Copyright © 2005, European Society of Cardiology
Evolution and modulation of age-related medial elastocalcinosis: Impact on large artery stiffness and isolated systolic hypertension
Faculty of Pharmacy, Université de Montréal, 2900 Édouard-Montpetit, Room R-313, P.O. Box 6128, Station "Centre-Ville", Montréal, Québec, Canada H3C 3J7
* Corresponding author. Tel.: +1 514 343 6111x3313; fax: +1 514 343 2102. Email address: pierre.moreau{at}umontreal.ca
Arteriosclerosis, characterized by remodeling and stiffening of large elastic arteries is the most significant manifestation of vascular aging. The increased stiffening is believed to originate from a gradual mechanical senescence of the elastic network, alterations in cross-linking of extracellular matrix components, fibrosis and calcification of elastic fibers (medial elastocalcinosis). The stiffening of large arteries reduces their capacitance and accelerates pulse wave velocity, thus contributing to a widening of pulse pressure and to the increased prevalence of isolated systolic hypertension with age. Current antihypertensive drugs were mainly designed to reduce peripheral resistance and are not adequate to alter the pathological process of vascular stiffening or even to selectively reduce systolic blood pressure in isolated systolic hypertension. This review puts forward the concept that elastocalcinosis is a valuable therapeutic target and presents evidence that this process can be prevented and reversed pharmacologically.
KEYWORDS Aging; Arteries; Elastocalcinosis; Calcification; Extracellular matrix; Remodeling; Endothelins; Diabetes; Renal diseases; Arteriosclerosis
Time for primary review 11 days
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