Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Nov 26, 2015; 7(11): 742-753
Published online Nov 26, 2015. doi: 10.4330/wjc.v7.i11.742
Therapeutic modification of arterial stiffness: An update and comprehensive review
Ching-Fen Wu, Pang-Yen Liu, Tsung-Jui Wu, Yuan Hung, Shih-Ping Yang, Gen-Min Lin
Ching-Fen Wu, Department of Internal Medicine, Mennonite Christian Hospital, Hualien 97144, Taiwan
Pang-Yen Liu, Yuan Hung, Shih-Ping Yang, Gen-Min Lin, Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, and National Defense Medical Center, Taipei 114, Taiwan
Tsung-Jui Wu, Gen-Min Lin, Department of Medicine, Hualien-Armed Forces General Hospital, Hualien 97144, Taiwan
Author contributions: Wu CF and Lin GM has substantial contributions to conception and design of the study, acquisition of data, and interpretation of data; Wu CF drafts the article; all authors make critical revisions related to important intellectual content of the manuscript and make final approval of the version of the article to be published.
Conflict-of-interest statement: No conflict of interest is declared by any of the authors.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gen-Min Lin, MD, MPH, Department of Medicine, Hualien-Armed Forces General Hospital, No. 163, Jiali Rd. Xincheng Township, Hualien 97144, Taiwan. farmer507@yahoo.com.tw
Telephone: +886-340-38260601 Fax: +886-340-38261370
Received: May 20, 2015
Peer-review started: May 22, 2015
First decision: July 10, 2015
Revised: September 9, 2015
Accepted: September 25, 2015
Article in press: September 28, 2015
Published online: November 26, 2015
Processing time: 193 Days and 13.4 Hours
Abstract

Arterial stiffness has been recognized as a marker of cardiovascular disease and associated with long-term worse clinical outcomes in several populations. Age, hypertension, smoking, and dyslipidemia, known as traditional vascular risk factors, as well as diabetes, obesity, and systemic inflammation lead to both atherosclerosis and arterial stiffness. Targeting multiple modifiable risk factors has become the main therapeutic strategy to improve arterial stiffness in patients at high cardiovascular risk. Additionally to life style modifications, long-term ω-3 fatty acids (fish oil) supplementation in diet may improve arterial stiffness in the population with hypertension or metabolic syndrome. Pharmacological treatment such as renin-angiotensin-aldosterone system antagonists, metformin, and 3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitors were useful in individuals with hypertension and diabetes. In obese population with obstructive sleep apnea, weight reduction, aerobic exercise, and continuous positive airway pressure treatment may also improve arterial stiffness. In the populations with chronic inflammatory disease such as rheumatoid arthritis, a use of antibodies against tumor necrosis factor-alpha could work effectively. Other therapeutic options such as renal sympathetic nerve denervation for patients with resistant hypertension are investigated in many ongoing clinical trials. Therefore our comprehensive review provides knowledge in detail regarding many aspects of pathogenesis, measurement, and management of arterial stiffness in several populations, which would be helpful for physicians to make clinical decision.

Keywords: Arterial stiffness; Cardio-ankle vascular index; Pulse-wave velocity; Renin-angiotensin-aldosterone system antagonist

Core tip: Arterial stiffness has been recognized as a marker of cardiovascular disease and associated with long-term worse clinical outcomes in several populations. Age, hypertension, smoking, and dyslipidemia, known as traditional vascular risk factors, as well as diabetes, obesity, and systemic inflammation lead to both atherosclerosis and arterial stiffness. Targeting multiple modifiable risk factors has become the main therapeutic strategy to improve arterial stiffness in patients at high cardiovascular risk.