The DOI matches its Crossref record; 43 of the 43 references it cites were found in a registry or an index.
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
Cited by
Sorted by citations
Items 201–300 of 999
Westenberg, J. J. M., van Poelgeest, E. P., Paul Steendijk, A., Grotenhuis, H. B., Jukema, J. W., & Roos, A. (2012) · Journal of Cardiovascular Magnetic Resonance · doi:10.1186/1532-429x-14-2 · Cited by 74
“Assessment of regional PWV is of high interest in cardiovascular research as the independent prognostic value of regional PWV-assessment for outcome prediction in various patient populations has been recognized [2-4,7-10].”
Systolic Hypertension in the Elderly: Addressing an Unmet Need
Duprez, D. A. (2008) · The American Journal of Medicine · doi:10.1016/j.amjmed.2007.10.027 · Cited by 74
End-organ dysfunction and cardiovascular outcomes: the role of the microcirculation
Lockhart, C., Hamilton, P., Quinn, C. E., & McVeigh, G. E. (2009) · Clinical Science · doi:10.1042/cs20080069 · Cited by 76
Aging Impairs Myogenic Adaptation to Pulsatile Pressure in Mouse Cerebral Arteries
Springó, Z., Tóth, P., Tarantini, S., Ashpole, N. M., Tucsek, Z., Sonntag, W. E., Csiszár, A., Koller, Á., & Ungvari, Z. I. (2015) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1038/jcbfm.2014.256 · Cited by 73
Chirinos, J. A., Segers, P., Gillebert, T. C., Buyzere, M. D., daele, C. M. V., Khan, Z., Khawar, U., Bacquer, D. D., Rietzschel, E. R., & on behalf of the Asklepios Investigators (2013) · Diabetes Care · doi:10.2337/dc12-1463 · Cited by 73
“Increased PP has also been associated with microalbuminuria in type 2 diabetes (1), consistent with a role for pressure pulsatility in microvascular target organ damage, as suggested by hemodynamic principles (4,5).”
BackgroundNg, K., Hildreth, C. M., Phillips, J. K., & Avolio, A. P. (2011) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.00079.2011 · Cited by 72
“Regardless of the underlying mechanism, a loss of large artery function also results in a reduced capacity of the system to buffer pulsatile changes in BP, with vulnerable end organs at risk of microvascular damage, particularly in the kidney and brain (36).”
BackgroundAortic Aging in ESRD: Structural, Hemodynamic, and Mortality Implications
London, G. M., Safar, M. E., & Pannier, B. (2015) · Journal of the American Society of Nephrology · doi:10.1681/asn.2015060617 · Cited by 72
Self-citationRenal intraparenchymal resistive index: the ultrasonographic answer to many clinical questions
Nicolò, P. D., & Granata, A. R. M. (2018) · Journal of Nephrology · doi:10.1007/s40620-018-00567-x · Cited by 72
Arterial stiffness and brain integrity: A review of MRI findings
Badji, A., Sabra, D., Bherer, L., Cohen‐Adad, J., Girouard, H., & Gauthier, C. J. (2019) · Ageing Research Reviews · doi:10.1016/j.arr.2019.05.001 · Cited by 82
van Elderen, S. G. C., Brandts, A., Westenberg, J. J. M., van der Grond, J., Tamsma, J. T., van Buchem, M. A., Romijn, J. A., Kroft, L. J. M., Smit, J. W. A., & Roos, A. (2009) · European Radiology · doi:10.1007/s00330-009-1655-4 · Cited by 72
“cells, disrupting the cerebral small vessels [6, 7].”
