This issue features several articles addressing different aspects of vascular function. The first is an extensive review of the vascular effects of aging and its relationship to systolic blood pressure and vascular disease by one of the experts in this area, Ed Lakatta, from the National Institute of Aging. The comprehensive nature of this review makes it a “must-read’ by all who treat hypertensive patients, as well as a stimulus for future research to investigators in the area of vascular disease, hypertension, and gerontology. In addition to this lengthy review, there are several original research articles.
Ounis-Skali and Bentley-Lewis and colleagues have examined hemodynamic and humoral factors in obese premenopausal women in comparison to lean subjects of the same age. They observed an increase in cardiac output and aortic flow along with increased blood pressure, albeit within the normal range, and increased levels of insulin and glucose among the obese subjects. These observations provide clues to the development of hypertension in individuals with the metabolic syndrome and/or obesity. In view of the recent concerns about “prehypertension”, these findings are of particular interest.
Turning to an animal model for “andropause” and the effect of testosterone deficiency, Touyz’s group demonstrated endothelial dysfunction in resistance vessels as well as increased evidence for inflammatory factors, which can contribute to vascular events. These findings provide new information that may be germane to the increased frequency of vascular disease in older men, particularly those in whom androgen levels fall, and suggest fertile new areas of exploration in clinical research.
Lazar and colleagues from Michael Weber’s group have explored the potential of self-measured ambulatory blood pressure measurements as a surrogate measure of arterial stiffness in humans. While preliminary and requiring further validation, this approach may be a simple and widely available technique for clinicians interested in less costly and labor-intensive ways of assessing vascular stiffness in humans than are presently available outside the research environment.
The final research article is from Berenson’s long-running Bogalusa Heart Study. The investigators measured polymorphisms of the endothelial nitric oxide synthase gene in their asymptomatic, young adult population and found an association between one of those genetic forms (G894T) and carotid artery intima-media thickness. These findings may help identify high risk individuals for whom intervention before the occurrence of vascular disease may be prophylactic. These findings beg both confirmation and future interventional trials.
I hope that you, the reader, find these articles as informative and provocative as I have in including them in this issue. JASH welcomes feedback from readers on any appropriate topic.
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