What is arterial stiffness?

Arterial stiffness is a general term for the elasticity (or compliance) of the arteries. The hardening or stiffening of the arteries is called arteriosclerosis. Atherosclerosis is a form of arteriosclerosis caused by fatty deposits (such as cholesterol) on the wall of the artery.

Why is arterial stiffness important?

Various measures of arterial stiffness in the large arteries have been shown to predict the likelihood of future cardiovascular events, such as heart attacks and strokes, which may lead to death. In addition, these measures of arterial stiffness have been shown to be better predictors than other commonly measured parameters such as upper arm blood pressure.

How can large artery stiffness be measured?

There are several ways of measuring large artery stiffness, including:

Augmentation index, which uses the shape of the pulse wave to provide measures of arterial stiffness. Pulse wave analysis can be carried out on waveforms measured non-invasively.

Central blood pressure, which is the pressure that the heart acts against. Central blood pressure tends to increase with higher arterial stiffness.

Pulse Wave Velocity, which is estimated by measuring the time it take for a pressure pulse to travel between two points in the arterial system, usually the carotid artery (neck) and femoral artery (groin), and estimating the length of the artery between these two points.

Carotid, intima-media thickness, which is measured using an ultrasound scan to gauge the thickness of the inner distance of the wall of the carotid artery.

How does Integrated Healthcare measure arterial stiffness?

USCOM BP Plus technology allows quick, easy and accurate measurement of augmentation index and central blood pressure; both recognized indicators of large artery stiffness.

What about the stiffness of the small arteries?

The stiffness of small arteries has been related to other types of disease such as diabetes, but is not strongly associated with cardiovascular diseases such as coronary artery disease, heart attacks and strokes.

How is arterial stiffness related to blood pressure?

Blood pressure is a symptom of underlying processes. The strength of each heart beat contributes to blood pressure. The resistance to the blood flow provided by the arteries is also an important determinant of blood pressure. When the large arteries are stiff, resistance is greater and blood pressure increases.Conversely, when arteries are soft, the heart does not need to work so hard to deliver blood to the rest of the body.

What can be done about high arterial stiffness?

We have developed The 90 Day Challenge, a program that has been designed to reduce Cardiovascular Health Risk. A key benefit of this program is an increase in arterial elasticity and reduction of stiffness.

How often should I measure arterial stiffness?

The medical community has not yet reached a consensus on how best to manage arterial stiffness. However, it is reasonable to measure arterial stiffness whenever blood pressure is being recorded.

“A man is as old as his arteries”* At consultations, do you recognize the real biological age of your patient?

Cardiovascular disease still poses a serious threat to public health. It is necessary to screen for classic risk factors, to evaluate, and to control with lifestyle recommendations or drug therapy.  However, in spite of prevention and all efforts in medical care, the risk of cardiovascular disease is still there. The answer to this challenge is to use a new pathophysiological concept for better understanding the process of the disease and find the ideal therapeutic aspect.

Between risk factors and cardiovascular events we have to look for easily recognizable biological markers. Target organ damage represents this intermediate step. The identification of age- or disease-associated changes in organ function may improve risk assessment and influence the therapeutic decision-making process.

Well-known examples of target organ damage are left ventricular hypertrophy and albumin excretion. In the recent years it has been demonstrated that arterial stiffness and increased pulse wave velocity (PWV), as well as central aortic pulse pressure, are important independent predictors of cardiovascular events, and have been included into the Guidelines for the management of arterial hypertension. These are considered to be „arterial tissue biomarkers”. They are shown to be more predictive than the simple brachial blood pressure measurement and the well known “circulating” biomarkers (like high-sensitivity C-reactive protein), and show a better additional prediction when coupled to classic cardiovascular risk scores. They give an insight into the real pathological process, by determining the degree of the deterioration of the arterial system through aortic stiffening, increased arterial pulse wave reflection, central pulse pressure and postload.

Aging is a common influencing factor to chronic disease manifestation, like cardiovascular disease. Aging alters the vascular structure and biochemistry that starts with an impairment of endothelial-mediated vasodilatation, and results in decreased arterial compliance and increased arterial stiffening. On this more or less normal process there is a pathological arterial aging, promoting the development and progression of atherosclerosis. In susceptible patients, the vascular aging appears to take a more rapid course, causing premature cardiovascular disease manifestations (coronary heart disease, heart attack, stroke and peripheral arterial disease). How to find these patients on time? Assessment of early vascular aging is a novel approach to estimate cardiovascular risk that leads to individual treatment optimization.

Vascular aging can be investigated directly, non-invasively through the measurement of arterial stiffness, central blood pressure, and endothelial dysfunction related pulse wave reflection as with the service provided by Integrated Health Care.