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Relationship Between Aortic Stiffening and Microvascular Disease in Brain and Kidney: Cause and Logic of Therapy
Abstract
A close relationship has been established between microvascular damage in brain and kidney and indices of age and hypertension (pulse pressure, aortic pulse wave velocity, and augmentation index). The mechanism of such association has not been established, nor has rationale for prevention and treatment of microvascular damage. A logical pathophysiological explanation can be offered on the basis of differential input impedance in the brain and kidney compared with other systemic vascular beds. Torrential flow and low resistance to flow in these organs exposes small arterial vessels to the high-pressure fluctuations that exist in the carotid, vertebral, and renal arteries. Such fluctuations, measurable as central pulse pressure, increase 3- to 4-fold with age. Exposure of small vessels to highly pulsatile pressure and flow explains microvascular damage and resulting renal insufficiency and intellectual deterioration, according to the mechanism established by Byrom >50 years ago. The logical approach to prevention and treatment requires reduction of central pulse pressure. Because the aorta and large arteries are not directly affected by drugs, this entails reduction of wave reflection by dilation of conduit arteries elsewhere in the body. This can be accomplished by regular exercise and by drugs such as nitrates, calcium channel blockers, angiotensin-converting enzyme inhibitors, and angiotensin receptor blockers. The explanation given here accounts for greater and earlier vascular damage in diabetes mellitus (relative microvascular fragility) and is similar to that given for vascular changes of pulmonary hypertension caused by ventricular septal defects and other congenital vascular shunts.
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“Several pathways may link aortic stiffness to microvascular brain damage. They include endothelial dysfunction and oxidative stress,209 a mutually reinforcing remodeling of large and small vessels (ie, large-/small-artery cross talk),210 and exposure of small vessels to the high-pressure fluctuations of the cerebral circulation,211”
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Cites
Laurent, S., Boutouyrie, P., Asmar, R., Gautier, I., Laloux, B., Guize, L., Ducimetiere, P., & Benetos, A. (2001) · Hypertension · doi:10.1161/01.hyp.37.5.1236 · Cited by 3,856
Hemodynamic Patterns of Age-Related Changes in Blood Pressure: The Framingham Heart Study
Franklin, S. S., Gustin, W., Wong, N. D., Larson, M. G., Weber, M. A., Kannel, W. B., & Levy, D. (1997) · Circulation · doi:10.1161/01.cir.96.1.308 · Cited by 2,321
Hypertension : pathophysiology, diagnosis, and management
Laragh, J. H., & Brenner, B. M. (1995) · Raven Press eBooks · Cited by 1,932
Aortic Stiffness Is an Independent Predictor of Primary Coronary Events in Hypertensive Patients
Boutouyrie, P., Tropeano, A., Asmar, R. G., Gautier, I., Bénétos, A., Lacolley, P. J., & Laurent, S. (2002) · Hypertension · doi:10.1161/hy0102.099031 · Cited by 1,745
McDonald's Blood Flow in Arteries: Theoretical, Experimental and Clinical Principles
Vlachopoulos, C., O'Rourke, M., & Nichols, W. W. (2011) · doi:10.1201/b13568 · Cited by 1,613
Self-citationArterial Calcifications, Arterial Stiffness, and Cardiovascular Risk in End-Stage Renal Disease
Blacher, J., Guérin, A. P., Pannier, B., Marchais, S. J., & London, G. M. (2001) · Hypertension · doi:10.1161/hy1001.096358 · Cited by 1,416
Pauca, A. L., O’Rourke, M. F., & Kon, N. D. (2001) · Hypertension · doi:10.1161/hy1001.096106 · Cited by 1,179
Self-citationArterial stiffness, wave reflections, and the risk of coronary artery disease
Weber, T., Auer, J., O’Rourke, M. F., Kvas, E., Lassnig, E., Berent, R., & Eber, B. (2004) · Circulation · doi:10.1161/01.cir.0000105767.94169.e3 · Cited by 1,081
Self-citationAortic Stiffness Is an Independent Predictor of Fatal Stroke in Essential Hypertension
Laurent, S., Katsahian, S., Fassot, C., Tropeano, A., Gautier, I., Laloux, B., & Boutouyrie, P. (2003) · Stroke · doi:10.1161/01.str.0000065428.03209.64 · Cited by 1,058
Impact of Aortic Stiffness Attenuation on Survival of Patients in End-Stage Renal Failure
Guérin, A. P., Blacher, J., Pannier, B., Marchais, S. J., Safar, M. E., & London, G. M. (2001) · Circulation · doi:10.1161/01.cir.103.7.987 · Cited by 1,038
Self-citation
Research works printed but not linked: 15
- 10.1161/hyp.39.3.735 · DOI
- 10.1161/hyp.39.1.10 · DOI
- 10.1161/hyp.38.4.938 · DOI
- 10.1161/hyp.37.5.1236 · DOI
- 10.1161/atvb.21.12.2046 · DOI
- 10.1161/hyp.38.3.429 · DOI
- SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug therapy in older persons with isolated systolic hypertension: final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA. 1991; 365: 3255–3264.
