Arteriálny vek

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“A man is as old as his arteries”* At consultations, do you recognize the real biological age of your patient?

Cardiovascular disease still poses a serious threat to public health. It is necessary to screen for classic risk factors, to evaluate, and to control with lifestyle recommendations or drug therapy. However, in spite of prevention and all efforts in medical care, the risk of cardiovascular disease is still there. The answer to this challenge is to use a new pathophysiological concept for better understanding the process of the disease and find the ideal therapeutic aspect.

Between risk factors and cardiovascular events we have to look for easily recognizable biological markers. Target organ damage represents this intermediate step. The identification of age- or disease-associated changes in organ function may improve risk assessment and influence the therapeutic decision-making process.

Well-known examples of target organ damage are left ventricular hypertrophy and albumin excretion. In the recent years it has been demonstrated that arterial stiffness and increased pulse wave velocity (PWV), as well as central aortic pulse pressure, are important independent predictors of cardiovascular events, and have been included into the Guidelines for the management of arterial hypertension. These are considered to be „arterial tissue biomarkers”. They are shown to be more predictive than the simple brachial blood pressure measurement and the well known “circulating” biomarkers (like high-sensitivity C-reactive protein), and show a better additional prediction when coupled to classic cardiovascular risk scores. They give an insight into the real pathological process, by determining the degree of the deterioration of the arterial system through aortic stiffening, increased arterial pulse wave reflection, central pulse pressure and postload.

Aging is a common influencing factor to chronic disease manifestation, like cardiovascular disease. Aging alters the vascular structure and biochemistry that starts with an impairment of endothelial-mediated vasodilatation, and results in decreased arterial compliance and increased arterial stiffening. On this more or less normal process there is a pathological arterial aging, promoting the development and progression of atherosclerosis. In susceptible patients, the vascular aging appears to take a more rapid course, causing premature cardiovascular disease manifestations (coronary heart disease, heart attack, stroke and peripheral arterial disease). How to find these patients on time? Assessment of early vascular aging is a novel approach to estimate cardiovascular risk that leads to individual treatment optimization.

Vascular aging can be investigated directly, non-invasively through the measurement of arterial stiffness, central blood pressure, and endothelial dysfunction related pulse wave reflection. The unique Arterialcare Product Line of Medexpert Ltd provides the original technology in cardiovascular diagnostics for the evaluation of arterial aging.

*Thomas Sydenham, English physician, 1624-1689

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