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.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“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”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
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 401–500 of 999
Stroke promotes the development of brain atrophy and delayed cell death in hypertensive rats
Sayed, M. A., Eldahshan, W., Abdelbary, M. A., Pillai, B. A., Althomali, W., Johnson, M. H., Arbab, A. S., Ergul, A., & Fagan, S. C. (2020) · Scientific Reports · doi:10.1038/s41598-020-75450-6 · Cited by 33
Saeed, S., Holm, H., & Nilsson, P. M. (2021) · Expert Review of Cardiovascular Therapy · doi:10.1080/14779072.2021.1955351 · Cited by 33
“Although central PP is mainly determined by aortic stiffness, it can also be influenced by LV ejection dynamics [27,30,31], reflecting the complex nature of VAC.”
BackgroundMechanical stress related to brain atrophy in Alzheimer's disease
Lévy, M., Lafitte, O. D., Steyaert, J., Bakardjian, H., Dubois, B., Hampel, H. J., & Schwartz, L. H. (2015) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2015.03.005 · Cited by 33
Choi, S.-W., Yun, W.-J., Kim, H.-Y., Lee, Y. H., Kweon, S., Rhee, J.-A., Choi, J., & Shin, M. (2010) · Kidney & Blood Pressure Research · doi:10.1159/000313594 · Cited by 33
“An increase in arterial pulse pressure could contribute to glomerular damage, because kidney cells have no protection against pulsatile stress [”
BackgroundComparison of vascular stiffness in vascular dementia, Alzheimer dementia and cognitive impairment
Rabkin, S. W., & Jarvie, G. (2011) · Blood Pressure · doi:10.3109/08037051.2011.566246 · Cited by 34
Syrseloudis, D., Tsioufis, C. P., Andrikou, I., Mazaraki, A., Thomopoulos, C., Mihas, C. C., Papaioannou, T., Tatsis, I., Tsiamis, E. G., & Stefanadis, C. (2010) · Hypertension Research · doi:10.1038/hr.2010.192 · Cited by 33
Nugroho, A. W., Arima, H., Miyazawa, I., Fujii, T., Miyamatsu, N., Sugimoto, Y., Nagata, S., Komori, M., Takashima, N., Kita, Y., et al. (2018) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.42812 · Cited by 32
Vascular Aging and Central Aortic Blood Pressure: From Pathophysiology to Treatment
Battistoni, A., Michielon, A., Marino, G., & Savoia, C. (2020) · High Blood Pressure & Cardiovascular Prevention · doi:10.1007/s40292-020-00395-w · Cited by 34
Albuminuria as a risk factor for mild cognitive impairment and dementia—what is the evidence?
Bikbov, B. T., Soler, M. J., Pešić, V., Capasso, G., Unwin, R. J., Endres, M., Remuzzi, G., Perico, N., Gansevoort, R. T., Mattace-Raso, F. U. S., et al. (2021) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfab261 · Cited by 32
Arterial Stiffness, Genetic Risk, and Type 2 Diabetes: A Prospective Cohort Study
Wang, M., Huang, J., Wu, T., & Qi, L. (2022) · Diabetes Care · doi:10.2337/dc21-1921 · Cited by 32
MRI of the ‘Alzheimer syndrome’
Henry–Feugeas, M.-C. (2007) · Journal of Neuroradiology · doi:10.1016/j.neurad.2007.07.002 · Cited by 32
Kim, Y. B., Park, K., Chung, P., Kim, J., Moon, H., & Youn, Y. C. (2015) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2015.12.006 · Cited by 32
“Arterial stiffness impairs compliance of the vessel walls, increases the pulse pressure and contributes to systemic hypertensive injury [2,5].”
