Aortic Stiffness: A Major Risk Factor for Multimorbidity in the Elderly

Abstract

Multimorbidity, the coexistence of multiple health conditions in an individual, has emerged as one of the greatest challenges facing health services, and this crisis is partly driven by the aging population. Aging is associated with increased aortic stiffness (AoStiff), which in turn is linked with several morbidities frequently affecting and having disastrous consequences for the elderly. These include hypertension, ischemic heart disease, heart failure, atrial fibrillation, chronic kidney disease, anemia, ischemic stroke, and dementia. Two or more of these disorders (multimorbidity) often coexist in the same elderly patient and the specific multimorbidity pattern depends on several factors including sex, ethnicity, common morbidity routes, morbidity interactions, and genomics. Regular exercise, salt restriction, statins in patients at high atherosclerotic risk, and stringent blood pressure control are interventions that delay progression of AoStiff and most likely decrease multimorbidity in the elderly.

Clinical Characteristics and Outcomes of Aortic Arch Emergencies: Takayasu Disease, Fibromuscular Dysplasia, and Aortic Arch Pathologies: A Retrospective Study and Review of the Literature

“…Aortic dissection and rupture are often consequences of disturbed shear stress. Some aortic arch variants and branching patterns, like bovine arch, CoA, vascular rings, aberrant subclavian artery, and bicarotid trunk, cause predisposition to stiffening of the aortic wall, thus promoting the growth of atherosclerosis and the formation of aneurysms [ 58 ]. Arterial stiffness is a key risk factor for cardiovascular mortality and morbidity [ 58 , 59 ].…”

A Non-Coronary, Peripheral Arterial Atherosclerotic Disease (Carotid, Renal, Lower Limb) in Elderly Patients—A Review: Part I—Epidemiology, Risk Factors, and Atherosclerosis-Related Diversities in Elderly Patients

“…A greater emphasis should be placed on ‘hardening of the vessels’ affected by atherosclerosis and improving arterial compliance to improve the prognosis, reduce symptoms, and strengthen the blood supply to target organs (brain, kidney, lower limb muscles, etc.) [ 66 , 67 , 68 , 69 ]. Surgical and endovascular interventions should be reserved for emergencies and life-threatening situations.…”

The Sympathetic Nervous System in Hypertensive Heart Failure with Preserved LVEF

“…Arterial HTN in elderly patients derives from different pathophysiological mechanisms compared with middle aged or younger patients. The predominant increase in the systolic arterial pressure observed in the former patient population is associated with an increase in large artery stiffness (LAS) [41]. The increased LAS leads to the increased velocity of the incident wave and early return of the reflected wave and shifts pressure augmentation from diastole to systole.…”