The two faces of hypertension: role of aortic stiffness
Smulyan, H., Mookherjee, S., & Safar, M. E. (2015) · Journal of the American Society of Hypertension · doi:10.1016/j.jash.2015.11.012 · Cited by 73
Self-citationPulse Pressure and Risk of Adverse Outcome in Coronary Bypass Surgery
Fontes, M. L., Aronson, S., Mathew, J. P., Miao, Y., Drenger, B., Barash, P. G., & Mangano, D. T. (2008) · Anesthesia & Analgesia · doi:10.1213/ane.0b013e31816ba404 · Cited by 71
“Arterial compliance, in turn, relates to the change in volume (stroke volume) and inversely to the ensuing change in pressure (PP).(14,15,34)”
BackgroundXu, T.-Y., Staessen, J. A., Wei, F., Xu, J., Li, F., Fan, W.-X., Gao, P., Wang, J.-G., & Li, Y. (2011) · American Journal of Hypertension · doi:10.1038/ajh.2011.223 · Cited by 71
Jorgensen, D. R., Shaaban, C. E., Wiley, C. A., Gianaros, P. J., Mettenburg, J., & Rosano, C. (2018) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00535.2017 · Cited by 71
Cerebral Haemodynamics: Effects of Systemic Arterial Pulsatile Function and Hypertension
Avolio, A. P., Kim, M., Adji, A. I., Gangoda, S. V. S., Avadhanam, B., Tan, I., & Butlin, M. (2018) · Current Hypertension Reports · doi:10.1007/s11906-018-0822-x · Cited by 72
Lessons About Brain Vascular Disease From Another Pulsating Organ, the Kidney
Seliger, S. L., & Longstreth, W. T., Jr. (2007) · Stroke · doi:10.1161/strokeaha.107.496000 · Cited by 71
Arterial Stiffness: From Basic Primers to Integrative Physiology
Regnault, V., Lacolley, P. J., & Laurent, S. (2024) · Annual Review of Physiology · doi:10.1146/annurev-physiol-042022-031925 · Cited by 76
25-Hydroxyvitamin D Status Is Associated With Chronic Cerebral Small Vessel Disease
Chung, P., Park, K., Kim, J., Shin, D. W., Park, M., Chung, Y. J., Ha, S.-Y., Ahn, S., Shin, H., Kim, Y. B., et al. (2014) · Stroke · doi:10.1161/strokeaha.114.007706 · Cited by 70
Pase, M. P., Pipingas, A., Kras, M., Nolidin, K., Gibbs, A., Wesnes, K. A., Scholey, A. B., & Stough, C. K. K. (2010) · Journal of Hypertension · doi:10.1097/hjh.0b013e32833b1ee7 · Cited by 69
Association of Renal Resistive Index With Target Organ Damage in Essential Hypertension
Doi, Y., Iwashima, Y., Yoshihara, F., Kamide, K., Takata, H., Fujii, T., Kubota, Y., Nakamura, S., Horio, T., & Kawano, Y. (2012) · American Journal of Hypertension · doi:10.1038/ajh.2012.113 · Cited by 68
Schäfer, M., Myers, C., Brown, R. D., Frid, M. G., Tan, W., Hunter, K. S., & Stenmark, K. R. (2016) · Current Hypertension Reports · doi:10.1007/s11906-015-0609-2 · Cited by 70
Renal Resistive Index: not only kidney
Nicolò, P. D., & Granata, A. R. M. (2016) · Clinical and Experimental Nephrology · doi:10.1007/s10157-016-1323-3 · Cited by 69
Arterial stiffness and chronic kidney disease
Townsend, R. R. (2014) · Current Opinion in Nephrology & Hypertension · doi:10.1097/mnh.0000000000000086 · Cited by 71
Blood Pressure, Carotid Flow Pulsatility, and the Risk of Stroke
Chuang, S., Cheng, H., Bai, C., Yeh, W.-T., Chen, J.-R., & Pan, W. (2016) · Stroke · doi:10.1161/strokeaha.116.013207 · Cited by 68
Qi Fu Yin–a Ming Dynasty Prescription for the Treatment of Dementia
Ong, W., Wu, Y., Farooqui, T., & Farooqui, A. A. (2018) · Molecular Neurobiology · doi:10.1007/s12035-018-0908-0 · Cited by 67
Different hypertension thresholds and cognitive decline: a pooled analysis of three ageing cohorts
Ma, Y., Hua, R., Yang, Z., Zhong, B., Yan, L., & Xie, W. (2021) · BMC Medicine · doi:10.1186/s12916-021-02165-4 · Cited by 64
“And arterial stiffening that was caused by long-standing hypertension might lead to small vessel ischemic disease in the brain [35].”
BackgroundHernandez, L. N., Ward, L. J., Arefin, S., Ebert, T., Laučytė-Cibulskienė, A., Collaborators, G.-F., Pilote, L., Norris, C. M., Raparelli, V., Kautzky‐Willer, A., et al. (2022) · Scientific Reports · doi:10.1038/s41598-022-08387-7 · Cited by 70
Silent cerebral microbleeds associated with arterial stiffness in an apparently healthy subject
Ochi, N., Tabara, Y., Igase, M., Nagai, T., Kido, T., Miki, T., & Kohara, K. (2009) · Hypertension Research · doi:10.1038/hr.2009.13 · Cited by 67
Arterial Stiffness: A Novel Risk Factor for Kidney Injury Progression?