BackgroundSnowhill, P. B., & Silver, F. H. (2005) · Cardiovascular Engineering An International Journal · doi:10.1007/s10558-005-9070-1 · Cited by 32
Noninvasive Techniques for Tracking Biological Aging of the Cardiovascular System
Raisi‐Estabragh, Z., Szabó, L. E., Schuermans, A., Salih, A. M., Chin, C., Vágó, H., Altmann, A., Ng, F. S., Garg, P., Pavanello, S., et al. (2024) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2024.03.001 · Cited by 31
Streese, L., Deiseroth, A., Schäfer, J., Schmidt‐Trucksäss, A., & Hanssen, H. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2018.00116 · Cited by 31
“Increased arterial stiffness seems to expose small vessels to highly pulsatile pressure and flow, thereby inducing damage to the microvascular bed (O’Rourke and Safar, 2005).”
BackgroundRenal impairment on clinical outcomes following endovascular recanalization
Xiao, L., Ma, M., Gu, M., Han, Y., Wang, H., Zi, W., Yang, D. W., Hao, Y., Lv, Q., Ye, R., et al. (2019) · Neurology · doi:10.1212/wnl.0000000000008748 · Cited by 31
“The human kidney and brain may be uniquely susceptible to vasculature insults because they are both lowresistance-end arterial organs that allow continuous and passive high-volume perfusion.(5)”
BackgroundMarini, S., Georgakis, M. K., & Anderson, C. D. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.785273 · Cited by 36
Vascular compliance in blood pressure
Raij, L. R., & Gonzalez-Ochoa, A. M. (2011) · Current Opinion in Nephrology & Hypertension · doi:10.1097/mnh.0b013e3283499d7b · Cited by 32
Miyagi, T., Ishida, A., Shinzato, T., & Ohya, Y. (2023) · Stroke · doi:10.1161/strokeaha.123.042512 · Cited by 30
“35,36 Although a recent randomized controlled study that examined the effects of an aortic PWV-guided therapeutic strategy using renin-angiotensin system blockers and calcium channel blockers failed to demonstrate a reduction in cardiovascular events, likely due to the small sample size, 33 future…”
BackgroundIs Alzheimer's disease amyloidosis the result of a repair mechanism gone astray?
Kokjohn, T. A., Maarouf, C. L., & Roher, A. E. (2011) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2011.05.2429 · Cited by 31
“As age advances, there is a direct relationship between stiffening of large elastic arteries and brain microvascular disease [50], as well as with increased pulse pressure and pulse velocity, which are correlated to cognitive decline [53].”
BackgroundFountoulakis, N., Thakrar, C., Patel, K., Viberti, G. C., Gnudi, L., & Karalliedde, J. J. (2017) · Journal of the American Heart Association · doi:10.1161/jaha.116.004934 · Cited by 30
“Both the kidney and the brain have high volume flow at very low vascular resistance and are therefore exquisitely vulnerable to pressure-induced damage.(5,6) We previously demonstrated an inverse relationship of Ao-PWV with eGFR in type 2 diabetes mellitus (T2DM) patients with comparatively preserved renal function, s…”
BackgroundKim, D.-H., Choi, J.-H., Moon, J.-S., Kim, H., & Cha, J. (2010) · European Neurology · doi:10.1159/000319923 · Cited by 30
Increased augmentation index and central aortic blood pressure in osteoporotic postmenopausal women
Mangiafico, R. A., Alagona, C., Pennisi, P. A., Parisi, N., Mangiafico, M., Purrello, F., & Fiore, C. E. (2007) · Osteoporosis International · doi:10.1007/s00198-007-0438-5 · Cited by 30
“This may have clinical importance, because left ventricular workload [12] and microvascular disease in kidney and brain [ 34 ] are influenced by central aortic, not brachial, blood pressure, and central aortic pressure is an independent predictor of coronary artery disease and cardiovascular events [33, 35].”
