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(Hypertension. 2009;53:602.)
© 2009 American Heart Association, Inc.

Editorial Commentaries

Arterial Stiffness, Fatness, and Physical Fitness

Ready for Intervention in Childhood and Across the Life Course?

J. Kennedy Cruickshank; Mohammadreza Rezailashkajani; Guillaume Goudot

From the Cardiovascular Sciences (J.K.C., M.R.), University of Manchester, Manchester, United Kingdom; and U 684 INSERM-UHP (G.G.), Faculty of Medicine, Nancy Universite, France.

Correspondence to J. Kennedy Cruickshank, Cardiovascular Sciences, 3rd Floor CTF, University of Manchester, 46 Grafton St, Manchester M13 9NT, United Kingdom. E-mail kennedy.cruickshank@manchester.ac.uk

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

	Introduction

 
Arterial distensibility and its converse stiffness have come of age as physiological concepts¹ and now as a target for intervention. The central hypothesis sustained so far is that an individual’s "arterial stiffness" measured as aortic pulse wave velocity (PWV) is a convenient, integrated index of vascular pathology over a person’s life course, more precise and reliable than other risk factors individually. For example, blood pressure (BP), whether casual or 24 hour, is more sensitive to stimuli and, therefore, more variable. Arterial distensibility is in part dependent on BP, yet its prognostic power is because of its "independence" from BP, including pulse pressure.² It appears to indicate the general burden of atherosclerotic disease and subclinical damage from multiple risk factors over time: the "wear and tear" of constant distension and recoil (part of "aging"), effects of smoking, lipid metabolism, (hyper)glycemia, ethnicity, how family history expresses itself, etc.³ European hypertension guidelines now include PWV as a recommended but optional measure. The relationship of arterial distensibility with cardiac function and structure, known as aorto-ventricular coupling, is tantalizing because, as a bioengineering feedback loop, cause and effect are still unclear. Many other key questions remain, most critically related to the natural history of arterial stiffness but also fundamental ones of basic structural biology in the vessel wall.

A clue to the natural history of arterial stiffness is published in this issue of Hypertension, an Australian study of 9- to 10-year-old, generally prepubescent schoolchildren.⁴ The study shows a clear relationship among degree of body . . . [Full Text of this Article]

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Hypertension 2009 53: 611-616. [Abstract] [Full Text] [PDF]

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