Georgianos, P. I., Sarafidis, P. A., & Liakopoulos, V. (2015) · American Journal of Hypertension · doi:10.1093/ajh/hpv004 · Cited by 67
Aortic–Brachial Arterial Stiffness Gradient and Cardiovascular Risk in the Community
Niiranen, T., Kalesan, B., Larson, M. G., Hamburg, N. M., Benjamin, E. J., Mitchell, G. F., & Vasan, R. S. (2017) · Hypertension · doi:10.1161/hypertensionaha.116.08917 · Cited by 67
Francis, C., Futschik, M. E., Huang, J. V., Bai, W., Sargurupremraj, M., Teumer, A., Breteler, M. M. B., Petretto, E. G., Ho, A. S. R., Amouyel, P., et al. (2022) · Nature Communications · doi:10.1038/s41467-022-32219-x · Cited by 72
The clinical significance of medial arterial calcification in end-stage renal disease in women
Abou-Hassan, N., Tantisattamo, E., D’Orsi, E. T., & O'Neill, W. C. (2014) · Kidney International · doi:10.1038/ki.2014.187 · Cited by 66
Blood pressure and sodium: Association with MRI markers in cerebral small vessel disease
Heye, A. K., Thrippleton, M. J., Chappell, F. M., Hernández, M. D. C. V., Armitage, P. A., Makin, S., Maniega, S. M., Sakka, E., Flatman, P. W., Dennis, M. S., et al. (2015) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1038/jcbfm.2015.64 · Cited by 67
“Our finding that arterial blood pressure is associated with increased WMH volume is broadly consistent with the results of previous studies and with the hypothesis that sustained pressure elevation and pressure fluctuations in the small cerebral vessels result in microvascular damage.(22) The independent association w…”
ResultArterial compliance and retinal vascular caliber in cerebrovascular disease
Cheung, N., Islam, A. F. M., Jacobs, D. R., Sharrett, A. R., Klein, R., Polak, J. F., Cotch, M. F., Klein, B. E. K., Ouyang, P., & Wong, T. Y. (2007) · Annals of Neurology · doi:10.1002/ana.21236 · Cited by 67
“These data provide further evidence to support the concept that diminished large-artery compliance is associated with microvascular dysfunction(39) and clinical microvascular diseases in the brain.(8) To the best of our knowledge, there have been no published data on the association between retinal vascular caliber an…”
BackgroundInfluentialKing, K. S., Chen, K. X., Hulsey, K., McColl, R. W., Weiner, M., Nakonezny, P. A., & Peshock, R. M. (2013) · Radiology · doi:10.1148/radiol.13121598 · Cited by 65
“Ther Adv Cardiovasc Dis 2009;3(5):367–378.”
BackgroundVascular Aging and Disease of the Small Vessels
Rizzoni, D., Rizzoni, M., Nardin, M., Chiarini, G., Rosei, C. A., Aggiusti, C., Paini, A., Salvetti, M., & Muiesan, M. L. (2019) · High Blood Pressure & Cardiovascular Prevention · doi:10.1007/s40292-019-00320-w · Cited by 65
Kuller, L. H., Margolis, K. L., Gaussoin, S. A., Bryan, R. N., Kerwin, D. R., Limacher, M. C., Wassertheil-Smoller, S. W., Williamson, J. D., & Robinson, J. G. (2009) · Journal of Clinical Hypertension · doi:10.1111/j.1751-7176.2009.00234.x · Cited by 67
Kuznetsova, T., Cauwenberghs, N., Knez, J., Thijs, L., Liu, Y.-P., Gu, Y., & Staessen, J. A. (2014) · American Journal of Hypertension · doi:10.1093/ajh/hpu185 · Cited by 63
Warfarin in haemodialysis patients with atrial fibrillation: what benefit?