BackgroundCarotid Stiffness: A Novel Cerebrovascular Disease Risk Factor
van Sloten, T. T., & Stehouwer, C. D. A. (2016) · Pulse · doi:10.1159/000445354 · Cited by 30
Akazawa, N., Tanahashi, K., Kosaki, K., Ra, S., Matsubara, T., Choi, Y., Zempo‐Miyaki, A., & Maeda, S. (2018) · Physiological Reports · doi:10.14814/phy2.13681 · Cited by 30
Schrank, F., Warmuth, C., Tzschätzsch, H., Kreft, B., Hirsch, S., Braun, J., Elgeti, T., & Sack, I. (2019) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1177/0271678x19850936 · Cited by 30
Wright, S., O’Prey, F. M., Hamilton, P., Lockhart, C., McCann, A. J., McHenry, M., McGivern, R. C., Plumb, R. D., Finch, M., Bell, A., et al. (2009) · Lupus · doi:10.1177/0961203309104865 · Cited by 30
Vitamin K Status, Warfarin Use, and Arterial Stiffness in Heart Failure
Hashmath, Z., Lee, J. J., Gaddam, S., Ansari, B. A., Oldland, G., Javaid, K., Mustafa, A., Vasim, I., Akers, S. R., & Chirinos, J. A. (2018) · Hypertension · doi:10.1161/hypertensionaha.118.12157 · Cited by 29
Weber, T., Ammer, M., Gündüz, D., Bruckenberger, P., Eber, B., & Wallner, M. (2011) · American Journal of Hypertension · doi:10.1038/ajh.2011.45 · Cited by 29
Central blood pressure and chronic kidney disease
Ohno, Y. (2016) · World Journal of Nephrology · doi:10.5527/wjn.v5.i1.90 · Cited by 29
A handheld microscope integrating photoacoustic microscopy and optical coherence tomography
Qin, W., Chen, Q., & Xi, L. (2018) · Biomedical Optics Express · doi:10.1364/boe.9.002205 · Cited by 29
Weir, M. R. (2009) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.03050509 · Cited by 29
“Why? Is this simply a poor technique for measuring BP? Because of the small wall-to-lumen ratio in distal arteries, changes in vessel stiffness are not as substantial with aging as compared with the elastic aorta, with a large-wall-to lumen ratio (19,20).”
BackgroundPrevalence of ambulatory hypotension in elderly patients with CKD stages 3 and 4
Tomlinson, L. A., Holt, S. G., Leslie, A., & Rajkumar, C. (2009) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfp357 · Cited by 29
“For these patients, CKD may be a manifestation of generalized small vessel disease [6], and the renal benefit of BP reduction is less clear.”
BackgroundElevated mean platelet volume is associated with silent cerebral infarction
Li, B., Liu, X., Cao, Z., Li, Y., Liu, T., & Wang, R. ‐. (2014) · Internal Medicine Journal · doi:10.1111/imj.12454 · Cited by 28
Destiffening effect of valsartan and atenolol
Boutouyrie, P., Beaussier, H., Achouba, A., & Laurent, S. (2013) · Journal of Hypertension · doi:10.1097/hjh.0000000000000014 · Cited by 28
Effects of Allopurinol on Arterial Stiffness: A Meta-Analysis of Randomized Controlled Trials
Deng, G., Qiu, Z., Li, D., Fang, Y., & Zhang, S. (2016) · Medical Science Monitor · doi:10.12659/msm.898370 · Cited by 28
Melgarejo, J. D., Thijs, L., Wei, D., Bursztyn, M., Yang, W., Li, Y., Asayama, K., Hansen, T. W., Kikuya, M., Ohkubo, T., et al. (2021) · American Journal of Hypertension · doi:10.1093/ajh/hpab048 · Cited by 28
“31 Policies shifting focus from treating to preventing disease have the added benefit of creating awareness, empowering individuals, and promoting self-management.”
BackgroundHenry-Feugeas, M. C. (2009) · Current Alzheimer Research · doi:10.2174/156720509790147124 · Cited by 28
Central Blood Pressure and Chronic Kidney Disease Progression
Cohen, D. L., & Townsend, R. R. (2011) · International Journal of Nephrology · doi:10.4061/2011/407801 · Cited by 28
“It stands to reason then, that in an organ like the kidney, whose blood flow (relative to mass) has been described as “torrential” [20], increasing pulse pressure would act like a progressively heavy hammer slamming into the delicate capillary network of the glomerulus particularly when the afferent arteriole fails as…”
BackgroundPase, M. P., Grima, N., Stough, C. K. K., Scholey, A. B., & Pipingas, A. (2014) · Physiology & Behavior · doi:10.1016/j.physbeh.2014.03.015 · Cited by 27
“This was anticipated to have negative effects on cognitive performance given that small cerebral vessels remain dilated throughout the cardiac cycle and are continuously exposed to the potentially damaging forces of high pressure pulsatile flow [12].”
