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(Hypertension. 2004;44:112.)
© 2004 American Heart Association, Inc.

Brief Review

Nitric Oxide and the Regulation of Large Artery Stiffness

From Physiology to Pharmacology

Ian B. Wilkinson; Stanley S. Franklin; John R. Cockcroft

From the Clinical Pharmacology Unit (I.B.W.), University of Cambridge, Addenbrooke’s Hospital, Cambridge; College of Medicine (S.S.F.), Department of Medicine, Medical Sciences I, University of California Irvine; Wales Heart Research Unit (J.R.C.), University of Wales College of Medicine, University Hospital, Heath Park, Cardiff, UK.

Correspondence to Professor John Cockcroft, Wales Heart Research Unit, University of Wales College of Medicine, University Hospital, Heath Park, Cardiff CF 14 4 XN UK. E-mail cockcroftjr@cf.ac.uk

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
The association between arterial stiffening and aging is well described and can be observed in almost all populations worldwide. A number of other cardiovascular risk factors including diabetes and cigarette smoking are also associated with increased large artery stiffness, often referred to as "premature arterial stiffening." It is now apparent that the aortic pulse wave velocity (PWV), a measure of arterial distensibility, predicts outcome in a variety of different populations, including hypertensives,¹ diabetics,² individuals with end-stage renal disease (ESRD),³ and even in older adults.⁴ Indeed, in some populations, aortic PWV is a better predictor of future events than peripheral blood pressure.⁴ Moreover, arterial stiffening may be more than just a marker of cardiovascular risk; stiffening may also play a more direct role in the development of atherosclerotic plaques. Thus, arterial stiffness would appear to be a novel therapeutic target for the prevention of excess cardiovascular morbidity and mortality.

	Factors Influencing Large Artery Stiffness

 
To exploit such an exciting prospect fully, it is necessary to understand the factors regulating arterial stiffness. Traditionally, the stiffness of a vessel was viewed as simply a function of the structural elements of the vessel wall and distending (mean arterial) pressure. However, the large arteries also have a generous coat of smooth muscle, which can alter the distribution of stresses between the elastic and collagenous fibers of the vessel wall and thus alter arterial stiffness. Because smooth muscle tone is influenced by a number of circulating and local vasoactive mediators, arterial stiffness may be actively regulated, and indeed modifiable, at least . . . [Full Text of this Article]

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