This Article Full Text Full Text (PDF) All Versions of this Article: 43/2/151    most recent 01.HYP.0000114581.77705.29v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mitchell, G. F. Search for Related Content PubMed PubMed Citation Articles by Mitchell, G. F. Related Collections Animal models of human disease Other hypertension Energy metabolism Other diagnostic testing

(Hypertension. 2004;43:151.)
© 2004 American Heart Association, Inc.

Editorial Commentaries

Increased Aortic Stiffness: An Unfavorable Cardiorenal Connection

From Cardiovascular Engineering, Inc., Holliston, Mass.

Correspondence to Dr Gary F. Mitchell, Cardiovascular Engineering, Inc., 327 Fiske Street, Holliston, MA 01746. E-mail GaryFMitchell@mindspring.com

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

	Introduction

 
Despite the many potentially life-threatening complications that can accompany renal disease, cardiovascular disease (CVD) remains the leading cause of death in these patients. Patients with renal dysfunction have more cardiovascular events at an earlier age and they tolerate these events poorly.^1,2 Established renal disease is associated with increased aortic stiffness and left ventricular (LV) hypertrophy, which are two important risk factors for CVD events. Conversely, aortic stiffness and LV mass have been related to each other and to early signs of renal damage, such as microalbuminuria.^3,4 There are several potential explanations for this 3-way interrelationship between cardiac, aortic, and renal function. These organs share several increasingly prevalent risk factors, including advanced age, hypertension, and diabetes, which may contribute to a parallel deterioration in function. Alternatively, dysfunction in one organ may damage the others. Unfortunately, our understanding of these complex interrelationships is currently limited.

The arterial and renal components of the cardio-aorto-renal ménage au trois are highlighted in a review by Safar et al in this issue of Hypertension.⁵ In work that has spanned nearly 3 decades, Professor Safar and colleagues have contributed immeasurably to our understanding of the role of abnormal arterial function in renal disease. As detailed in the review, they have shown that after accounting for common risk factors, increased arterial stiffness is present at various stages of renal dysfunction and represents a grave prognostic indicator. In an end-stage renal disease cohort, they demonstrated that arterial wall stiffness was an independent predictor of all-cause and cardiovascular mortality . . . [Full Text of this Article]

This article has been cited by other articles:

				A. Upadhyay, S.-J. Hwang, G. F. Mitchell, R. S. Vasan, J. A. Vita, P. I. Stantchev, J. B. Meigs, M. G. Larson, D. Levy, E. J. Benjamin, et al. Arterial Stiffness in Mild-to-Moderate CKD J. Am. Soc. Nephrol., September 1, 2009; 20(9): 2044 - 2053. [Abstract] [Full Text] [PDF]

				R. D. Smith and P. J. Levy Review: New techniques for assessment of vascular function Therapeutic Advances in Cardiovascular Disease, October 1, 2008; 2(5): 373 - 385. [Abstract] [PDF]

				N. Cheung, A. R. Sharrett, R. Klein, M. H. Criqui, F.M. A. Islam, K. J. Macura, M. F. Cotch, B. E.K. Klein, and T. Y. Wong Aortic Distensibility and Retinal Arteriolar Narrowing: The Multi-Ethnic Study of Atherosclerosis Hypertension, October 1, 2007; 50(4): 617 - 622. [Abstract] [Full Text] [PDF]

				M. E. Safar Mechanism(s) of Systolic Blood Pressure Reduction and Drug Therapy in Hypertension Hypertension, July 1, 2007; 50(1): 167 - 171. [Full Text] [PDF]

				G. Schillaci, M. Pirro, M. R. Mannarino, G. Pucci, G. Savarese, S. S. Franklin, and E. Mannarino Relation Between Renal Function Within the Normal Range and Central and Peripheral Arterial Stiffness in Hypertension Hypertension, October 1, 2006; 48(4): 616 - 621. [Abstract] [Full Text] [PDF]

				G. F. Mitchell, J. A. Vita, M. G. Larson, H. Parise, M. J. Keyes, E. Warner, R. S. Vasan, D. Levy, and E. J. Benjamin Cross-Sectional Relations of Peripheral Microvascular Function, Cardiovascular Disease Risk Factors, and Aortic Stiffness: The Framingham Heart Study Circulation, December 13, 2005; 112(24): 3722 - 3728. [Abstract] [Full Text] [PDF]

				A. P. V. Dantas and K. Sandberg Regulation of ACE2 and ANG-(1-7) in the aorta: new insights into the renin-angiotensin system in the control of vascular function Am J Physiol Heart Circ Physiol, September 1, 2005; 289(3): H980 - H981. [Full Text] [PDF]

				J. C. Verhave, P. Fesler, G. du Cailar, J. Ribstein, M. E. Safar, and A. Mimran Elevated Pulse Pressure Is Associated With Low Renal Function in Elderly Patients With Isolated Systolic Hypertension Hypertension, April 1, 2005; 45(4): 586 - 591. [Abstract] [Full Text] [PDF]

				G. F. Mitchell, H. Parise, E. J. Benjamin, M. G. Larson, M. J. Keyes, J. A. Vita, R. S. Vasan, and D. Levy Changes in Arterial Stiffness and Wave Reflection With Advancing Age in Healthy Men and Women: The Framingham Heart Study Hypertension, June 1, 2004; 43(6): 1239 - 1245. [Abstract] [Full Text] [PDF]