Choi, J. C., Lee, J. S., Kang, S., Kang, J., Bae, J., & Lee, D. H. (2009) · Cerebrovascular Diseases · doi:10.1159/000209236 · Cited by 27
“In addition to ischemic stroke, hemorrhagic stroke is another important type of stroke that is caused by rupture of a cerebral artery. Although some researchers have suggested that cerebral small-vessel disease is associated with increased arterial stiffness, it is unknown currently which type of stroke or subtype of…”
BackgroundPeralta, C. A., Katz, R., Madero, M., Sarnak, M. J., Kramer, H., Criqui, M. H., & Shlipak, M. G. (2009) · American Journal of Epidemiology · doi:10.1093/aje/kwn392 · Cited by 27
Kim, J.-H., Jung, Y., Kim, J.-W., Ha, M., Ha, S.-M., & Kim, D. (2018) · Experimental Gerontology · doi:10.1016/j.exger.2018.03.024 · Cited by 28
Ikonomidis, I., Frogoudaki, A., Vrettou, A., Andreou, I., Palaiodimou, L., Katogiannis, K., Liantinioti, C., Vlastos, D., Zervas, P., Varoudi, M., et al. (2019) · Thrombosis and Haemostasis · doi:10.1055/s-0039-1694752 · Cited by 27
Diabetes and Arterial Stiffening
Winer, N., & Sowers, J. R. (2006) · KARGER eBooks · doi:10.1159/000096745 · Cited by 27
Non-compressible arterial disease and the risk of coronary calcification in type-2 diabetes
Lilly, S. M., Qasim, A., Mulvey, C. K., Churchill, T. W., Reilly, M. P., & Eraso, L. H. (2013) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2013.06.004 · Cited by 27
Kidney Function and White Matter Disease in Young Stroke Patients
Steinicke, R., Gaertner, B., Grittner, U., Schmidt, W. U., Dichgans, M., Heuschmann, P. U., Tanislav, C., Jukka Putaala, A., Kaps, M., Endres, M., et al. (2012) · Stroke · doi:10.1161/strokeaha.111.645713 · Cited by 27
Arterial Stiffness and Functional Outcome in Acute Ischemic Stroke
Lee, Y., Park, J., Kim, E., Kang, C., & Park, H.-M. (2014) · Journal of Cerebrovascular and Endovascular Neurosurgery · doi:10.7461/jcen.2014.16.1.11 · Cited by 28
Pase, M. P. (2012) · Journal of Alzheimer s Disease · doi:10.3233/jad-2012-120565 · Cited by 28
“Although these indices have previously been hypothesized to predict cognitive decline based on mechanistic understanding and clinical observations [16], strong empirical support has until recently lagged behind theory.”
InfluentialNormal cerebral vascular pulsations in humans
Kim, M. O., Li, Y., Wei, F., Wang, J., O’Rourke, M. F., Adji, A. I., & Avolio, A. P. (2017) · Journal of Hypertension · doi:10.1097/hjh.0000000000001459 · Cited by 27
“There is increasing evidence that microvascular disease, consequent on aortic stiffening with age [2], is due to higher pressure (as circumferential stress) and/or flow (as longitudinal shear stress) pulsations in small cerebral arteries [3,7].”
