Published online before print May 4, 2009, doi: 10.1161/HYPERTENSIONAHA.109.132308
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(Hypertension. 2009;53:900.)
© 2009 American Heart Association, Inc.
Editorial Commentaries |
Mechanisms of Decreased Vascular Function With Aging
From the Division of Cardiology, Washington Hospital Center, Washington, DC.
Correspondence to Julio A. Panza, Washington Hospital Center, 110 Irving St, NW, Suite 2A-74, Washington, DC 20010. E-mail julio.a.panza@medstar.net
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
Atherosclerosis of the coronary, cerebral, or peripheral circulation, the single leading cause of morbidity and mortality in most countries, develops with aging. Therefore, advanced age is one of the primary risk factors for the presence of atherosclerotic cardiovascular disease. Abnormalities in the regulatory functions of the vascular endothelium, commonly referred to as "endothelial dysfunction," are among the earliest detectable stages in the process of atherosclerosis. For example, patients with traditional risk factors, eg, hypertension, hypercholesterolemia, smoking, diabetes mellitus, and obesity, but without overt evidence of atherosclerosis, have demonstrable endothelial dysfunction. In turn, this abnormality contributes to the premature development and to the progression of the atherosclerotic process.
All of those aforementioned conditions are also associated with advanced age, thus leading to an important question: are there mechanisms that result in vascular degeneration and disease with aging that are independent of known or traditional risk factors? The answer seems to be yes, based on the results of earlier studies that have shown the presence of endothelial dysfunction and other vascular abnormalities in older subjects, even when controlling for risk factors.1 It is important to note that not all studies have controlled for all risk factors. Moreover, even when the known traditional risk factors are accounted for, other so-called novel risk factors may still be more prevalent among older patients and may help to contribute to any reported vascular abnormality, hence the difficulty in establishing the independent contribution of aging to atherosclerosis.
What are the mechanisms that may lead to progressive worsening
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