Download presentation
Presentation is loading. Please wait.
Published byUrsula Mason Modified over 9 years ago
2
Early Vascular aging & Arterial Stiffness
3
Features of normal vascular aging.
A gradual change of the vascular structure and function Decreased arterial Increased arterial compliance stiffening Features of normal vascular aging. Influenced by age dependent structural and biochemical changes, eg, in the content of elastin and collagen in the vessel wall. Subtle increased intima media thickening (IMT) in the vessel wall followed by atherosclerosis with characteristic lesions and plaque. Impairment of endothelial-mediated vasodilatation and decrease in fibrinolysis. Nilsson PM1.Early vascular aging (EVA): consequences and prevention. Vasc Health Risk Manag. 2008;4(3):
4
When vascular aging takes a rapid course
Premature CVD manifestations : Coronary heart disease (CHD), Myocardial infarction, Stroke Symptoms from peripheral arterial disease (PAD). Progressing vascular dementia : Impaired cognitive function, Depression Disturbed central regulation of physiological processes, eg, blood pressure regulation. Nilsson PM1.Early vascular aging (EVA): consequences and prevention. Vasc Health Risk Manag. 2008;4(3):
5
Features of early vascular ageing (EVA)
Increased arterial stiffness and pulse wave velocity Impaired endothelial function and vasodilatation Chronic vascular inflammation Intima media thickness and early atherosclerosis Hemorheological disturbances of blood flow Capillary rarefaction and dysfunctional regulation Shorter telomere length/lower telomerase activity Impaired glucose and lipid metabolis Insulin resistance Oxidative stress Arterial calcification Increased deposition of matrix substances Small vessel degeneration in brain and kidney Increased left ventricular heart (LVH) load with hypertrophy Nilsson PM1.Early vascular aging (EVA): consequences and prevention. Vasc Health Risk Manag. 2008;4(3):
6
Vascular Age Benchmark
7
Early Vascular Aging (EVA) Aging Dis. 2014 Apr; 5(2): 109–113.
Structural changes in arterial wall Increased stiffening caused by: A decrease in the elastin content of the arterial media Dominance of collagen content Increased non-enzymatic cross-linkages between collagen structures. Nilsson PM1. Hemodynamic Aging as the Consequence of Structural Changes Associated with Early Vascular Aging (EVA) Aging Dis Apr; 5(2): 109–113.
8
Arterial stiffness – hemodynamic effects
Changes in brachial BP Isolated systolic hypertension (ISH) Elevated pulse pressure (PP) Changes in central BP Increased central systolic BP and PP Increased BP variability Decreased heart rate variability Impaired endothelial function - Less vasodilation Impaired baroreceptor function, orthostatic hypotension Nilsson PM1. Hemodynamic Aging as the Consequence of Structural Changes Associated with Early Vascular Aging (EVA) Aging Dis Apr; 5(2): 109–113.
9
Arterial stiffness – a nexus between cardiac and renal disease
A key driver of (chronic) human disorders Pulmonary arterial hypertension, Kidney disease, and Atherosclerosis. . Huveneers S1, Daemen MJ2, Hordijk PL2 Between Rho(k) and a Hard Place: The Relation Between Vessel Wall Stiffness, Endothelial Contractility, and Cardiovascular Disease Circ Res Feb 27;116(5): Jia G1, Aroor AR1, Sowers JR2Arterial Stiffness: A Nexus between Cardiac and Renal Disease. Cardiorenal Med. 2014 Apr;4(1):60-71.
10
Preventing Arterial stiffness
Role of Vitamin D in Preventing Arterial stiffness
11
Low serum 25-hydroxyvitamin D levels is associated with both
arterial and ventricular stiffness Vitamin D and arterial stiffness: Regulates the renin–angiotensin system Suppresses proliferation of vascular smooth muscle Improves endothelial cell dependent vasodilatation. These mechanisms may play a role in pathogenesis of arterial and left ventricular stiffness. Seker T1, Gür M2, Kuloğlu O2, Serum 25-hydroxyvitamin D is associated with both arterial and ventricular stiffness in healthy subjects. J Cardiol Dec;62(6):361-5.
12
Low serum 25-hydroxyvitamin D levels is associated with both
arterial and ventricular stiffness Vitamin D deficient group have Higher Pulse wave velocity (PWV) Serum calcium Left ventricular filling index Systolic blood pressure values Lower Mitral peak early/peak late flow velocities values compared with patients with vitamin D sufficient group Şeker T1, Gür M2, Kuloğlu O2, Serum 25-hydroxyvitamin D is associated with both arterial and ventricular stiffness in healthy subjects. J Cardiol Dec;62(6):361-5.
13
Vitamin D status and vascular effects
LVID, left ventricular inner dimension; LAD, left atrium dimension; LVMI, left ventricular mass index; PWV, pulse wave velocity.
14
Low serum 25-hydroxyvitamin D levels is associated with both
arterial and ventricular stiffness Conclusions Low 25-hydroxyvitamin D levels are associated with increased ventricular and arterial stiffness as well as systolic blood pressure in healthy subjects. Arterial stiffness plays a role in pathogenesis of hypertension. Ventricular stiffness plays a role in pathogenesis of heart failure. Therefore, vitamin D may play a role in pathogenesis of both hypertension and heart failure. Şeker T1, Gür M2, Kuloğlu O2, Serum 25-hydroxyvitamin D is associated with both arterial and ventricular stiffness in healthy subjects. J Cardiol Dec;62(6):361-5.