BackgroundSelf-citationIdeal Cardiovascular Health and Arterial Stiffness in Spanish Adults—The EVIDENT Study
García‐Hermoso, A., Martínez‐Vizcaíno, V., Gómez-Marcos, M. Á., Cavero‐Redondo, I., Recio-Rodriguez, J. I., & García‐Ortiz, L. (2018) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2017.12.031 · Cited by 27
Vascular aging and preclinical target organ damage in community-dwelling elderly
Ji, H., Teliewubai, J., Lu, Y., Xiong, J., Yu, S., Chi, C., Li, J., Blacher, J., Zhang, Y., & Xu, Y. (2018) · Journal of Hypertension · doi:10.1097/hjh.0000000000001692 · Cited by 27
Matsui, Y., Eguchi, K., Shibasaki, S., Ishikawa, J., Hoshide, S., Shimada, K., & Kario, K. (2010) · Journal of Hypertension · doi:10.1097/hjh.0b013e32833a3981 · Cited by 27
Pulse pressure reduction and cardiovascular protection
Laurent, S., Tropeano, A., & Boutouyrie, P. (2006) · Journal of Hypertension · doi:10.1097/01.hjh.0000229464.09610.ff · Cited by 27
Aleksandrowicz, M., Konop, M., Rybka, M., Mazurek, Ł., Stradczuk‐Mazurek, M., Kciuk, M., Bądzyńska, B., Dobrowolski, L., & Kuczeriszka, M. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26136467 · Cited by 31
Kanhai, D. A., de Kleijn, D. P. V., Kappelle, L. J., Uiterwaal, C. S. P. M., van der Graaf, Y., Pasterkamp, G., Geerlings, M. I., Visseren, F. L. J., & on behalf of the SMART Study Group (2014) · BMJ Open · doi:10.1136/bmjopen-2013-003824 · Cited by 26
Saleem, M., Herrmann, N., Dinoff, A., Mazereeuw, G., OH, P. I., Goldstein, B. I., Kiss, A., Shammi, P., & Lanctôt, K. L. (2018) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000651 · Cited by 26
Chang, L.-H., Lin, H.-D., Kwok, C., Won, J. G. S., Chen, H.-S., Chu, C., Hwu, C., Kuo, C., Jap, T., Shih, K., et al. (2014) · Internal Medicine · doi:10.2169/internalmedicine.53.2999 · Cited by 26
Climie, R. E., Srikanth, V. K., Beare, R. J., Keith, L. J., Fell, J. W., Davies, J. E., & Sharman, J. E. (2014) · Cardiovascular Diabetology · doi:10.1186/s12933-014-0143-6 · Cited by 26
“Unique to the brain is the continuous passive perfusion of high volume blood flow to the organ throughout systole and diastole [29].”
BackgroundZhang, X., Low, S. K., Sum, C. F., Subramaniam, T., Yeoh, L. Y., Liu, J., Li, N., Ang, K., Lee, S. B., Tang, W. E., et al. (2017) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2017.02.004 · Cited by 26
Aortic hemodynamics and white matter hyperintensities in normotensive postmenopausal women
Barnes, J. N., Harvey, R. E., Zuk, S. M., Lundt, E. S., Lesnick, T. G., Gunter, J. L., Senjem, M. L., Shuster, L. T., Miller, V. M., Jack, C. R., et al. (2017) · Journal of Neurology · doi:10.1007/s00415-017-8476-1 · Cited by 27
Aldosterone, inactive matrix gla-protein, and large artery stiffness in hypertension
Chirinos, J. A., Sardana, M., Syed, A. A., Koppula, M. R., Varakantam, S., Vasim, I., Oldland, H. G., Phan, T. S., Drummen, N. E. A., Vermeer, C., et al. (2018) · Journal of the American Society of Hypertension · doi:10.1016/j.jash.2018.06.018 · Cited by 26
Kujawski, S., Kujawska, A., Gajos, M., Topka, W., Perkowski, R., Androsiuk-Perkowska, J., Newton, J. L., Zalewski, P., & Kędziora–Kornatowska, K. (2018) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2018.00421 · Cited by 27
Baumann, M., Hermans, J. J. R., Janssen, B. J., Peutz‐Kootstra, C. J., Witzke, O., Heemann, U. W., Smits, J. F. M., & Struijker-Boudier, H. A. J. (2007) · Journal of Hypertension · doi:10.1097/hjh.0b013e3282ef84f8 · Cited by 26
Miyagi, T., Koga, M., Yamagami, H., Okuda, S., Okada, Y., Kimura, K., Shiokawa, Y., Nakagawara, J., Furui, E., Hasegawa, Y., et al. (2014) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2014.08.015 · Cited by 25
“Both the kidneys and brain are end organs that are vulnerable to hypertensive damage.(6) Thus, it is important to consider the contribution of BP and its management to cerebrorenal interactions.”