- 10.1161/hyp.38.4.932 · DOI
- 10.1161/res.16.5.401 · DOI
- 10.1161/res.25.6.637 · DOI
- 10.1161/res.27.6.921 · DOI
- 10.1161/res.66.1.2403863 · DOI
- 10.1161/circ.96.1.308 · DOI
- 10.1161/circ.103.7.987 · DOI
- 10.1161/circ.15.2.164 · DOI
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Items 901–999 of 999
Liu, W., Yao, Y., Yang, J., Song, D., Zhang, Y., Sun, G., Xu, L., & Avolio, A. P. (2021) · Physiological Measurement · doi:10.1088/1361-6579/ac23a7 · Cited by 5
Photoplethysmographic assessment of arterial stiffness and endothelial function
Zheng, D., Yao, Y., Morrison, I., & Greenwald, S. (2021) · Elsevier eBooks · doi:10.1016/b978-0-12-823374-0.00007-4 · Cited by 7
Zhou, W., Yu, Y., Zhu, L., Fang, W., Yu, T., Li, M., Huang, X. B., Wang, T., Bao, H., & Cheng, X. (2021) · International Journal of Endocrinology · doi:10.1155/2021/7722269 · Cited by 5
“Stage two: arteriosclerosis led to thickening and stiffening of the arterial vessel wall, loss of elasticity, and narrowing of the lumen and caused greater damage to high flow and low-resistance organs, such as the liver and pancreas [30].”
BackgroundOverview of the Normal Structure and Function of the Macrocirculation and Microcirculation
Nichols, W. W., Heffernan, K. S., & Chirinos, J. A. (2015) · Springer eBooks · doi:10.1007/978-3-319-14556-3_2 · Cited by 5
Camarda, J., Dholakia, R., Wang, H.-F., Samyn, M. M., Cava, J., & LaDisa, J. (2022) · Frontiers in Pediatrics · doi:10.3389/fped.2022.772142 · Cited by 4
Hendrickx, J. O., Adams, C., Sieben, A., Laukens, K., Dam, D. V., & Meyer, G. R. Y. D. (2022) · Biomedicines · doi:10.3390/biomedicines10081772 · Cited by 5
“Given its extensive microvasculature, the brain is not only a high-flow, but also a low-resistant organ that is continuously exposed to cardiac pulsatile pressures and mechanical forces [19].”
BackgroundWang, L., Cao, T., Li, J., Ding, C., Li, J., Ying, H.-B., Liu, L., & Huang, X. B. (2022) · PubMed Central · doi:10.11909/j.issn.1671-5411.2022.10.006 · Cited by 5
Zeng, X., Fu, X., Li, X., Zhou, J., Huang, S., Li, X., Liao, L., & Gao, Q. (2019) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2019.03.045 · Cited by 5
Increased cardio-ankle vascular index values in patients with acute branch retinal vein occlusion
Kocayiğit, İ., Atum, M., Şahinkuş, S., Aksoy, M., & Can, Y. (2020) · Indian Journal of Ophthalmology · doi:10.4103/ijo.ijo_1300_19 · Cited by 5
“On the other hand, recent studies showed the role of increased large arterial stiffness on microvascular diseases, especially the damages of target organs such as the brain and kidney.[24] Retinal microcirculation was also related to arterial stiffness shown by CAVI.”
BackgroundWei, F., Raaijmakers, A., Melgarejo, J. D., Cauwenberghs, N., Thijs, L., Zhang, Z., Yu, C., Levtchenko, E. N., Struijker-Boudier, H. A. J., Yang, W., et al. (2020) · Journal of the American Heart Association · doi:10.1161/jaha.119.014305 · Cited by 5
“systole and diastole, so that pulsations are transmitted through the capillary network up to the venous efflux, 6 in particular if the elastic properties of the aorta degrade.”
