Arterial stiffness in chronic kidney disease: a modifiable cardiovascular risk factor?

被引:13
作者
Pickup, Luke
Radhakrishnan, Ashwin
Townend, Jonathan N.
Ferro, Charles J.
机构
[1] Univ Hosp Birmingham, Birmingham Cardiorenal Grp, Birmingham, W Midlands, England
[2] Univ Birmingham, Queen Elizabeth Hosp, Birmingham, W Midlands, England
关键词
arterial stiffness; blood pressure; cardiovascular disease; renal dysfunction; GROWTH-FACTOR; 23; PULSE-WAVE VELOCITY; GLYCATION END-PRODUCTS; PRESSURE-INDEPENDENT REDUCTION; NITRIC-OXIDE SYNTHASE; CROSS-LINK BREAKER; AORTIC STIFFNESS; BLOOD-PRESSURE; VASCULAR CALCIFICATION; VITAMIN-D;
D O I
10.1097/MNH.0000000000000535
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose of review There is an inverse, graded relationship between worsening chronic kidney disease (CKD) and increasing cardiovascular risk independent of traditional cardiovascular risk factors. Increasing arterial stiffness is a powerful predictor of cardiovascular outcomes in CKD. Developing novel therapeutic strategies to reverse this process is an attractive concept. This review presents the results of a literature survey of the last 18 months to establish if arterial stiffness can be considered a reversible cardiovascular risk factor in patients with CKD. Recent findings Multiple potential therapeutic approaches to reduce arterial stiffness have been proposed and tested. However, arterial stiffness and blood pressure (BP) have a very close bidirectional relationship. Any change in BP will have an effect on arterial stiffness and vice versa. At present, there is no robust evidence to support the notion that arterial stiffness can be considered reversible other than as a direct consequence of reduction in BP. For now, arterial stiffness should be considered an indirectly modifiable cardiovascular risk factor through optimal control of BP. Measures of arterial stiffness should be regarded as research and risk stratification tools rather than a therapeutic target in itself.
引用
收藏
页码:527 / 536
页数:10
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