BackgroundUmemura, T., Senda, J., Fukami, Y., Mashita, S., Kawamura, T., Sakakibara, T., & Sobue, G. (2013) · Stroke · doi:10.1161/strokeaha.113.003164 · Cited by 25
Associations Between Biomarkers of Renal Function With Cerebral Microbleeds in Hypertensive Patients
Zhang, J.-B., Liu, L., Li, Z., Sun, H.-R., & Ju, X. (2014) · American Journal of Hypertension · doi:10.1093/ajh/hpu229 · Cited by 25
Kennedy, G., Meyer, D., Hardman, R. J., Macpherson, H., Scholey, A. B., & Pipingas, A. (2018) · Journal of Alzheimer s Disease · doi:10.3233/jad-171107 · Cited by 25
Vitamin D concentration and risk of Alzheimer disease
Yang, K., Chen, J., Li, X., & Zhou, Y. (2019) · Medicine · doi:10.1097/md.0000000000016804 · Cited by 25
“These studies showed that high levels of serum vitamin D status were associated with a low risk of AD.”
BackgroundInfluentialGarcía‐Cruz, E., Garcia, B. E. B., Sandoval, D. M., Gopar‐Nieto, R., González-Ruiz, F. J., Gallardo, L. D., Ronco, C., Madero, M., & Vásquez-Jiménez, E. (2021) · Blood Purification · doi:10.1159/000517469 · Cited by 25
Mapping creatinine- and cystatin C-related white matter brain deficits in the elderly
Rajagopalan, P., Refsum, H., Hua, X., Toga, A. W., Jack, C. R., Weiner, M. W., & Thompson, P. M. (2012) · Neurobiology of Aging · doi:10.1016/j.neurobiolaging.2012.10.022 · Cited by 25
Shimoyama, T., Iguchi, Y., Kimura, K., Mitsumura, H., Sengoku, R., Kono, Y., Morita, M., & Mochio, S. (2012) · Hypertension Research · doi:10.1038/hr.2012.84 · Cited by 25
Carotid Artery Calcification Is Associated with Deep Cerebral Microbleeds
Chung, P., Park, K., Kim, J., Shin, D. W., & Ha, S.-Y. (2014) · European Neurology · doi:10.1159/000358513 · Cited by 27
Bruno, R. M., Salvati, A., Barzacchi, M., Raimo, K., Taddei, S., Ghiadoni, L., & Solini, A. (2015) · Cardiovascular Diabetology · doi:10.1186/s12933-015-0227-y · Cited by 25
Wasicek, P. J., Teeter, W. A., Yang, S., Banchs, H. L., Galvagno, S. M., Hu, P., Gamble, W. B., Hoehn, M. R., Scalea, T. M., & Morrison, J. J. (2019) · Trauma Surgery & Acute Care Open · doi:10.1136/tsaco-2018-000194 · Cited by 25
What Do We Know about Diet and Markers of Cardiovascular Health in Children: A Review
Saeedi, P., Shavandi, A., & Skidmore, P. M. L. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16040548 · Cited by 26
“, transferring nutrient-rich blood to the peripheral arteries and body organs) will be compromised [89].”
BackgroundAssociation of Arterial Stiffness With Kidney Function Among Adults Without Chronic Kidney Disease
Itano, S., Yano, Y., Nagasu, H., Tomiyama, H., Kanegae, H., Makino, H., Higashi, Y., Kobayashi, Y., Sogawa, Y., Satoh, M., et al. (2020) · American Journal of Hypertension · doi:10.1093/ajh/hpaa097 · Cited by 24
Hendrickx, J. O., Martinet, W., Dam, D. V., & Meyer, G. R. Y. D. (2021) · Frontiers in Molecular Biosciences · doi:10.3389/fmolb.2021.651215 · Cited by 28
“As arterial tissue loses its elasticity with age, increased pulsatile strain damages the most vulnerable microcirculations (O’Rourke and Safar, 2005) such as the cerebrovasculature, leading to severe lesions and end-organ failure, e.”