InfluentialSilva, N. C. B. S., Gill, D. P., Nagamatsu, L. S., Owen, A. M., & Petrella, R. J. (2020) · Experimental Gerontology · doi:10.1016/j.exger.2020.111100 · Cited by 5
Call, C., Han, S., Speich, J. E., Eddinger, T. J., & Ratz, P. H. (2006) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00086.2006 · Cited by 4
Vascular Aging and Cardiovascular Disease
Cunha, P., & Olsen, M. H. (2015) · Elsevier eBooks · doi:10.1016/b978-0-12-801387-8.00025-9 · Cited by 5
Development of a technique for determination of pulmonary artery pulse wave velocity in horses
Silva, G., Guest, B. B., Gómez, D. E., McGregor, M. E., Viel, L., O’Sullivan, M. L., Runciman, J., & Arroyo, L. G. (2017) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00962.2016 · Cited by 5
“In fact, increased arterial stiffness has been associated with the development of systemic hypertension, microvascular disease in the brain and kidneys, and the development of pulmonary hypertension (11, 26, 33).”
BackgroundSilva, N. C. B. S., Gregory, M. A., Gill, D. P., McGowan, C. L. M., & Petrella, R. J. (2018) · Gerontology and Geriatric Medicine · doi:10.1177/2333721418770333 · Cited by 5
“exercise, aging, blood pressure, cognition, mobility Manuscript received: December 27, 2017; final revision received: February 21, 2018; accepted: March 13, 2018. vascular-related brain injury, including microbleeds, lacunar infarcts, and white matter (WM) hyperintensities (O’Rourke & Safar, 2005).”
Genetics of Alzheimer’s Disease
de la Torre, J. C. (2016) · Springer eBooks · doi:10.1007/978-3-319-34057-9_9 · Cited by 5
Commentary on “Vascular cognitive impairment: Today and tomorrow”
Kuller, L. H. (2006) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2006.03.014 · Cited by 5
Kuller, L. H. (2006) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2005.12.005 · Cited by 5
Classification, pathology, and basic aspects
Pantoni, L., & Gorelick, P. B. (2014) · Cambridge University Press eBooks · doi:10.1017/cbo9781139382694.002 · Cited by 5
O’Rourke, M. F., & Hayward, C. (2009) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2009.04.065 · Cited by 5
Self-citationShaaban, C. E., & Molad, J. (2020) · Neurology · doi:10.1212/wnl.0000000000009477 · Cited by 5
“The pulsatile waveform of blood should be dampened by the highly elastic aorta and large arteries as flow proceeds to the small vessels, but when vessels become less elastic, as with aging, their dampening ability is compromised, and highly pulsatile flow is transmitted to the cerebral small vessels with attendant neg…”
BackgroundChronological age and vascular age staring at each other on the ring of cardiovascular prevention
Pucci, G., & Verdecchia, P. (2021) · International Journal of Cardiology Hypertension · doi:10.1016/j.ijchy.2021.100076 · Cited by 5
“This process ultimately causes a series of secondary negative consequences on cardiac function and perfusion of peripheral organs and tissues, particularly at the level of the brain and the kidney microvasculature [3].”
BackgroundZhang, F., Bai, Y., Huang, L., & Zhong, Y. (2025) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2025.112472 · Cited by 4
Gao, J., Deng, H., Wang, G., Deng, H., Feng, D.-Y., Wu, S.-L., Chen, S., & Zhou, Y. (2025) · Diabetologia · doi:10.1007/s00125-025-06609-x · Cited by 4
Chirinos, J. A. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-91391-1.00010-8 · Cited by 4
Sugawara, J., Hashimoto, T., Tsukamoto, H., Secher, N. H., & Ogoh, S. (2023) · Experimental Physiology · doi:10.1113/ep091119 · Cited by 3
Liu, X., Pan, Z., Li, Y., Huang, X., Zhang, X., & Xiong, F. (2024) · Frontiers in Neurology · doi:10.3389/fneur.2024.1428625 · Cited by 4
“Both the kidneys and the brain possess similar low-resistance microvascular structures that receive blood at sustained high flow rates (7).”
BackgroundHuang, S., Nunez, J., Toresco, D. L., Wen, C., Slotabec, L. A., Wang, H., Zhang, H., Rouhi, N., Adenawoola, M. I., & Li, J. (2025) · The FASEB Journal · doi:10.1096/fj.202402725rr · Cited by 4
“113 In cases of impaired microvascular responsiveness, increased short-term blood pressure fluctuations can affect the supply of oxygen and nutrients to the brain, 114 leading to neuroinflammation and neurodegeneration, which accelerate cognitive decline.”
