Vascular compliance in the cardiometabolic syndrome.

Elevated systolic blood pressure and increased pulse pressure are important predictors of vascular stiffening (compliance), left ventricular hypertrophy, coronary heart disease, heart failure, stroke, vascular dementia, and chronic kidney disease. Advances in noninvasive methods that measure arterial stiffness have led to increased understanding of the mechanisms underlying vascular dysfunction and the development of associated risk factors. The ability to detect and monitor changes in the physical properties of arteries has the potential to allow early interventions that may prevent disease or attenuate its progression. In this paper, the authors briefly review the various methods available to measure vascular compliance and review pathologic processes that lead to insulin resistance, endothelial dysfunction, inflammation, and sympathetic activation, all of which may contribute to increased arterial stiffness in the cardiometabolic syndrome. Strategies to improve vascular compliance are also discussed.