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Defining vascular aging and cardiovascular risk

Laurent, Stéphane

doi: 10.1097/HJH.0b013e328353e501
Original Articles

Whereas vascular aging has been identified as an emerging cardiovascular risk factor, definitions of ‘normal’ and ‘early’ vascular aging (EVA) and their precise relationship with cardiovascular risk are currently equivocal. The present review discusses the concept of vascular aging; that structural and functional changes occur in the large arteries with aging; and EVA; that such age-associated changes are accelerated in individuals at increased cardiovascular risk; and their metrics; indeed, in order to provide a definition of when EVA occurs in clinical practice, reference values of normal and accelerated vascular aging are needed. Due to the complex nature of age-associated changes in the large arteries described above, there are different parameters relating to vascular aging which can be measured. These broadly include aortic and carotid stiffening; aortic and carotid lumen dilation; endothelial dysfunction (usually measured via brachial flow-mediated dilatation); and carotid intima-media thickness.

Department of Pharmacology, Hôpital Européen Georges Pompidou, INSERM U970, Université Paris Descartes, Paris, France

Correspondence to Stéphane Laurent, MD, PhD, FESC, Department of Pharmacology and INSERM U970, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 7505 Paris, France. Tel: +33 1 56 09 39 91; fax: +33 1 56 09 39 92; e-mail: stephane.laurent@egp.aphp.fr

Abbreviations: BP, blood pressure; CAD, coronary artery disease; CVD, cardiovascular disease; ESRD, end stage renal disease; EVA, early vascular aging; FMD, flow mediated dilation; FRS, Framingham risk score; cIMT, carotid intima-media thickness; PP, pulse pressure; PWV, pulse wave velocity; SCORE, European Systemic COronary Risk Evaluation; TOD, target organ damage

Received 20 March, 2012

Accepted 20 March, 2012

© 2012 Lippincott Williams & Wilkins, Inc.