Benefits of aldosterone receptor antagonism in chronic kidney disease: the BARACK-D RCT
Hobbs, R. F., McManus, R. J., Taylor, C. J., Jones, N. R., Rahman, J. K., Wolstenholme, J. L., Jones, L., Hirst, J. A., Mort, S., & Yu, L. (2025) · Health Technology Assessment · doi:10.3310/pyft6977 · Cited by 4
Coronary artery calcium and risk of chronic kidney disease in young and middle-aged adults
Kim, Y., Kang, J., Chang, Y., Hyun, Y. Y., Lee, K., Shin, H. C., Wild, S. H., Byrne, C. D., & Ryu, S. (2022) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfac272 · Cited by 4
Sakai, S., Hagii, J., Shikanai, S., SORIMACHI, Y., Hamaura, S., Yamazaki, K., YAMADA, N., Shiroto, H., Saito, S., Kamada, T., et al. (2023) · In Vivo · doi:10.21873/invivo.13084 · Cited by 4
“Consequently, these may lead to renal impairment and cerebral stroke or damage (25-27).”
BackgroundCerebral blood flow pulsatility and cerebral artery stiffness acutely decrease during hemodialysis
Paré, M., Obeid, H., Labrecque, L., Drapeau, A., Brassard, P., & Agharazii, M. (2023) · Physiological Reports · doi:10.14814/phy2.15595 · Cited by 4
Changes in Rat Cerebral Blood Flow Velocities at Different Stages of Aging
Gorshkova, O. P. (2023) · Journal of Evolutionary Biochemistry and Physiology · doi:10.1134/s0022093023020229 · Cited by 4
Stone, J., Mitrofanis, J., Johnstone, D. M., & Robinson, S. R. (2024) · Journal of Alzheimer s Disease · doi:10.3233/jad-231202 · Cited by 4
“Subsequently, we proposed [78], following others [79–81], that the link from age to dementia lies in the wall of the aorta, which loses its elasticity with age (as the elastin in the wall’s tunica elastica dena-tures), increasing the elastic modulus (stiffness) of the wall (Fig.”
Stone, J., Robinson, S. R., Mitrofanis, J., & Johnstone, D. M. (2024) · Biomedicines · doi:10.3390/biomedicines12091969 · Cited by 4
“…above, epidemiological evidence indicates that age-related hypertension, whether assessed as pulse wave velocity (a measure of arterial stiffening) [6,7,45,76,77], as pulse pressure [46] or as the augmentation index (the summing of direct and reflected pulse waves) [77], is associated with a…”
BackgroundBiochemical variations in patients with renal failure: A comparative study
Abo-Ghneim, F. D. F., Mohammed, H., & Al-Koofee, D. A. F. (2024) · World Academy of Sciences Journal · doi:10.3892/wasj.2024.281 · Cited by 4
Li, L., Xia, G., Lei, L., Hu, Q., Wei, X., Cui, M., Tang, Q., Yang, D., & Zhao, A. (2025) · Acta cardiologica. Supplementum · doi:10.1080/00015385.2024.2445339 · Cited by 4
“This phenomenon results in excessive pressure and blood flow pulsation into the microvascular bed of the kidney, thus exposing the renal artery to higher shear stress [45], causing hyper-filtration and hyper-perfusion in the kidney.”
Time is Aorta in Uncomplicated Type B Aortic Dissection
Civilini, E., Pascucci, M. G., Jubouri, M., Bashir, M., D’Oria, M., & Piffaretti, G. (2025) · Annals of Vascular Surgery · doi:10.1016/j.avsg.2025.01.028 · Cited by 4
Xu, Y., Hertig, A., Lebranchu, Y., de Ligny, B. H., Thervet, É., Jaureguy, M., Touchard, G., Pogamp, P. L., Meur, Y. L., Toupance, O., et al. (2013) · Transplant International · doi:10.1111/tri.12253 · Cited by 4
“In the kidneys, the blood flow is torrential but the vascular resistance to flow is low [34]: A rapid increase in pp after transplantation might thus cause small vascular damage.”
BackgroundWhat Is Left Ventricular Hypertrophy and Is There a Reason to Regress Left Ventricular Hypertrophy?
