Abstract
The world population is aging and the number of old people is continuously increasing. Arterial structure and function change with age, progressively leading to arterial stiffening. Arterial stiffness is best characterized by measurement of pulse wave velocity (PWV), which is its surrogate marker. It has been shown that PWV could improve cardiovascular event prediction in models that included standard risk factors. Consequently, it might therefore enable better identification of populations at high-risk of cardiovascular morbidity and mortality. The present review is focused on a survey of different pharmacological therapeutic options for decreasing arterial stiffness. The influence of several groups of drugs is described: antihypertensive drugs (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, calcium channel blockers, beta-blockers, diuretics, and nitrates), statins, peroral antidiabetics, advanced glycation end-products (AGE) cross-link breakers, anti-inflammatory drugs, endothelin-A receptor antagonists, and vasopeptidase inhibitors. All of these have shown some effect in decreasing arterial stiffness. Nevertheless, further studies are needed which should address the influence of arterial stiffness diminishment on major adverse cardiovascular and cerebrovascular events (MACCE).
Highlights
The world population is aging so the number of old people is continuously increasing [1, 2]
Evidence of the importance of pulse wave velocity (PWV) is growing, there was no study reported in which a decrease of cardiovascular mortality due to reducing arterial stiffness by pharmacologic approaches had been observed
Arterial stiffness progressively increases with age and was found to be a risk factor of cardiovascular disease
Summary
The world population is aging so the number of old people is continuously increasing [1, 2]. In a recent meta-analysis, aortic PWV was found to improve cardiovascular event prediction in models that included standard risk factors (arterial hypertension, smoking, diabetes, etc.) and might enable better identification of high-risk populations [8, 9]. Even though this data exists, there is still no pharmacological approach regularly used in clinical practice aiming to decrease arterial stiffness. Evidence of the importance of PWV is growing, there was no study reported in which a decrease of cardiovascular mortality due to reducing arterial stiffness by pharmacologic approaches had been observed. New therapeutic approaches to decrease arterial stiffness are highly desirable
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