Is Blood Pressure Independent Arterial Destiffening Possible?

<span class="paragraphSection">Aging is associated with a stiffening of the large conduit arteries, which is accelerated by different cardiovascular risk factors, in particular by hypertension. Elevated aortic stiffness has therefore been included in the list of target organ damages to be screened for in hypertension by the European Society of Hypertension.^{<a href="#CIT0001" class="reflinks">1</a>} Carotid-femoral pulse wave velocity (cfPWV) is the noninvasive "gold-standard" for the assessment of aortic stiffness^{<a href="#CIT0002" class="reflinks">2</a>} and has been shown to be a powerful predictor of all-cause and cardiovascular mortality as well as cardiovascular events independent of classic cardiovascular risk factors.^{<a href="#CIT0003" class="reflinks">3</a>} However, cfPWV has not yet fully qualified as surrogate endpoint,^{<a href="#CIT0004" class="reflinks">4</a>} since its clinical use as therapeutic target still has to be demonstrated.^{<a href="#CIT0005" class="reflinks">5</a>} Furthermore, a consensus on which strategy to pursue to selectively improve cfPWV is missing.^{<a href="#CIT0006" class="reflinks">6</a>} In this context, the question if and how antihypertensive agents cause an arterial destiffening beyond the effect of blood pressure (BP) lowering alone has been receiving much attention.^{<a href="#CIT0007" class="reflinks">7–9</a>}</span>

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