Weir, M. R., & Townsend, R. R. (2009) · Journal of Clinical Hypertension · doi:10.1111/j.1751-7176.2009.00156.x · Cited by 4
Wave reflection signatures: identifying early microvascular abnormalities in type 2 diabetes
Plumb, R., Hamilton, P., Rea, D. J., Wright, S. A., Hughes, S., McGivern, R. C., & McVeigh, G. E. (2011) · The British Journal of Diabetes · doi:10.1177/1474651411422650 · Cited by 4
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Joannidès, R., Bellien, J., & Thuillez, C. (2014) · Springer eBooks · doi:10.1007/978-1-4471-5198-2_10 · Cited by 4
Dietary Approaches to Reduce Aortic Stiffness
Pase, M. P. (2016) · Elsevier eBooks · doi:10.1016/b978-1-63067-036-8.00007-x · Cited by 4
Burak, C., Süleymanoğlu, M., Yesın, M., Çap, M., Yıldız, İ., Rencüzoğulları, İ., Çağdaş, M., Karabağ, Y., Hamideyin, Ş., İliş, D., et al. (2020) · Medical Principles and Practice · doi:10.1159/000508249 · Cited by 4
Exercise Training and Cognitive Function in Kidney Disease
Bronas, U. G., Hannan, M. F., Lash, J. P., Ajilore, O., Zhou, X. J., & Lamar, M. (2021) · Nursing Research · doi:10.1097/nnr.0000000000000554 · Cited by 4
Shen, Y., Dong, Z., Xu, G., Zhong, J., Pan, P., Chen, Z., & Shi, H. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.740656 · Cited by 4
Huang, S., Yu, T., Chen, C., Cheng, Y.-C., Chuang, Y., Cheng, C.-H., Liu, J., Hsu, C., & Wu, M. (2023) · Metabolites · doi:10.3390/metabo13020266 · Cited by 4
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BackgroundTrajectories of glycated hemoglobin of T2DM and progress of arterial stiffness: a prospective study
Li, K., Cao, B., Dong, H., Yang, L., & Zhao, D. (2023) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-023-01108-8 · Cited by 4
A multi-omics glimpse into the biology of arterial stiffness
Eales, J., Romaine, S. P. R., Charchar, F. J., & Tomaszewski, M. (2015) · Journal of Hypertension · doi:10.1097/hjh.0000000000000783 · Cited by 3
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BackgroundScuteri, A., Stone, J., & O’Rourke, M. F. (2014) · Springer eBooks · doi:10.1007/978-1-4471-5198-2_25 · Cited by 4
Self-citationYu, B., Dejun, X., Sun, H., Yang, K., & Luo, M. (2015) · Europe PMC (PubMed Central) · doi:10.6515/acs20150119e · Cited by 4
High blood pressure: An obscuring misnomer?
Aslanger, E. K. (2016) · The Anatolian Journal of Cardiology · doi:10.14744/anatoljcardiol.2016.7054 · Cited by 4
“flow Although comparing different organs may be subject to misjudgments because of their inherent structural differences and the dissimilarity of exposed pulsatile stress (7), intriguing observational evidence comes forth when one considers differential effects of gravity on distending and perfusion pressures: (1) one…”
BackgroundLo, S., Chen, W.-L., Muo, C., Chen, P., Chen, S., Kuo, C.-L., & Sung, F. (2018) · Frontiers in Neurology · doi:10.3389/fneur.2018.00719 · Cited by 4
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BackgroundPreoperative Pulse Pressure and Adverse Postoperative Outcomes: A Meta-Analysis
Zeng, J., Guoquan, Z., Li, Y., & Yang, Y. (2019) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2019.09.036 · Cited by 4
Dželetović, B., Aleksić, N., Radak, D. J., Stratimirović, D., Djukić, L., & Stojić, D. L. (2020) · Journal of Endodontics · doi:10.1016/j.joen.2019.12.008 · Cited by 4
Kennedy, G., Meyer, D., Hardman, R. J., Macpherson, H., Scholey, A. B., & Pipingas, A. (2020) · Journal of Alzheimer s Disease Reports · doi:10.3233/adr-190164 · Cited by 4
“As a result, the cerebral microvasculature is more exposed to increases in maximal pressures that of other tissue [11, 14].”
BackgroundThe Influence of Resting Heart Rate on Central Pulse Pressure is Age-Dependent
Alfie, J., Aparicio, L. S., & Cuffaro, P. E. (2021) · High Blood Pressure & Cardiovascular Prevention · doi:10.1007/s40292-020-00432-8 · Cited by 4
“Pulse pressure (PP), the difference between systolic and diastolic blood pressure, is a well-established risk factor [1] and at least equally prognostic for cardiovascular events whether it is measured at the central aortic or peripheral brachial site [2].”
