Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The . gov means it’s official. Federal government websites often end in . gov or VSports app下载. mil. Before sharing sensitive information, make sure you’re on a federal government site. .

Https

The site is secure V体育官网. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. .

Review
. 2008 Nov;105(5):1652-60.
doi: 10.1152/japplphysiol.90549.2008. Epub 2008 Sep 4.

Effects of central arterial aging on the structure and function of the peripheral vasculature: implications for end-organ damage (V体育ios版)

Gary F Mitchell  1
Affiliations
Review

VSports - Effects of central arterial aging on the structure and function of the peripheral vasculature: implications for end-organ damage

Gary F Mitchell. J Appl Physiol (1985). 2008 Nov.

Abstract

Over the past decade, numerous studies have shown that increased aortic stiffness is associated with major cardiovascular disease end points, including heart disease, stroke, and kidney disease. Cardiac abnormalities and enhanced atherogenesis in the setting of increased pulsatile load on heart and arteries have been well described. However, recent studies have shown a further association between excessive pressure pulsatility and a number of afflictions of aging that share a predominant microvascular etiology, including many forms of kidney disease and cognitive impairment. In these disorders, microvascular remodeling and impaired regulation of local blood flow, which are related to large artery stiffness and pressure pulsatility, are associated with evidence of diffuse microscopic tissue damage. This brief review will summarize age-related changes in aortic and peripheral vascular function and will discuss potential mechanisms leading from changes in properties of large arteries to excessive pressure pulsatility, abnormal microvascular structure and function, and end-organ dysfunction and damage. VSports手机版.

PubMed Disclaimer

Figures

Fig. 1.
Fig. 1.
A brief synopsis of pulsatile hemodynamics. A: a simple model of the arterial system with a single dominant reflecting site at the interface between aorta and muscular arteries. When the forward wave (Pf) encounters the reflecting site, a portion is reflected (Pb) and most is transmitted (Pt). B: when the aorta stiffens (denoted by a thicker wall), impedance mismatch is reduced, the reflecting site shifts distally, a smaller fraction of Pf is reflected, and therefore more is transmitted into the microcirculation, which may trigger hypertrophic remodeling. C: the input flow wave interacts with input impedance (Zi) to produce the resulting pressure wave. The forward-flow wave (Qf) interacts with characteristic impedance (Zc) to produce Pf. Wave reflection and overlap between Pf and Pb creates late systolic augmentation (Paug), which contributes to central pulse pressure (CPP). The timings of wave reflection (ti) and systolic ejection (tes) are noted, and considerable overlap between Pf and Pb is evident (ti < tes). Total arterial compliance (TAC) can be computed by analyzing the pressure decay in diastole. PPP, peripheral pulse pressure. D: representative carotid (dark) and brachial (light) waveforms in a young healthy person. Note substantial amplification (Amp) of the pulse pressure with distal propagation. E: similar waveforms in an older individual with prominent central augmentation (Aug), which obscures normal peripheral amplification (Amp) of the forward-wave peak. [A and B reproduced with permission from Vyas et al. (96).]
Fig. 2.
Fig. 2.
A schematic representation of approximate patterns of change in key pulsatile hemodynamic measures with advancing age. Peripheral systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) all increase modestly before age 60 yr, whereas PPP falls slightly. During this early phase, augmentation index (AI) increases dramatically, whereas aortic and peripheral pulse wave velocity (PWV) change modestly. In contrast, after 60 yr of age, PPP increases dramatically and AI plateaus despite an ongoing increase in aortic PWV. At this transition point, aortic PWV meets then exceeds peripheral PWV, leading to a reduction in reflection at this junction (Fig. 1B), likely explaining the plateau in AI despite increasing aortic PWV.
Fig. 3.
Fig. 3.
Forearm vascular resistance (FVR) at rest (A) and during hyperemia (B) induced by 5 min of forearm ischemia. Data are least square means of natural log-transformed FVR, plotted according to tertiles of carotid-femoral PWV (CFPWV) and forward pressure wave amplitude, and adjusted for age, sex, body mass index, heart rate, total-to-high-density lipoprotein cholesterol ratio, triglycerides, fasting glucose, prevalent cardiovascular disease, diabetes, use of lipid-lowering or antihypertensive therapy, smoking, hormone replacement in women, timing of walk test. and daily aspirin use. [Reproduced with permission from Mitchell et al (65).]
See this image and copyright information in PMC

VSports在线直播 - References

    1. Allen SP, Wade SS, Prewitt RL. Myogenic tone attenuates pressure-induced gene expression in isolated small arteries. Hypertension 30: 203–208, 1997. - PubMed
    1. Aono Y, Ohkubo T, Kikuya M, Hara A, Kondo T, Obara T, Metoki H, Inoue R, Asayama K, Shintani Y, Hashimoto J, Totsune K, Hoshi H, Satoh H, Izumi S, Imai Y. Plasma fibrinogen, ambulatory blood pressure, and silent cerebrovascular lesions: the Ohasama study. Arterioscler Thromb Vasc Biol 27: 963–968, 2007. - PubMed
    1. Bakker SL, de Leeuw FE, De Groot JC, Hofman A, Koudstaal PJ, Breteler MM. Cerebral vasomotor reactivity and cerebral white matter lesions in the elderly. Neurology 52: 578–583, 1999. - PubMed
    1. Ballard C, O'Brien J, Barber B, Scheltens P, Shaw F, McKeith I, Kenny RA. Neurocardiovascular instability, hypotensive episodes, and MRI lesions in neurodegenerative dementia. Ann NY Acad Sci 903: 442–445, 2000. - "VSports注册入口" PubMed
    1. Baumbach GL Effects of increased pulse pressure on cerebral arterioles. Hypertension 27: 159–167, 1996. - PubMed

Publication types

"V体育平台登录" MeSH terms