Arterial stiffness – Causes and consequences: Recommendations of the German Hypertension League (DHL®) – German Society of Hypertension and Prevention [Arterielle Gefäßsteifigkeit – Ursachen und Konsequenzen: Empfehlungen der Deutschen Hochdruckliga e. V. DHL® – Deutsche Gesellschaft für Hypertonie und Prävention]
Mengden T.,Excellence Center European Society of Hypertension |
Hausberg M.,Med. Klinik I |
Heiss C.,University Klinikum Dusseldorf |
Mitchell A.,University Klinikum der RuhrUniversitat Bochum |
And 4 more authors.
Kardiologe | Year: 2016
Measurement of the aortic pulse wave velocity (aPWV) is a direct measure for the arterial stiffness of the aorta and is 4–9 m/s in normotensive healthy individuals, depending on age. In comparison to classical cardiovascular parameters, the aPWV has an additive predictive value for cardiovascular events. An increase in the aPWV of 1 m/s is associated with an increase in cardiovascular risk of up to 15 %. The differentiation between calcified arteriosclerosis and non-calcified atherosclerosis is clinically important. The presence of atherosclerosis, such as coronary heart disease, cannot be directly deduced from a finding of increased vascular stiffness. The gold standard for measurement of aortic stiffness is considered to be the PWV between the carotid and femoral arteries. Until the results of further studies are available, an aPWV above 10 m/s should be considered as pathological in normotensive individuals. Many of the instruments available on the market for measurement of vascular stiffness still show an insufficient standardization with respect to the measurement method and measurement accuracy. A standardized validation against invasive or non-invasive gold standards should be available, independent of the manufacturer and an additive predictive value confirmed by epidemiological and prognostic studies. The most important therapeutic aim of the treatment of arterial vascular stiffness is a normalization of blood pressure values according to the current European Society of Hypertension (ESH) guidelines. Based on long-term influences on vascular remodeling, according to the current state of the art blockers of the renin-angiotensin-aldosterone system are assumed to be more suitable to achieve extended effects on vascular stiffness other than pure blood pressure effects. Whether antihypertensive therapy with the target parameter of vascular stiffness also has a positive influence on concrete cardiovascular endpoints, is the subject of currently running studies. © 2015, Springer-Verlag Berlin Heidelberg.