BackgroundKidney Disease, Hypertension Treatment, and Cerebral Perfusion and Structure
Tamura, M. K., Gaussoin, S. A., Pajewski, N. M., Zaharchuk, G., Freedman, B. I., Rapp, S. R., Auchus, A. P., Haley, W. E., Oparil, S., Kendrick, J., et al. (2021) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2021.07.024 · Cited by 4
Yi, S. S. (2022) · Laboratory Animal Research · doi:10.1186/s42826-022-00113-8 · Cited by 4
Wang, L., Li, H., Hao, J., Liu, C., Wang, J., Feng, J., Guo, Z., Zheng, Y., Zhang, Y., Li, H., et al. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.999568 · Cited by 4
“Increased pulse pressure may expose cerebral small vessels to high pulsatile pressure and flow, which damage the cerebral microvasculature and hinder the restoration of stroke-impaired neurological function (O’Rourke and Safar, 2005; Ishizuka et al., 2016).”
BackgroundKereiakes, D. J., Maa, J., Shojaee, A., & Dubiel, R. (2010) · American Journal of Cardiovascular Drugs · doi:10.2165/11538630-000000000-00000 · Cited by 4
Kim, M., Li, J., Qasem, A., Graham, S. L., & Avolio, A. P. (2012) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc.2012.6347267 · Cited by 4
Takenaka, T., Uchida, K., Kojima, E., Gen, S., Nodaira, Y., Hoshi, H., Kato, N., Takane, H., Ohno, Y., & Suzuki, H. (2011) · Clinical and Experimental Hypertension · doi:10.3109/10641963.2011.583965 · Cited by 4
“Like the brain and the heart, the kidney is directly connected to the aorta (central artery) through the renal artery, and thus influenced with central BP rather than brachial BP (14).”
BackgroundRisk Factors for Lacunar Strokes with Visible Cerebral Lesions on Computed Tomography Scan
Muscari, A., Conte, C., Esposti, D. D., Faccioli, L., Falcone, R., Kolce, B., Marabini, L., Puddu, G. M., Rosticci, M., Spinardi, L., et al. (2016) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2016.01.050 · Cited by 4
Erdan, A., Özkök, A., Alpay, N., Akkaya, V., & Yıldız, A. (2018) · The International Journal of Artificial Organs · doi:10.1177/0391398818778212 · Cited by 4
Timing and Amplitude of Wave Reflection
O’Rourke, M. F., & Nichols, W. W. (2006) · Hypertension · doi:10.1161/01.hyp.0000250823.15229.37 · Cited by 4
Self-citationAortic Stiffening, Aortic Blood Flow Reversal, and Renal Blood Flow
Laurent, S., Boutouyrie, P., & Mousseaux, É. (2015) · Hypertension · doi:10.1161/hypertensionaha.115.05357 · Cited by 4
“Stiff Central Arteries” Syndrome: Does A Weak Heart Really Stiff the Kidney?
Baliga, R. R., & Young, J. B. (2008) · Heart Failure Clinics · doi:10.1016/j.hfc.2008.06.001 · Cited by 4
Indexing Cerebrovascular Health Using Transcranial Doppler Ultrasound
Afkhami, R. G., Wong, R. H. X., Ramadan, S. A., Walker, F. R., & Johnson, S. J. (2021) · Ultrasound in Medicine & Biology · doi:10.1016/j.ultrasmedbio.2020.12.022 · Cited by 4
Day, T. K. (2021) · IntechOpen eBooks · doi:10.5772/intechopen.100048 · Cited by 3
Interaction Effect of Estimated Pulse Wave Velocity and Serum Klotho Level on Chronic Kidney Disease
Zou, P., Li, J., Chen, L., Liu, M., Nie, H., Yan, J., Zhang, L., Gao, H., Zhang, C., & Zhang, Y. (2025) · Aging Medicine · doi:10.1002/agm2.70005 · Cited by 3
“In detail, the pressure from pulse wave can penetrate deeply into the microvasculature of the kidney [28], leading to the loss of renal function and proteinuria caused by damage to the glomerulus [29].”
Impact of diabetes and glycemic status on ventricular–arterial coupling in the general population
Holm, H., Zilic, H., Jujić, A., Johnsson, L., Engström, G., Nilsson, P. M., Östgren, C. J., Kylhammar, D., Engvall, J. E., & Magnusson, M. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02731-7 · Cited by 3
“This effect may be mediated by the impact of arterial stiffness on low-resistance organs, such as the pancreas, potentially exacerbating insulin resistance and further compromising glycemic control [35].”
