Elevated blood pressure is therefore a clinical manifestation of ageing that continues to increase with advancing years, and is also linked with an increased risk of cardiac, cerebrovascular and chronic kidney disease. These manifestations arise due to changing haemodynamics associated with ageing, and therefore treatments that reduce the development of these conditions or delay their progression have the potential to improve patient outcomes. This may be possible with existing therapies as well as new treatments currently under investigation.
Chair of Medicine, Institute of Cardiovascular Science, University College London, Maple House, First Floor, Suite A, 149 Tottenham Court Road, London W1T 7DN, UK bryan.williams@ucl.ac.uk.
Bryan
B
Williams
D000375:Aging / Q000502:physiology*; D000613:Aminobutyrates / Q000627:therapeutic use; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000818:Animals; D001161:Arteriosclerosis / Q000209:etiology; D001713:Biphenyl Compounds; D001794:Blood Pressure; D004338:Drug Combinations; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology; D013777:Tetrazoles / Q000627:therapeutic use; D000068756:Valsartan; D059289:Vascular Stiffness
D000613:Aminobutyrates; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D001713:Biphenyl Compounds; D004338:Drug Combinations; D013777:Tetrazoles; D000068756:Valsartan; C549068:sacubitril and valsartan sodium hydrate drug combination
angiotensin II; cardiovascular remodelling; renin–angiotensin system