Systemic arterial stiffness (AS)

Systemic arterial stiffness refers to the reduced elasticity and compliance of the large conduit arteries, most notably the aorta. This condition arises from a complex interplay of structural changes, such as the fragmentation of elastin fibers and the accumulation of cross-linked collagen, alongside functional changes like impaired endothelial nitric oxide production and increased vascular smooth muscle tone. It is a hallmark of vascular aging and is significantly exacerbated by chronic conditions like hypertension, diabetes, and kidney disease. Increased stiffness leads to elevated pulse wave velocity and higher systolic blood pressure, which increases the pulsatile workload on the heart and can result in end-organ damage to the brain and kidneys. While not a single molecular receptor or enzyme, systemic arterial stiffness is a major clinical endpoint and a target for "de-stiffening" therapies, including RAAS inhibitors and calcium channel blockers, which aim to restore vascular compliance and reduce cardiovascular risk.

Other names

Arterial stiffnessArterial wall stiffnessAortic stiffnessVascular stiffnessReduced arterial complianceVascular aging

Reduction of vascular smooth muscle tone through vasodilation, prevention of extracellular matrix remodeling by inhibiting collagen deposition and elastin degradation, reduction of advanced glycation end-product (AGE) cross-linking, and mitigation of oxidative stress and vascular inflammation.