BackgroundLarge Artery Stiffness, Microvascular Function, and Cardiovascular Risk
Chirinos, J. A. (2016) · Circulation: Cardiovascular Imaging · doi:10.1161/circimaging.116.005903 · Cited by 24
Riba‐Llena, I., Nafría, C., Mundet, X., López‐Rueda, A., Fernández‐Cortiñas, I., Jarca, C. I., Jiménez‐Balado, J., Domingo, M., Tovar, J. L., Orfila, F., et al. (2016) · European Journal of Neurology · doi:10.1111/ene.12979 · Cited by 25
“Small vessels in kidney and brain have similar anatomical and hemodynamic characteristics such as exposure to high flow volumes during the entire cardiac cycle and low vascular resistance [23].”
BackgroundImpact of multimorbidity on risk and outcome of stroke: Lessons from chronic kidney disease
Kelly, D., & Rothwell, P. M. (2020) · International Journal of Stroke · doi:10.1177/1747493020975250 · Cited by 24
“This association may simply be related to their shared vascular risk factors such as hypertension and diabetes,(93) but it has also been proposed that SVD and CKD may be part of a multi-system small vessel disorder.(94) This theory was explored in an analysis of 1080 consecutive patients with TIA/stroke who underwent…”
BackgroundCerebrovascular alterations in NAFLD: Is it increasing our risk of Alzheimer's disease?
Hadjihambi, A. (2021) · Analytical Biochemistry · doi:10.1016/j.ab.2021.114387 · Cited by 25
Kumar, V. R. S., Sankar, V., Chandrasekaran, N., Saravanan, V., Sukumaran, A., Rajendran, V., Choudhary, S. K., Radhakrishnan, P. K., Oommen, C., Panchal, D., et al. (2022) · Physics of Fluids · doi:10.1063/5.0086638 · Cited by 24
RetractedFotheringham, J., Odudu, A., McKane, W. S., & Ellam, T. (2014) · Hypertension · doi:10.1161/hypertensionaha.114.04656 · Cited by 24
Ryu, W., Lee, S., Kim, C. K., Kim, B. J., & Yoon, B. (2012) · International Journal of Stroke · doi:10.1111/j.1747-4949.2011.00732.x · Cited by 24
Llena, I. R., Nafría, C., Filomena, J., Tovar, J. L., Vinyoles, E., Mundet, X., Jarca, C. I., Vilar‐Bergua, A., Montaner, J., & Delgado, P. (2015) · Journal of Cerebral Blood Flow & Metabolism · doi:10.1038/jcbfm.2015.90 · Cited by 24
“increased resistance to blood flow.(32) Microvascular disease may produce hypoperfusion that could lead to cognitive impairment.”
BackgroundCerebro‐renal interaction and stroke
Shah, B., Jagtap, P., Sarmah, D., Datta, A., Raut, S., Sarkar, A., Bohra, M., Singh, U., Baidya, F., Kalia, K., et al. (2020) · European Journal of Neuroscience · doi:10.1111/ejn.14983 · Cited by 27
“According to this, brain and kidney are low vessel resistance organs and share similar anatomical feature with their hemostatic mechanisms that provides continuous blood flow while maintaining perfusion pressure in the brain and GFR in kidney despite variation in BP (O’Rourke & Safar, 2005).”
BackgroundA Brain–Kidney Connection: The Delicate Interplay of Brain and Kidney Physiology
Freeman, W. D., & Wadei, H. M. (2015) · Neurocritical Care · doi:10.1007/s12028-015-0119-8 · Cited by 24
“Nevertheless, despite these limitations, this study is an extension of previously published evidence that cerebral perfusion and GFR are interconnected, with patients who experience cerebral hypoperfusion at an increased risk of renal injury and vice versa, with subsequent effects on outcome and mortality [6, 7].”
BackgroundLiu, G., Sha, W., Wu, Y., Luo, J., Cai, Y., Zhang, T., & Yang, Y. (2025) · European journal of medical research · doi:10.1186/s40001-024-02217-4 · Cited by 23
“The resulting haemodynamic stress, pulse pressure, and blood pressure variability can harm the brain and heart [46], increasing the risk of cardiovascular diseases.”