Yang, F., Chou, D. E., Schweitzer, P., & Hanon, S. (2010) · EP Europace · doi:10.1093/europace/euq387 · Cited by 65
van Sloten, T. T., Mitchell, G. F., Sigurdsson, S. O., van Buchem, M. A., Jónsson, P. V., Garcia, M. E., Harris, T. B., Henry, R. M. A., Levey, A. S., Stehouwer, C. D. A., et al. (2016) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.140334 · Cited by 64
Kranenburg, G., de Jong, P. A., Mali, W. P. T. M., Attrach, M., Visseren, F. L. J., & Spiering, W. (2016) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2016.11.012 · Cited by 63
Disentangling the Relationship Between Chronic Kidney Disease and Cognitive Disorders
Kelly, D., & Rothwell, P. M. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.830064 · Cited by 70
Feugeas, M. C. H., de Marco, G., Idy-Peretti, I., Godon-Hardy, S., Frédy, D., & Schouman‐Claeys, E. (2005) · Magnetic Resonance Imaging · doi:10.1016/j.mri.2005.09.002 · Cited by 63
“The close relationship between high arterial pulse pressure and cerebral microvascular damage may also contribute to the association between subcortical LA and idiopathic normal pressure hydrocephalus [45,63].”
BackgroundInfluentialAssociation of Arterial Stiffness with Silent Cerebrovascular Lesions: The Ohasama Study
Hatanaka, R., Obara, T., Watabe, D., Ishikawa, T., Kondo, T., Ishikura, K., Aikawa, T., Aono, Y., Hara, A., Metoki, H., et al. (2011) · Cerebrovascular Diseases · doi:10.1159/000322599 · Cited by 65
“The exact mechanism explaining how increased arterial stiffness is associated with microvascular diseases has not been elucidated yet. According to O’Rourke and Safar [”
BackgroundMethods for assessing arterial stiffness
Tomlinson, L. A. (2012) · Current Opinion in Nephrology & Hypertension · doi:10.1097/mnh.0b013e32835856e3 · Cited by 63
“brain and kidneys are exposed to greater pressure fluctuations linked to an increased risk of stroke and renal impairment [7].”
BackgroundNagai, M., Hoshide, S., Nishikawa, M., Shimpo, M., & Kario, K. (2013) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2013.11.071 · Cited by 62
Harris, B., Klein, R., Jerosch‐Herold, M., Hoffman, E. A., Ahmed, F. S., Jacobs, D. R., Klein, B. E. K., Wong, T. Y., Lima, J. A. C., Cotch, M. F., et al. (2012) · PLoS ONE · doi:10.1371/journal.pone.0050224 · Cited by 62
Homocysteine in Neurology: A Possible Contributing Factor to Small Vessel Disease
Moretti, R., Giuffrè, M., Caruso, P., Gazzin, S., & Tiribelli, C. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22042051 · Cited by 64
Tarumi, T., de Jong, D. L. K., Zhu, D. C., Tseng, B. Y., Liu, J., Hill, C., Riley, J. R., Womack, K. B., Kerwin, D. R., Lu, H., et al. (2015) · NeuroImage · doi:10.1016/j.neuroimage.2015.01.041 · Cited by 62
“Cerebral circulation has a high flow, low vascular resistance and impedance which may facilitate the transmission of hemodynamic pulsatility (O'Rourke and Safar, 2005).”
BackgroundSha, T., Cheng, W., & Yan, Y. (2018) · Alzheimer s Research & Therapy · doi:10.1186/s13195-018-0355-1 · Cited by 61
Rouch, L., Cestac, P., Sallerin, B. A.-M., Andrieu, S., Bailly, H., Beunardeau, M., Cohen, A., Dubail, D., Hernandorena, I., Seux, M., et al. (2018) · Hypertension · doi:10.1161/hypertensionaha.118.11443 · Cited by 60
Chronic Kidney Disease and Cognitive Impairment
Murtaza, A., & Dasgupta, I. (2020) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2020.105529 · Cited by 60
Arterial Stiffness and Gait Speed in Older Adults With and Without Peripheral Arterial Disease
Watson, N. L., Sutton-Tyrrell, K., Youk, A. O., Boudreau, R. M., Mackey, R. H., Simonsick, E. M., Rosano, C., Hardy, S. E., Windham, B. G., Harris, T. B., et al. (2010) · American Journal of Hypertension · doi:10.1038/ajh.2010.193 · Cited by 59
Association of Central Systolic Blood Pressure With Intracerebral Small Vessel Disease in Japanese
Ochi, N., Kohara, K., Tabara, Y., Nagai, T., Kido, T., Uetani, E., Ochi, M., Igase, M., & Miki, T. (2010) · American Journal of Hypertension · doi:10.1038/ajh.2010.60 · Cited by 59
“antiplatelet drugs, n (%) 37 (7) 25 (6) 12 (23) <0.”
