Arterial stiffness is a measure of the elasticity of the arteries. It is a known that as we age our arteries lose elastic fibers and their walls become more rigid . It is also known that stiffer arteries are associated with a greater risk of cardiovascular events , such as stroke and acute myocardial infarction, among others. However, although arterial stiffness inevitably increases with age, there are factors that can accelerate this process and, therefore, age the arteries prematurely, such as: Hypertension; Diabetes; High cholesterol; Tobacco use. With this knowledge, the concept of premature vascular aging was introduced to translate the presence of premature changes in the structure and function of arteries similar to those that occur with aging. Determining individual arterial stiffness is thus another instrument that can be used to assess individual cardiovascular risk. How is arterial stiffness determined? Arterial stiffness can be determined by pulse wave velocity . This is a simple and non-invasive test, in which blood pressure measurements are taken in the femoral artery and carotid artery. Age of arteries and cardiovascular risk The Malmö Diet and Cancer Study studied the risk of fatal and non-fatal cardiovascular events in 2,642 people whose arterial stiffness was determined using pulse wave velocity measurement and vascular age was estimated. Based on the arterial stiffness results, participants were divided into three groups: Group with early vascular aging , with vascular age greater than chronological age. In people included in this group, the arteries were on average 7 years older than expected for their chronological age; Reference group , with vascular age equal to chronological age; Group with super-normal vascular age , with vascular age lower than chronological age. In the people included in this group, the arteries were on average 9 years younger than expected for their age. People included in these three groups were compared in relation to the occurrence of cardiovascular events and mortality. The main results obtained were: There is a direct association between vascular age, assessed by vascular stiffness determined from pulse wave velocity, and the risk of cardiovascular events; Individuals in the group with premature vascular aging were younger on average (64 years vs 70 years in the control group), but had a higher risk of events: This risk was three times higher than that of the control group; Individuals in the group with super-normal vascular age, despite being older on average (79 years vs 70 years in the control group), presented the lowest risk of events. The cardiovascular risk in this group was approximately half that of the control group. The authors concluded that determining arterial stiffness using a simple technique makes it possible to estimate the vascular age of arteries and identify patients at greater risk of cardiac events and in whom it is necessary to implement more intensive cardiovascular prevention measures. Author : José Ferreira Santos Source: Bruno RM, Nilsson PM, Engström G, et al. Early and supernormal vascular aging: clinical characteristics and association with incident cardiovascular events. Hypertension 2020;76:1616-24. Chirinos JA, Segers P, Hughes T, et al. Large-artery stiffness in health and disease: jacc state-of-the-art review. J Am Coll Cardiol 2019;74:1237-63. Oh YS. Arterial stiffness and hypertension. Clin Hypertens 2018;24:17. Author : José Ferreira Santos Meet the cardiology clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
