Mechanisms, pathophysiology, and therapy of arterial stiffness

Susan J. Zieman, Vojtech Melenovsky, David A. Kass

Research output: Contribution to journalShort survey


Arterial stiffness is a growing epidemic associated with increased risk of cardiovascular events, dementia, and death. Decreased compliance of the central vasculature alters arterial pressure and flow dynamics and impacts cardiac performance and coronary perfusion. This article reviews the structural, cellular, and genetic contributors to arterial stiffness, including the roles of the scaffolding proteins, extracellular matrix, inflammatory molecules, endothelial cell function, and reactive oxidant species. Additional influences of atherosclerosis, glucose regulation, chronic renal disease, salt, and changes in neurohormonal regulation are discussed. A review of the hemodynamic impact of arterial stiffness follows. A number of lifestyle changes and therapies that reduce arterial stiffness are presented, including weight loss, exercise, salt reduction, alcohol consumption, and neuroendocrine-directed therapies, such as those targeting the renin-angiotensin aldosterone system, natriuretic peptides, insulin modulators, as well as novel therapies that target advanced glycation end products.

Original languageEnglish (US)
Pages (from-to)932-943
Number of pages12
JournalArteriosclerosis, thrombosis, and vascular biology
Issue number5
StatePublished - May 2005


  • Arterial stiffness
  • Isolated systolic hypertension
  • Mechanisms
  • Pathophysiology
  • Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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