Brandts, A., van Elderen, S. G. C., Westenberg, J. J. M., van der Grond, J., van Buchem, M. A., Huisman, M. V., Kroft, L. J. M., Tamsma, J. T., & Roos, A. (2009) · Radiology · doi:10.1148/radiol.2533082264 · Cited by 61
“One possible mechanism is that increased aortic stiffness leads to a deficient absorption of the pulse wave and an increase in central pulse pressure, which may augment small vessel disease of the brain through high pulsatile flow (10,13,44).”
BackgroundInfluentialRegional Cerebrovascular Reactivity and Cognitive Performance in Healthy Aging
Catchlove, S. J., Parrish, T. B., Chen, Y., Macpherson, H., Hughes, M. E., & Pipingas, A. (2018) · Journal of Experimental Neuroscience · doi:10.1177/1179069518785151 · Cited by 61
“temporal lobes was higher in the younger compared to the older group, F(1, 50) = 2.”
BackgroundWohlfahrt, P., Somers, V. K., Cífková, R., Filipovský, J., Seidlerová, J., Krajčoviechová, A., Sochor, O., Kullo, I. J., & López-Jiménez, F. A. (2014) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2014.05.958 · Cited by 59
“Loss of the buffering function of the aorta due to aging and cardiovascular risk factors leads to left ventricular hypertrophy, increased oxygen demand and subendocardial myocardial ischemia (8,9) and, ultimately, to microvascular damage to the brain (10-12) and kidneys (13).”
BackgroundChronic Kidney Disease and Drinking Status in Relation to Risks of Stroke and Its Subtypes
Shimizu, Y., Maeda, K., Imano, H., Ohira, T., Kitamura, A., Kiyama, M., Okada, T., Ishikawa, Y., Shimamoto, T., Yamagishi, K., et al. (2011) · Stroke · doi:10.1161/strokeaha.110.600759 · Cited by 58
Small Vessel Disease-Related Dementia: An Invalid Neurovascular Coupling?
Moretti, R., & Caruso, P. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21031095 · Cited by 62
Tang, X., Han, Y., Chai, Y.-H., Gong, H., Xu, H., Patel, I., Qiao, Y.-S., Zhang, J., Cardoso, M. A., & Zhou, J. (2022) · Ageing Research Reviews · doi:10.1016/j.arr.2022.101762 · Cited by 59
“Both the brain and the kidney consist of abundant vascular tissues and also have similar hemodynamic properties that can respond to diseases such as hypertension and diabetes mellitus (O’Rourke and Safar, 2005) in similar ways at the microscopic level.”
Noninvasive Imaging of Flow and Vascular Function in Disease of the Aorta
Whitlock, M. C., & Hundley, W. G. (2015) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2015.08.001 · Cited by 57
“Furthermore, it has been hypothesized that the loss of dampening also results in increased pulsations being transmitted to the vulnerable tissues such as the kidney and brain leading to microvascular and end-organ damage (68).”
Carotid Arterial Stiffness and Risk of Incident Cerebral Microbleeds in Older People
Ding, J., Mitchell, G. F., Bots, M. L., Sigurdsson, S. O., Harris, T. B., Garcia, M., Eiríksdóttir, G., van Buchem, M. A., Gudnason, V. G., & Launer, L. J. (2015) · Arteriosclerosis Thrombosis and Vascular Biology · doi:10.1161/atvbaha.115.305451 · Cited by 57
“Increased pulsatile stress may lead to damage in the endothelium and smooth muscle cells disrupting cerebral small vessels.(11) A stiffened artery may also increase pulse-wave velocity, which potentially causes wave reflections to appear earlier in the cardiac cycle and may further augment central systolic BP.”
Cerebral Microbleeds Are Independently Associated with Arterial Stiffness in Stroke Patients
Seo, W., Lee, J., Park, M. H., Park, K. W., & Lee, D. H. (2008) · Cerebrovascular Diseases · doi:10.1159/000166837 · Cited by 57
“Recently, a novel hypothesis was proposed for the impact of arterial stiffness on cerebral microvasculature on the basis of differential input impedance in the brain compared to other systemic vascular beds [”
BackgroundOvbiagele, B. I., Liebeskind, D. S., Pineda, S., & Saver, J. L. (2010) · Archives of Neurology · doi:10.1001/archneurol.2009.310 · Cited by 57
MR Imaging Evaluation of Cardiovascular Risk in Metabolic Syndrome
van der Meer, R. W., Lamb, H. J., Smit, J. W. A., & Roos, A. (2012) · Radiology · doi:10.1148/radiol.12110772 · Cited by 55
Johnson, A. C., Miller, J. E., & Cipolla, M. J. (2019) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1177/0271678x19848510 · Cited by 60
“To compensate for the excessive pressure and flow pulsatility, cerebral arterioles remodel and constrict to protect microvessels from damage.(61) However, increased vasoconstriction can cause hypoperfusion and neuronal injury that, if occurring in the hippocampus, could potentiate memory and cognitive dysfunction.”
