Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Commentary
  • Published:

Total arterial compliance: the future of cardiovascular risk assessment?

Journal of Human Hypertension volume 24, pages 227–229 (2010)Cite this article

In recent years, cardiovascular risk assessment has developed into an important area of research in the management of patients at risk of developing cardiovascular disease (CVD) and to gain more insight into the risk progression of those suffering from CVD. A multitude of new invasive and non-invasive assessments, questionnaires and combinations of the aforementioned have been introduced and tested in order to determine their clinical utility in the stratification of cardiovascular risk. Circulating markers of endothelial function and inflammation, such as endothelin, von Willebrand factor and C-reactive protein, have been identified as useful markers not only in the diagnosis of CVD but also in disease monitoring, progression and risk assessment.1, 2, 3, 4, 5 Nevertheless, there are limitations as to how much information these markers are able to provide with respect to CVD risk and local structure and organ integrity. Thus, other technologies assessing more structural and functional parameters have been evaluated with regard to their strength and value in CVD risk assessment.5 Lifestyle factors, age and other environmental factors have added to the list of risk identifiers and predictors.6, 7 All of these facets provide valuable information describing an individual's cardiovascular health. However, the sheer multitude of the available assessments has rather caused confusion than clarification, because of the lack of a common basis, structure and guidelines not only in administering those tests but also in their interpretation.

More recently, total arterial compliance (TAC) has been added to this list and has been shown to be a valuable assessment not only for CVD risk evaluation but also for assessment of the relationship between structural and functional changes in the vascular system with respect to its elasticity and capacity.8, 9 The study presented in the current issue by Haluska et al.10 highlights the strength of TAC over more traditional evaluation techniques such as pulse pressure and echocardiography. The assessment of TAC has also proven to be capable of differentiating between hypertensive, elderly and healthy individuals, which is of particular importance in an increasingly ageing society.11, 12, 13

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Gurbel PA, Kreutz RP, Bliden KP, DiChiara J, Tantry US . Biomarker analysis by fluorokine multianalyte profiling distinguishes patients requiring intervention from patients with long term quiescent coronary artery disease: a potential approach to identify atherosclerotic disease progression. Am Heart J 2008; 155: 56–61.

    Article  CAS  Google Scholar 

  2. Di Gennaro C, Biggi A, Barilli AL, Fasoli E, Carra N, Novarini A et al. Endothelial dysfunction and cardiovascular risk profile in long term withdrawing alcoholics. J Hypertens 2007; 25: 367–373.

    Article  CAS  Google Scholar 

  3. Yip HK, Wu CJ, Chang HW, Yang CH, Yu TH, Chen YH et al. Prognostic value of circulating levels of endothelin-1 in patients after acute myocardial infarction undergoing primary coronary angioplasty. Chest 2005; 127: 1491–1497.

    Article  CAS  Google Scholar 

  4. Kaski JC, Cruz-Fernandez JM, Fernandez-Berges D, Garcia-Moll X, Marin Jadraque L, Mostaza J et al., Investigadores del studio SIESTA. Inflammation markers and risk stratification in patients with acute coronary syndromes: design of the SIESTA Study (Systemic Inflammation Evaluation in Patients with non-ST segment elevation acute coronary syndromes). Rev Esp Cardiol 2003; 56: 389–395.

    Article  Google Scholar 

  5. Koenig W . Update on integrated biomarkers for assessment of long term risk of cardiovascular complications in initially healthy subjects and patients with manifest atherosclerosis. Ann Med 2009; 41: 332–343.

    Article  CAS  Google Scholar 

  6. Faergeman O, stergaard L . Climate change, food production and human health. Ugeskr Laeger 2009; 171: 3181–3184.

    PubMed  Google Scholar 

  7. Wennberg P, Wnsley F, Johansson L, Boman K, Angelantonio ED, Rumley A et al. Reduced risk of myocardial infarction related to active commuting: inflammatory and haemostatic effects are potential major mediating mechanisms. Eur J Cardiovasc Prev Rehabil 2009 (e-pub ahead of print 8 October 2009).

