Should we Measure Arterial Stiffness in Hypertensive Women

C. Bhaktavatsal Reddy
2020 Indian Journal of Cardiovascular Disease in Women WINCARS  
Ind J Car Dis Wom:2020;5:305-307 hypertension, however, were not significant. That is due to the fact that most of patients were using vasodilators. Duration of antihypertensive use, location of PWV assessment, blood pressure, heart rate smoking, alcohol, and salty diet intake prior to PWV measurement should be considered as confounding factors when assessing differences in PWV values across these groups. Hypertension, a major cardiovascular disease risk factor, can contribute to increased
more » ... e to increased oxidative stress, microvascular inflammation, and endothelial damage. During hypertension, elastic fibers become compromised and damaged, resulting in decreased arterial wall stiffness. 18 Hypertension duration is substantially correlated with artery stiffening due to excessive oxidative load and prolonged strain, resulting in gradual vascular remodeling and loss of artery elasticity. In women under 60 years of age, PWV is smaller than in males, but values increase sharply after menopause. 19 In postmenopausal women, endogenous vasodilatory estrogen 20 depletion leads to increased arterial rigidity. 21 Increased arterial stiffness in women results in poor hypertension control, weaker diastolic activity, impaired cardiac-arterial coupling, and left ventricular remodeling, all related to adverse cardiovascular effects. 22 Interventions should aim to alter modifiable risk factors and prevent early development of increased arterial rigidity. Aerobic exercise, 23 intake of moderate alcohol, 24 and diet rich in flavonoids 25 and low in salt 26 have been shown to enhance artery compliance despite decreased blood pressure. By lowering blood pressure, vasodilators such as nitroglycerin, 27 drugs that inhibit renin angiotensin, 28-31 and calcium channel blockers 32 have shown increased compliance. Among vasodilators, drugs inhibiting renin-angiotensin-aldosterone pathways tend to have superior effect than others in decreasing arterial stiffness. 33 Statins, 34 by restoring endothelial functionality, demonstrated positive impact on arterial stiffness. Nebivolol, a NO donor β-blocker, has shown to reduce PWV independent of blood pressure and
doi:10.1055/s-0040-1722561 fatcat:nlhcd7lyknhsjcsp2qx4mcvdxy