BackgroundThe Impact of the Blood Lipids Levels on Arterial Stiffness
Baba, M., Mariș, M. I., Jianu, D., Luca, C. T., Stoian, D. L., & Mozos, I. M. (2023) · Journal of Cardiovascular Development and Disease · doi:10.3390/jcdd10030127 · Cited by 56
Geijselaers, S. L. C., Sep, S. J. S., Schram, M. T., van Boxtel, M. P. J., van Sloten, T. T., Henry, R. M. A., Reesink, K. D., Kroon, A. A., Koster, A., Schaper, N. C., et al. (2016) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2016.07.912 · Cited by 56
Becker, R. C. (2021) · Journal of Thrombosis and Thrombolysis · doi:10.1007/s11239-021-02549-6 · Cited by 61
Large Artery Stiffening as a Link Between Cerebral Lacunar Infarction and Renal Albuminuria
Hashimoto, J., Aikawa, T., & Imai, Y. (2008) · American Journal of Hypertension · doi:10.1038/ajh.2008.291 · Cited by 55
Cerebral Microvascular Disease Predicts Renal Failure in Type 2 Diabetes
Uzu, T., Kida, Y., Shirahashi, N., Harada, T., Yamauchi, A., Nomura, M., Isshiki, K., Araki, S., Sugimoto, T., Koya, D., et al. (2010) · Journal of the American Society of Nephrology · doi:10.1681/asn.2009050558 · Cited by 55
Castelpoggi, C. H., Pereira, V. S., Fiszman, R., Cardoso, C. R. L., Muxfeldt, E. S., & Salles, G. F. (2009) · Hypertension Research · doi:10.1038/hr.2009.71 · Cited by 55
Determinants and Prognostic Significance of the Renal Resistive Index
Cauwenberghs, N., & Kuznetsova, T. (2015) · Pulse · doi:10.1159/000442445 · Cited by 55
Dhaun, N., Moorhouse, R., MacIntyre, I. M., Melville, V., Oosthuyzen, W., Kimmitt, R. A., Brown, K. E., Kennedy, E. D., Goddard, J., & Webb, D. J. (2014) · Hypertension · doi:10.1161/hypertensionaha.114.03533 · Cited by 54
“It has been suggested that arterial stiffening may be protective, reducing the transmission of pulsatility to the microcirculation, particularly in organs with low resistances to flow such as the kidney.(31) However, this was recently discounted in a study looking at renal vascular damage in patients with hypertension.”
BackgroundGhiadoni, L., Bruno, R. M., Stea, F., Virdis, A., & Taddei, S. (2009) · Current Hypertension Reports · doi:10.1007/s11906-009-0034-5 · Cited by 54
“Moreover, peculiar characteristics of cerebral blood fl ow, which is torrential and low-resistance, expose small arterial vessels to high-pressure fl uctuations from the carotid and vertebral arteries [ 29 ].”
BackgroundZou, R., Park, E., Kelly, E. M., Egnor, M. R., Wagshul, M. E., & Madsen, J. R. (2008) · Journal of Neurosurgery Pediatrics · doi:10.3171/ped/2008/2/7/083 · Cited by 54
Cerebral Perfusion Enhancing Interventions: A New Strategy for the Prevention of Alzheimer Dementia
de la Torre, J. C. (2016) · Brain Pathology · doi:10.1111/bpa.12405 · Cited by 58
“Damage from high blood pressure to brain endothelial cells and smooth muscle cells that control vascular tone is suspected to be a culprit of cognitive impairment caused by the pulsatile pressure changes generated on the cerebral microvasculature from hypertension (114).”