  8. Haluska BA, Jeffries L, Carlier S, Marwick TH . Measurement of arterial distensibility and compliance to assess prognosis. Atherosclerosis 2009 (e-pub ahead of print 22 October 2009).

  9. Mendoca MI, Reis RP, Sous AC, Gomes S, Faria P, Pereira A et al. Pulse wave velocity and coronary risk stratification. Rev Port Cardiol 2009; 28: 155–171.

    Google Scholar 

  10. Haluska BA, Jeffriess L, Brown J, Carlier S, Marwick TH . A comparison of methods for assessing total arterial compliance. J Hum Hypertens 2010; 24: 254–262.

    Article  CAS  Google Scholar 

  11. Beltran A, McVeigh G, Morgan D, Glasser SP, Neutel JM, Weber M et al. Arterial compliance abnormalities in isolated systolic hypertension. Am J Hypertens 2001; 14: 1007–1011.

    Article  CAS  Google Scholar 

  12. Lind L . Arterial compliance and endothelium-dependent vasodilation are independently related to coronary risk in the elderly: the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. Clin Physiol Funct Imaging 2008; 28: 373–377.

    Article  Google Scholar 

  13. Van Bortel LM, Spek JJ . Influence on aging on arterial compliance. J Hum Hypertens 1998; 12: 583–586.

    Article  CAS  Google Scholar 

  14. Frank O . Die Grundform des arteriellen Pulses. Zeitung Biol 1899; 37: 483–586.

    Google Scholar 

  15. Saba PS, Roman MJ, Pini R, Spitzer M, Ganau A, Devereux RB . Relation of arterial pressure waveform to left ventricular and carotid anatomy in normotensive subjects. J Am Coll Cardiol 1993; 22: 1873–1880.

    Article  CAS  Google Scholar 

  16. Celentano A, Crivaro M, Roman MJ, Pietropaolo I, Greco R, Pauciullo P et al. Left ventricular geometry and arterial function in hypercholesterolemia. Nutr Metab Cardiovasc Dis 2001; 11: 312–319.

    CAS  PubMed  Google Scholar 

  17. Sharman JE, Fang ZY, Haluska B, Stowasser M, Prins JB, Marwick TH . Left ventricular mass in patients with type 2 diabetes is independently associated with central but not peripheral pulse pressure. Diabetes Care 2005; 28: 937–939.

    Article  Google Scholar 

  18. Stergiopulos N, Westerhof BE, Westerhof N . Total arterial inertance as the fourth element of the Windkessel model. Am J Physiol 1999; 276: H81–H88.

    CAS  Google Scholar 

  19. Haluska BA, Jeffriess L, Mottram PM, Carlier SG, Marwick TH . A new technique for assessing arterial pressure wave forms and central pressure with tissue Doppler. Cardiovasc Ultrasound 2007; 5: 6.

    Article  Google Scholar 

  20. Sun YH, Anderson TJ, Parker KH, Tyberg JV . Analysis: a new approach to coronary hemodynamics. J Appl Physiol 2000; 89: 1636–1644.

    Article  CAS  Google Scholar 

  21. Mohiuddin MW, Laine GA, Quick CM . Increase in pulse wavelength causes the systemic arterial tree to degenerate into a classical Windkessel. Am J Physiol Heart Circ Physiol 2007; 293: H1164–H1171.

    Article  CAS  Google Scholar 

  22. McVeigh GE, Bratteli CW, Morgan DJ, Alinder CM, Glasser SP, Finkelstein SM et al. Age-related abnormalities in arterial compliance identified by pressure pulse contour analysis: aging and arterial compliance. Hypertension 1999; 33: 1392–1398.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Life and Health Sciences, Aston University, Birmingham, UK

    R Heitmar

Authors
  1. R Heitmar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to R Heitmar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Heitmar, R. Total arterial compliance: the future of cardiovascular risk assessment?. J Hum Hypertens 24, 227–229 (2010). https://doi.org/10.1038/jhh.2009.106

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jhh.2009.106

This article is cited by

Search

Advanced search

Quick links