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Large artery stiffness and inflammation

Journal of Human Hypertension volume 19, pages 507–509 (2005)Cite this article

Atherosclerosis remains the leading cause of death worldwide, and although the underlying pathophysiology is incompletely understood, it is increasingly viewed as an inflammatory condition.1 Indeed, levels of circulating white cells and inflammatory mediators, such as C-reactive protein (CRP) and interleukin-6 (IL-6), are raised in patients with cardiovascular disease, and in those with cardiovascular risk factors, including a family history of premature cardiovascular disease.2 Moreover, when assessed with highly sensitive assays, CRP levels independently predict outcome in patients with coronary heart disease,3, 4 and in apparently healthy individuals.5, 6 More direct evidence concerning the role of inflammation in atheroma formation comes from in vitro studies and animal models of atherosclerosis.1

Much mechanistic research in humans has focused on the relationship between inflammation and vascular function so-called ‘surrogate markers’ such as endothelial function. Endothelial dysfunction, or reduced nitric oxide bioavailability is viewed as a key event in the development of atheromatous plaques,7 and endothelial function is an independent predictor of outcome in patients with cardiovascular disease8 or hypertension.9 Interestingly, CRP levels correlate with endothelial function in patients with coronary artery disease,10 and induction of acute inflammation by vaccination results in endothelial dysfunction in humans,11 which can be attenuated by co-administration of aspirin.12 We and others have also demonstrated endothelial dysfunction in patients with acute systemic vasculitis13, 14 and chronic inflammatory conditions such as rheumatoid arthritis,15, 16 which are also associated with increased risk of cardiovascular disease.17 Moreover, successful anti-inflammatory therapy in such patients can restore ‘normal’ endothelial function.13, 14

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  1. Clinical Pharmacology Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK

    C M McEniery & I B Wilkinson

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  1. C M McEniery
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Correspondence to I B Wilkinson.

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McEniery, C., Wilkinson, I. Large artery stiffness and inflammation. J Hum Hypertens 19, 507–509 (2005). https://doi.org/10.1038/sj.jhh.1001814

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