BackgroundArterial Stiffness and Cerebral Small Vessel Disease
Zhai, F., Ye, Y., Chen, S., Ding, F., Han, F., Yang, X., Wang, Q., Zhou, L., Ni, J., Yao, M., et al. (2018) · Frontiers in Neurology · doi:10.3389/fneur.2018.00723 · Cited by 54
Parfenov, V. A., Ostroumova, O. D., Оstroumova, Т. М., Кочетков, А. И., Fateeva, V. V., Khacheva, K. K., Khakimova, G. R., & Epstein, O. I. (2019) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s197032 · Cited by 56
“Compensatory remodeling and thickening of the cerebral vascular walls occurs to withstand high pressure in the microcirculatory bed.(123,124) Over time, this kind of protective mechanism is transformed into pathology, contributing to vascular reactivity disturbances, hypoperfusion, chronic cerebral ischemia, and VCI.”
BackgroundGundert, T. J., Shadden, S. C., Williams, A. R., Koo, B., Feinstein, J. A., & LaDisa, J. F. (2011) · Annals of Biomedical Engineering · doi:10.1007/s10439-010-0238-5 · Cited by 53
Pulse Pressure Is an Age-Independent Predictor of Stroke Development After Cardiac Surgery
Benjo, A. M., Thompson, R. E., Fine, D. M., Hogue, C. W. J., Alejo, D. E., Kaw, A., Gerstenblith, G., Shah, A. S., Berkowitz, D. E., & Nyhan, D. P. (2007) · Hypertension · doi:10.1161/hypertensionaha.107.095513 · Cited by 53
Some mechanical aspects of arterial aging: physiological overview based on pulse wave analysis
Hashimoto, J., & Ito, S. (2009) · Therapeutic Advances in Cardiovascular Disease · doi:10.1177/1753944709338942 · Cited by 53
“Effect of arterial aging on microvascular damage Large artery stiffening may also be associated with microvascular damage of the brain and kidneys [O’Rourke and Hashimoto, 2006; O’Rourke and Safar, 2005; Safar 2004].”
BackgroundAssociation between Risk Factors for Vascular Dementia and Adiponectin
Song, J., Lee, W. T., Park, K. A., & Lee, J. E. (2014) · BioMed Research International · doi:10.1155/2014/261672 · Cited by 58
“Hypertension exposes the cerebral microvasculature to pulsatile pressure and flow that cause vascular endothelium and smooth muscle cell tearing [151].”
BackgroundPaoletti, E., Bellino, D., Gallina, A. M., Amidone, M., Cassottana, P., & Cannella, G. (2010) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfq409 · Cited by 52
Walker, A. E., Henson, G. D., Reihl, K. D., Morgan, R. G., Dobson, P. S., Nielson, E. I., Jing, L., Mecham, R. P., Li, D. Y., Lesniewski, L. A., et al. (2015) · The Journal of Physiology · doi:10.1113/jphysiol.2014.285338 · Cited by 52
“A stiffer aorta and carotid arteries can result in less pulse dampening, leading to greater pulsatility in peripheral resistance arteries that may induce arterial dysfunction and tissue impairment (O’Rourke & Safar, 2005; Mitchell, 2008).”
BackgroundInfluentialPhan, T. S., Li, J. K. ‐., Segers, P., Koppula, M. R., Akers, S. R., Kuna, S. T., Gíslason, Þ., Pack, A. I., & Chirinos, J. A. (2016) · Journal of the American Heart Association · doi:10.1161/jaha.116.003733 · Cited by 52
“Available evidence therefore strongly supports that wave reflections, which arrive earlier to the proximal aorta as PWV increases with aging, are deleterious for target organs, including the heart and the brain.(35,55,65,66) We note that this study did not aim to compare the general population and the clinical samples.”
BackgroundAortic Stiffness is Associated with Increased Risk of Incident Dementia in Older Adults
Cui, C., Sekikawa, A. M., Kuller, L. H., López, O. L., Newman, A. B., Kuipers, A. L., & Mackey, R. H. (2018) · Journal of Alzheimer s Disease · doi:10.3233/jad-180449 · Cited by 52
“The stiffening of the aorta with age and other cardiovascular risk factors allows increased transmission of pulsatile pressures to peripheral arteries, including the vulnerable small cerebral arteries, resulting in damage such as microvascular ischemia or hemorrhage [1, 2].”
Menon, A., Wendell, D. C., Wang, H., Eddinger, T. J., Toth, J. M., Dholakia, R., Larsen, P. M., Jensen, E. S., & LaDisa, J. F. (2011) · Journal of Pharmacological and Toxicological Methods · doi:10.1016/j.vascn.2011.10.003 · Cited by 52
“8 adjusting Rc:Rt ratios to replicate measured BP using the pulse pressure method [12, 13].”