Primary Aldosteronism and Cognitive Dysfunction: A Case-Control Study
Herceg, J., Vukorepa, G., & Karanović, S. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14134618 · Cited by 3
Effects of Mild Orthostatic Stimulation on Cerebral Pulsatile Hemodynamics
Ninomiya, Y., Tomoto, T., Ogoh, S., Imai, T., Takahashi, K., & Sugawara, J. (2019) · Frontiers in Physiology · doi:10.3389/fphys.2019.00230 · Cited by 3
“The augmented cerebral flow and pressure fluctuations cause several cerebral small vessel diseases (O’Rourke and Safar, 2005; Mitchell et al., 2011; Tarumi et al., 2014).”
BackgroundMahadappa, P., Jeyaraja, K., Thirunavakkarasu, P., & Krishnaswamy, N. (2023) · Topics in companion animal medicine · doi:10.1016/j.tcam.2023.100843 · Cited by 3
Association between estimated pulse wave velocity and all-cause death in patients with heart failure
Yuan, X., Chen, C.-W., Mao, J., Bao, W., Chen, C., & Xu, T. J. (2023) · Revista Clínica Española (English Edition) · doi:10.1016/j.rceng.2023.12.008 · Cited by 3
Fat, fib, and forgetfulness: The interplay between adiposity, atrial fibrillation, and dementia
Burnham, T. S., Ranjan, R., Konstantinidis, K., Steinberg, B. A., & Bunch, T. J. (2025) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2025.07.006 · Cited by 3
Kong, N., Won, G. H., & Jung, J. H. (2025) · Scientific Reports · doi:10.1038/s41598-025-12821-x · Cited by 3
Pulmonary Vascular Remodeling: Cellular and Molecular Mechanisms
Stenmark, K. R., & Frid, M. G. (2010) · Springer eBooks · doi:10.1007/978-0-387-87429-6_52 · Cited by 3
Wave Reflection in Acute Ischemic Stroke
Weber, T. (2010) · American Journal of Hypertension · doi:10.1038/ajh.2010.79 · Cited by 3
SUBCLINICAL BRAIN DAMAGE AND HYPERTENSION
Tzourio, C., Nilsson, P. M., Scuteri, A., Inserm, U., & Geriatria, U. (2010) · Cited by 3
Elevated pulse amplification in hypertensive patients with advanced kidney disease
for the ABC-J II study group, Takenaka, T., Suzuki, H., Eguchi, K., Miyashita, H., & Shimada, K. (2018) · Hypertension Research · doi:10.1038/s41440-017-0010-4 · Cited by 3
“Thus, proximal aortic stiffening inadequately reduces PP in CKD, which accounts for a high prevalence of microvascular as well as macrovascular diseases of the brain and kidney in this patient population [31].”
BackgroundThe pathophysiology of chronic cardiorenal disease based on central hemodynamics
Ohno, M. (2018) · Journal of Cardiovascular Medicine and Cardiology · doi:10.17352/2455-2976.000067 · Cited by 3
Tomiyama, H., & Shiina, K. (2020) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.ed153 · Cited by 3
Putowski, Z., Krzych, Ł. J., & Czajka, S. (2022) · Advances in Clinical and Experimental Medicine · doi:10.17219/acem/145946 · Cited by 3
Siepmann, R. M., Bruners, P., Lang, S. A., Bednarsch, J., Amygdalos, I., Joechle, K., Pedersoli, F., Keil, S., Isfort, P., Ulmer, T. F., et al. (2022) · Abdominal Radiology · doi:10.1007/s00261-022-03629-8 · Cited by 3
“This hypertension is accompanied by normal or even low diastolic pressure which promotes enhanced pulsatile energy penetration into the microvasculature of the organs including the kidneys, which must therefore operate at low arteriolar resistance [37].”
BackgroundEvaluation of ventricular–vascular coupling with critical care metrics: An in silico approach
Mulligan, L. J., Ungerleider, J. B., Friedman, A., Sanders, B., Thrash, J., Ewert, D. L., Mitrev, L. V., & Hill, J. C. (2024) · Physiological Reports · doi:10.14814/phy2.15920 · Cited by 3
“A decrease in C A and the resulting increase in arterial pulsatility leads to a loss of autoregulatory microvascular control, increasing the difficulty of controlling IOH (Georgianos et al., 2015; London et al., 2004; O'Rourke & Safar, 2005).”
BackgroundTamaki, H., Eriguchi, M., Nishimoto, M., Uemura, T., Tasaki, H., Furuyama, R., Fukata, F., Kosugi, T., Morimoto, K., Matsui, M., et al. (2024) · Hypertension Research · doi:10.1038/s41440-024-01882-6 · Cited by 3
“Kidney arteries are subjected to high pulsate circumferential stress and high longitudinal shear stress [31].”