Zhao, L., Li, L., Ren, H., Zou, Y., Zhang, R., Wang, S., Xu, H., Zhang, J., & Liu, F. (2020) · Renal Failure · doi:10.1080/0886022x.2020.1804402 · Cited by 24
“Increased arterial stiffness led to elevated systemic blood pressure in the defective glomerular capillaries, with low resistance, and exacerbated intraglomerular hypertension and hyperfiltration, and eventually, nephrosclerosis [12,40,41].”
BackgroundSubclinical Carotid Artery Atherosclerosis and Cognitive Function: A Mini-Review
Ihle‐Hansen, H., Ihle‐Hansen, H., Sandset, E. C., & Hagberg, G. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.705043 · Cited by 23
The Attributable Burden of Hypertension: Focus on CKD
Jamerson, K., & Townsend, R. R. (2011) · Advances in Chronic Kidney Disease · doi:10.1053/j.ackd.2010.11.006 · Cited by 23
Matsui, Y., Eguchi, K., Ishikawa, J., Shimada, K., & Kario, K. (2010) · American Journal of Hypertension · doi:10.1038/ajh.2010.240 · Cited by 23
Melo, X., Fernhall, B., Santos, D. A., Pinto, R., Pimenta, N. M., Sardinha, L. B., & Clara, S. (2015) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2015-0204 · Cited by 23
“This appears to offset the increase in wall stiffness, preventing an increase in afterload that could adversely affect ventricular performance (Kingwell 2000; Kingwell et al. 1997; O'Rourke and Safar 2005).”
BackgroundO’Rourke, M. F., Adji, A. I., Namasivayam, M. J., & Mok, J. (2011) · Drugs & Aging · doi:10.2165/11592730-000000000-00000 · Cited by 25
Self-citationUsing High-Field Magnetic Resonance Imaging to Estimate Distensibility of the Middle Cerebral Artery
Warnert, E. A. H., Verbree, J., Wise, R. G., & van Osch, M. J. P. (2016) · Neurodegenerative Diseases · doi:10.1159/000446397 · Cited by 23
Ding, L., Hong, Y., & Peng, B. (2017) · Stroke and Vascular Neurology · doi:10.1136/svn-2016-000049 · Cited by 25
“Advanced age and long-term hypertension may cause structural changes in microvessels, represented by fibrinoid necrosis and lipohyalinosis, thus increasing the risk of rupture and bleeding.(31) Histopathological analyses have found hypertensive vasculopathy was specially associated with CMBs in the thalamus, basal gan…”
BackgroundLiang, F., Guan, D., & Alastruey, J. (2017) · Journal of Biomechanical Engineering · doi:10.1115/1.4038430 · Cited by 23
Arterial damage and cognitive decline in chronic kidney disease patients
Karasavvidou, D. P., Boutouyrie, P., Kalaitzidis, R., Kettab, H., Pappas, K., Stagikas, D., Antonakis, N., Tsalikakis, D., Elisaf, M., & Laurent, S. (2018) · Journal of Clinical Hypertension · doi:10.1111/jch.13350 · Cited by 23
“Exclusion criteria were (1) diagnosis of depression or delirium according to the history and neuropsychological tests, (2) history of prior stroke or transient ischemic attack documented in the medi‐ cal chart, and (3) low Hb level <10 g/dL.”
BackgroundMethodHatleberg, C. I., Ryom, L., Kamara, D. A., Wit, S. D., Law, M. G., Phillips, A. N., Reiss, P., Monforte, A. D., Mocroft, A., Pradier, C., et al. (2019) · EClinicalMedicine · doi:10.1016/j.eclinm.2019.07.008 · Cited by 23
“Adjustment for other CVD risk factors did not markedly affect the eGFR estimate, possibly implying a causal relationship between low eGFR and hemorrhagic stroke; low eGFR may induce platelet dysfunction leading to prolonged bleeding time and increasing risk of cerebral hemorrhages [16], or be correlated with cerebral…”
Background
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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
