Time course and determinants of arterial stiffening
Research type
Research Study
Full title
Time course and determinants of arterial stiffening
IRAS ID
209628
Contact name
Barry McDonnell
Contact email
Sponsor organisation
Cardiff Metropolitan University
Duration of Study in the UK
5 years, 0 months, 0 days
Research summary
Cardiovascular disease is now the leading cause of death worldwide, with heart attacks and stroke accounting for over 20% of all deaths. A number of surrogate markers of cardiovascular risk have been established, including carotid (artery wall) intimal-medial thickness and left ventricular mass. However, accumulating evidence suggests that arterial stiffness is a key additional and independent determinant of cardiovascular risk and may be involved in the process of atherosclerosis itself. Aortic pulse wave velocity (PWV), a well-validated index of regional arterial stiffness, and central augmentation index (AIx), a measure of systemic arterial stiffness and wave reflections, predict outcome in a number of patient groups and in the general population.
The major determinants of arterial stiffness are the mean arterial pressure, structural elements within the vessel wall, and smooth muscle tone. However, the precise mechanisms driving the increase in arterial stiffness remain incompletely understood. Interestingly, arterial stiffness is itself associated with a number of traditional cardiovascular risk factors, including cigarette smoking, hypercholesterolaemia and diabetes mellitus. However, based upon our own data, these factors alone account for only ~ 30-40% of the variance in arterial stiffness. In addition, the results of a number of small, cross-sectional studies indicate that other factors such as renal impairment, arterial calcification and loss of bone mineral density, sympathetic nervous system activity and the metabolic syndrome, are also likely to be important determinants of arterial stiffness. However, as yet, there are no longitudinal data describing the relationship between these factors and changes in stiffness over time. Such data would, potentially, highlight the most important factors influencing arterial stiffness, and would be helpful in devising which therapeutic strategies (either lifestyle or pharmacological) are most likely to retard the process of arterial stiffening, and thus, potentially, cardiovascular risk.
REC name
Wales REC 2
REC reference
16/WA/0191
Date of REC Opinion
23 Sep 2016
REC opinion
Further Information Favourable Opinion