Arterial Stiffness
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Trunk Fat Unhealthy: In the 648 elderly in the Hoorn Study, a larger trunk fat mass was consistently associated with higher peripheral arterial stiffness while larger leg fat mass (P = 0.009) and leg lean mass were associated with lower peripheral arterial stiffness. Trunk or leg fat mass were not associated with central arterial stiffness. Leg lean mass, however, was consistently associated with lower central arterial stiffness (P < 0.001). Regional body composition as a determinant of arterial stiffness in the elderly: The Hoorn Study. Snijder MB, Henry RM, et al. VU University Medical Center, Amsterdam.. J Hypertens. 2004 Dec;22(12):2339-47

ACE Inhibitor Decreases Arterial Stiffness: Perindopril, an angiotensin-converting enzyme (ACE) inhibitor, decreases the stiffness of the larger arteries; arterial stiffness is evaluated by pulse wave velocity (PWV). In a study of 162 adults with essential hypertension, reductions in BP and PWV appear to be correlated during the first two months of perindopril therapy. After six months, PWV continues to decrease independently of any further reduction in BP, suggesting the occurrence of a pressure-independent pharmacological remodelling of the arterial wall. Effects of perindopril on elastic and structural properties of large arteries in essential hypertension. Lacourciere Y, Beliveau R, et al; l'Universite Laval, Sainte-Foy, Quebec. Can J Cardiol. 2004 Jun;20(8):795-9

ACE-Gene Polymorphisms Increase Arterial Stiffness: The insertion/deletion (I/D) polymorphism of the ACE gene was found to increase common carotid stiffness in a cohort study of 3001 adults over age 54. Angiotensin-converting enzyme gene polymorphism and common carotid stiffness. The Rotterdam study. Mattace-Raso FU, van der Cammen TJ, et al. Erasmus Medical Center, Rotterdam, The Netherlands. Atherosclerosis. 2004 May;174(1):121-6.

Nebivolol Good for Arterial Stiffness: The vasodilating beta-blocker nebivolol, but not atenolol, was found to increase arterial distensibility in sheep.  Nebivolol may be of benefit in conditions of increased large artery stiffness, such as isolated systolic hypertension. Nebivolol increases arterial distensibility in vivo. McEniery CM, Schmitt M, et al. University of Cambridge, UK. Hypertension. 2004 Sep;44(3):305-10. Ed: Extensa is a new blood pressure medication available in England for about $36 per month.

Thomas E. Radecki, M.D., J.D.

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