15
Vitamin D insufficiency associated with increased endothelial
dysfunction irrespective of traditional risk burden. 25-OH D levels independently associated with: Flow-mediated vasodilation (β = 0.1, p = 0.03), Reactive hyperemia index (β = 0.23, p < 0.001), Pulse wave velocity (β = -0.09, p = 0.04), Augmentation index (β = -0.11, p = 0.03), Subendocardial viability ratio (β = 0.18, p = 0.001). Al Mheid I1, Patel R, Murrow J, Vitamin D status is associated with arterial stiffness and vascular dysfunction in healthy humans. J Am Coll Cardiol Jul 5;58(2):
16
Vitamin D insufficiency associated with increased
endothelial dysfunction irrespective of traditional risk burden. Normalization of 25-OH D at 6 months was associated with : Increase in reactive hyperemia index (0.38 ± 0.14, p = 0.009) Subendocardial viability ratio (7.7 ± 3.1, p = 0.04), Decrease in mean arterial pressure (4.6 ± 2.3 mm Hg, p = 0.02). Al Mheid I1, Patel R, Murrow J, Vitamin D status is associated with arterial stiffness and vascular dysfunction in healthy humans. J Am Coll Cardiol Jul 5;58(2):
17
Vitamin D insufficiency associated with increased
endothelial dysfunction irrespective of traditional risk burden. Conclusions Vitamin D insufficiency associated with : Increased arterial stiffness and endothelial dysfunction in the conductance and resistance blood vessels in humans, irrespective of traditional risk factor burden. Normalization of vitamin D status in insufficient individuals is associated with improvements in several parameters of vascular function Al Mheid I1, Patel R, Murrow J, Vitamin D status is associated with arterial stiffness and vascular dysfunction in healthy humans. J Am Coll Cardiol Jul 5;58(2):
18
Arterial stiffness, Vitamin D, CVD and CKD
Abnormalities in mineral metabolism [calcium, phosphate, and immunoreactive parathyroid hormone (PTH)] and vitamin D have been linked to increase in central arterial stiffness. There is a significant association between augmentation index - AIx (a composite measure of central arterial stiffness) and 1,25-(OH)2D3 in a diverse group of individuals with CVD, CKD, or both. Andrade J1, Er L, Ignaszewski A, Levin AExploration of association of 1,25-(OH)2D3 with augmentation index, a composite measure of arterial stiffness. Clin J Am Soc Nephrol Nov;3(6):
19
Vitamin D, Arterial stiffness and Diabetes
Type 2 diabetes mellitus (DM) is an established major independent risk factor for cardiovascular disease. Serum 25-hydroxyvitamin D (vitamin D) is a prevalent condition in patients with type 2 Macrovascular complications of DM are associated with stiffening of the aorta, which is a major contributing factor to the target organ damage . Kuloğlu O1, Gür M, Şeker T Serum 25-hydroxyvitamin D level is associated with aortic distensibility and left ventricle hypertrophy in newly diagnosed type 2 diabetes mellitus. Diab Vasc Dis Res Nov;10(6):546-9. ,
20
Short Term Vitamin D Supplementation on the Inflammatory
and Oxidative Mediators of Arterial Stiffness Authors conclude : Vitamin D has been postulated to mediate its cardiovascular effect by modulating the mediators of inflammation and oxidative stress Cardiovascular benefit of vitamin D : •May require near maximum serum 25(OH)D levels of vitamin D sufficiency •May be more apparent in a subset of the population with an excess burden of oxidative stress Martins D1, Meng YX2, Tareen N1The Effect of Short Term Vitamin D Supplementation on the Inflammatory and Oxidative Mediators of Arterial Stiffness. Health (Irvine Calif) Jun;6(12):
21
Vitamin D, Arterial stiffness and Diabetes
Patients with vitamin D deficiency group have : Higher Left ventricle mass index (LVMI )and Lower aortic distensibility (AD ) values Compared with patients with vitamin D sufficient group Kuloğlu O1, Gür M, Şeker T Serum 25-hydroxyvitamin D level is associated with aortic distensibility and left ventricle hypertrophy in newly diagnosed type 2 diabetes mellitus. Diab Vasc Dis Res Nov;10(6):546-9.
22
Vitamin D Supplementation
23
Short Term Vitamin D Supplementation on the Inflammatory
and Oxidative Mediators of Arterial Stiffness Monthly dose of 100,000IU of vitamin D3 for three months Significant increase in the serum 25(OH)D levels to a mean level of 34.5 ng/ml (SD = 7.1) (p < 0.001). The increase in 25(OH)D levels was associated with a significant decrease in the serum level of intact PTH (p = 0.02), mean urinary isoprostane (p = 0.02) and adipocyte cytokine expression. significant decrease in the augmentation index among the participants with the highest tertile of urinary isoprostane (p = 0.007). Martins D1, Meng YX2, Tareen N1The Effect of Short Term Vitamin D Supplementation on the Inflammatory and Oxidative Mediators of Arterial Stiffness. Health (Irvine Calif) Jun;6(12):
24
Short Term Vitamin D Supplementation on the Inflammatory
and Oxidative Mediators of Arterial Stiffness Authors conclude : Vitamin D has been postulated to mediate its cardiovascular effect by modulating the mediators of inflammation and oxidative stress Cardiovascular benefit of vitamin D : May require near maximum serum 25(OH)D levels of vitamin D sufficiency May be more apparent in a subset of the population with an excess burden of oxidative stress Martins D1, Meng YX2, Tareen N1The Effect of Short Term Vitamin D Supplementation on the Inflammatory and Oxidative Mediators of Arterial Stiffness. Health (Irvine Calif) Jun;6(12):
25
Summary Arterial stiffness is a feature of early vascular aging
Low vitamin D levels are associated with both arterial and ventricular stiffness Vitamin D plays a major role in pathogenesis of heart failure and hypertension Supplementation of Vitamin D modulates cardiovascular inflammatory mediators and oxidative stress.
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.