Umemura, T., Kawamura, T., Sakakibara, T., Mashita, S., Hotta, N., & Sobue, G. (2012) · American Journal of Hypertension · doi:10.1038/ajh.2011.254 · Cited by 51
CKD in the Elderly—Old Questions and New Challenges: World Kidney Day 2008
Stevens, L. A., Coresh, J., & Levey, A. S. (2008) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2008.01.009 · Cited by 51
Munakata, M., Miura, Y., & YOSHINAGA, K. (2009) · Journal of Hypertension · doi:10.1097/hjh.0b013e32832b4740 · Cited by 51
Association of Fatal and Nonfatal Cardiovascular Outcomes With 24-Hour Mean Arterial Pressure
Melgarejo, J. D., Yang, W., Thijs, L., Li, Y., Asayama, K., Hansen, T. W., Wei, F., Kikuya, M., Ohkubo, T., Dolan, E., et al. (2020) · Hypertension · doi:10.1161/hypertensionaha.120.14929 · Cited by 50
Darabont, R., Mihalcea, D. J., & Vinereanu, D. (2023) · Diagnostics · doi:10.3390/diagnostics13101687 · Cited by 50
“The best illustration of this correlation concerns the fact that the RRI in transplanted kidneys varies with the age, general prognosis, and systemic vascular parameters of the recipient rather with the histopathological characteristics and survival of the graft [16,17].”
BackgroundResistant hypertension in patients with type 2 diabetes
Solini, A., Zoppini, G., Orsi, E., Fondelli, C., Trevisan, R., Vedovato, M., Cavalot, F. L., Lamacchia, O., Arosio, M., Baroni, M. G., et al. (2014) · Journal of Hypertension · doi:10.1097/hjh.0000000000000350 · Cited by 53
“com be due to the higher pulse pressure values, which were shown to be associated with disease of small blood vessels in the kidney [31] and retina [32].”
BackgroundCastro, P., Azevedo, E. I., Rocha, I., Sorond, F. A., & Serrador, J. M. (2018) · BMC Neurology · doi:10.1186/s12883-018-1025-4 · Cited by 50
Huang, Q., Aparicio, L. S., Thijs, L., Wei, F., Melgarejo, J. D., Cheng, Y., Sheng, C., Yang, W., Gilis‐Malinowska, N., Boggia, J. G., et al. (2020) · Hypertension · doi:10.1161/hypertensionaha.120.14787 · Cited by 50
“Diastolic and mean arterial BP (MAP), the steady BP components, drive blood flow and are similar throughout the arterial tree from the ascending aorta up to the small arterioles, running through vital organs.(2) Systolic BP and pulse pressure (PP), the difference between systolic and diastolic BP oscillate around MAP,…”
BackgroundInfluentialGlymphatic system function in patients with newly diagnosed focal epilepsy
Lee, D. A., Park, B. S., Ko, J., Park, S. H., Park, J., Kim, I. H., Lee, Y. J., & Park, K. M. (2022) · Brain and Behavior · doi:10.1002/brb3.2504 · Cited by 50
“In addition, mechanical remodeling of the microvasculature, resulting from the deposition of advanced glycation end-products in the vessel wall and intima and media calcification, contributes to arterial stiffening seen with aging (O’Rourke & Safar, 2005).”
BackgroundHeliopoulos, I., Artemis, D., Vadikolias, Κ., Trιpsianis, G., Piperidou, C., & Tsivgoulis, G. K. (2012) · Cardiovascular Psychiatry and Neurology · doi:10.1155/2012/616572 · Cited by 49
“Recent data indicate that measures of large-artery stiffness are closely related to the effects of microvascular changes in the brain (including leukoaraiosis) and kidney of hypertensive individuals [25].”
BackgroundHypertension and Mild Cognitive Impairment
Sierra, C., Doménech, M., Camafort, M., & Coca, A. (2012) · Current Hypertension Reports · doi:10.1007/s11906-012-0315-2 · Cited by 55
“It has been suggested as a pathophysiological explanation on the basis of differential input impedance in the brain, and also in the kidney, compared with other systemic vascular beds [60].”
BackgroundKim, D., Kim, J., Kim, J.-M., & Lee, A. Y. (2008) · Clinical Neurology and Neurosurgery · doi:10.1016/j.clineuro.2008.03.009 · Cited by 49
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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