Journal article
Is It Good to Have a Stiff Aorta with Aging? Causes and Consequences
Physiology (Bethesda, Md.), Vol.37(3), pp.154-173
05/01/2022
DOI: 10.1152/physiol.00035.2021
PMCID: PMC8977146
PMID: 34779281
Abstract
Aortic stiffness increases with advancing age, more than doubling during the human life span, and is a robust predictor of cardiovascular disease (CVD) clinical events independent of traditional risk factors. The aorta increases in diameter and length to accommodate growing body size and cardiac output in youth, but in middle and older age the aorta continues to remodel to a larger diameter, thinning the pool of permanent elastin fibers, increasing intramural wall stress and resulting in the transfer of load bearing onto stiffer collagen fibers. Whereas aortic stiffening in early middle age may be a compensatory mechanism to normalize intramural wall stress and therefore theoretically "good" early in the life span, the negative clinical consequences of accelerated aortic stiffening beyond middle age far outweigh any earlier physiological benefit. Indeed, aortic stiffness and the loss of the "windkessel effect" with advancing age result in elevated pulsatile pressure and flow in downstream microvasculature that is associated with subclinical damage to high-flow, low-resistance organs such as brain, kidney, retina, and heart. The mechanisms of aortic stiffness include alterations in extracellular matrix proteins (collagen deposition, elastin fragmentation), increased arterial tone (oxidative stress and inflammation-related reduced vasodilators and augmented vasoconstrictors; enhanced sympathetic activity), arterial calcification, vascular smooth muscle cell stiffness, and extracellular matrix glycosaminoglycans. Given the rapidly aging population of the United States, aortic stiffening will likely contribute to substantial CVD burden over the next 2-3 decades unless new therapeutic targets and interventions are identified to prevent the potential avalanche of clinical sequelae related to age-related aortic stiffness.
Details
- Title: Subtitle
- Is It Good to Have a Stiff Aorta with Aging? Causes and Consequences
- Creators
- Gary L Pierce - University of IowaThais A Coutinho - University of OttawaLyndsey E DuBose - University of Colorado Anschutz Medical CampusAnthony J Donato - University of Utah
- Resource Type
- Journal article
- Publication Details
- Physiology (Bethesda, Md.), Vol.37(3), pp.154-173
- DOI
- 10.1152/physiol.00035.2021
- PMID
- 34779281
- PMCID
- PMC8977146
- ISSN
- 1548-9213
- eISSN
- 1548-9221
- Grant note
- R01 AG050238 / NIA NIH HHS 19TPA34910016 / American Heart Association (AHA) AG071273-01 / HHS | NIH | National Institute on Aging (NIA) AG060395 / HHS | NIH | National Institute on Aging (NIA) AG000279 / HHS | NIH | National Institute on Aging (NIA) AG063790 / HHS | NIH | National Institute on Aging (NIA) AG050238 / HHS | NIH | National Institute on Aging (NIA) T32 AG000279 / NIA NIH HHS F32 AG071273 / NIA NIH HHS R01 AG063790 / NIA NIH HHS R01 AG060395 / NIA NIH HHS HSF | Heart And Stroke Foundation Of Ontario
- Language
- English
- Date published
- 05/01/2022
- Academic Unit
- Health and Human Physiology; Internal Medicine
- Record Identifier
- 9984267243902771
Metrics
29 Record Views