Sztywność tętnicza w zespole metabolicznym: różnice płci, konsekwencje kliniczne, jak zapobiegać?

Abstract

Non-invasively assessed arterial stiffness has been recently growing interest as a novel marker of cardiovascular (CV) risk. The effects of risk factors on the progression of arterial changes and the development of CV diseases seem to be different in women and men. Arterial stiffness was shown to be primarily determined by age and mean arterial pressure (MAP). Hyperglycaemia and resistance to insulin were identified as contributors to increased arterial stiffness. Metabolic syndrome (MS) accelerates age-related arterial stiffening, leading to the so-called early vascular ageing. Arterial stiffness was also shown to increase with the number of MS components. The effects of MS and its components on arterial stiffness are stronger in women than in men. The sex-specific differences in age-related changes within the cardiovascular system might explain why heart failure with preserved ejection fraction occurs more often in older women than in men. Published evidence suggests that arterial stiffness may be associated with left ventricular diastolic dysfunction in MS patients. Hence, a question arises whether a therapy aimed at optimal control of glycaemia and reduction of arterial stiffness could slow down the development of diastolic heart failure? Lifestyle modifications and pharmacological interventions(de-stiffening) may exert a beneficial effect on arterial stiffness independently from the reduction of blood pressure.