Kim, H., Park, Y., Ko, S., Cho, Y., Kim, H. W., Kim, Y. K., Han, K., Yun, J., Kim, K., & Moon, D. (2025) · Scientific Reports · doi:10.1038/s41598-025-91835-x · Cited by 3
“This can result in microvascular ischemia and injury to renal tissue 35,44 .”
Correia, M. C., Lima, M. H. D. J., Bitencourt, A. R., Carneiro, A. R. D. C., de Oliveira, R. O., Inuzuka, S., Oliveira, A. C., Pedatella, M. T. A., Piza, P. V. D. T., Frigieri, G. H., et al. (2025) · Artery Research · doi:10.1007/s44200-025-00085-9 · Cited by 3
“Increased arterial stiffness mainly affects organs with higher blood flow demand and low resistance, such as the brain and kidneys, and can result in cerebral damage (cognitive impairment/dementia) and the progression of chronic kidney disease [21, 22].”
Österlind, J., Birnefeld, J., Eklund, A., Hultin, M., Wåhlin, A., Holmlund, P., & Zarrinkoob, L. (2025) · Anesthesiology · doi:10.1097/aln.0000000000005651 · Cited by 3
Functional MRI signatures of autonomic physiology in aging
Fan, J., Juttukonda, M. R., Goodale, S. E., Wang, S., Orbán, C., Varadarajan, D., Polimeni, J. R., Chang, C. E., Salat, D. H., & Chen, J. E. (2025) · Communications Biology · doi:10.1038/s42003-025-08703-7 · Cited by 3
Smooth Muscle Cell Molecular Underpinnings of Vascular Ageing
Regnault, V., Raoul, A., Schellenberg, C., & Lacolley, P. J. (2021) · Heart Lung and Circulation · doi:10.1016/j.hlc.2021.09.002 · Cited by 3
Honma, H., Ohno, T., Tokita, Y., Matsuzaki, T., Fujimoto, H., Yoshinaga, A., Sato, A., Yokoshima, T., Ito, K., & Mizuno, K. (2011) · Journal of Medical Ultrasonics · doi:10.1007/s10396-011-0318-7 · Cited by 3
“Exposure of small vessels to pulsatile arterial changes in pressure and flow could lead to microvascular damage [25, 26], and endothelial dysfunction is associated with renal dysfunction.”
BackgroundO’Rourke, M. F. (2009) · American Journal of Hypertension · doi:10.1038/ajh.2009.51 · Cited by 3
Self-citationO’Rourke, M. F. (2012) · Journal of Hypertension · doi:10.1097/hjh.0b013e32835522e2 · Cited by 3
Self-citationThe link between large artery aging and cerebral small vessel disease
Scuteri, A., & Lakatta, E. G. (2014) · Cambridge University Press eBooks · doi:10.1017/cbo9781139382694.010 · Cited by 3
Chronic kidney disease and cardiovascular events: a focus on central blood pressure
Murkamilov, I. T., Айтбаев, К. А., Sabirov, I. S., Fomin, V. V., & Yusupov, F. A. (2017) · Systemic Hypertension · doi:10.26442/sg29181 · Cited by 3
Koç, A. S., Demirtaş, D., Görgülü, F. F., & Sümbül, H. E. (2018) · Abdominal Radiology · doi:10.1007/s00261-018-1798-3 · Cited by 3
Metadata
- Authors
- O’Rourke, M. F., & Safar, M. E.
- Affiliations
- UNSW Sydney (AU)
- Venue
- Hypertension
- Published
- 2005-07
- Volume
- 46
- Issue
- 1
- Pages
- 200-204
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2103868761
- Cited by
- 1,279
- References
- 43
- Citations by year
- 2026: 33 · 2025: 65 · 2024: 56 · 2023: 50 · 2022: 62 · 2021: 73 · 2020: 74 · 2019: 67 · 2018: 98 · 2017: 67 · 2016: 84 · 2015: 80 · 2014: 91 · 2013: 59 · 2012: 63
- FWCI
- 19.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Nephrology › Renal and Vascular Pathologies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- aortic stiffness, microangiopathy, central pulse pressure, aortic pulse wave velocity, augmentation index, input impedance, wave reflection, aging, renal failure, cognitive decline, diabetes mellitus, vascular fragility, nitrate, calcium channel blockers, ACE inhibitors, angiotensin receptor blockers, physical activity
- MeSH terms
- Aorta, Brain, Compliance, Humans, Kidney, Microcirculation, Vascular Diseases
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