Vol.:(0123456789) High Blood Pressure & Cardiovascular Prevention https://doi.org/10.1007/s40292-019-00318-4 REVIEW ARTICLE Vascular Aging and Disease of the Large Vessels: Role of Infammation Alessandro Maloberti 1,2  · Paola Vallerio 2  · Nicola Triglione 1,2  · Lucia Occhi 1,2  · Francesco Panzeri 1,2  · Ilaria Bassi 1,2  · Francesco Pansera 1,2  · Enrico Piccinelli 1,2  · Alessio Peretti 1,2  · Laura Garatti 1,2  · Matteo Palazzini 1,2  · Jinwei Sun 1,2  · Enzo Grasso 1,2  · Cristina Giannattasio 1,2 Received: 6 March 2019 / Accepted: 25 April 2019 © Italian Society of Hypertension 2019 Abstract Structural and functional arterial properties commonly impair with aging process. These efects on vasculature could act at many levels from microcirculation to large vessels. Above normal aging process classic cardio-vascular risk factors (hyperten- sion, diabetes mellitus, dyslipidemia, etc.) accelerate the physiological process leading to premature structural and functional alterations that has also been termed early vascular aging. Target organ damage evaluation could be clinically important since these alterations precede by many years’ cardiovascular events and so their assessment can predict the onset of more serious and costly events giving the opportunity to prevent CV events by earlier therapeutic intervention. This review will focus on large artery functional properties and particularly on the role of infammation on the aortic stifening process. Keywords Vascular aging · Large vessels · Infammation · Arterial stifness · Pulse wave velocity 1 Introduction Structural and functional arterial properties commonly impair with aging process [1]. These efects on vasculature are determined by many biochemical factors (such as reac- tive oxygen species and chronic infammation) that could act at many levels from microcirculation to large vessels [2]. Above normal aging process classic cardio-vascular (CV) risk factors (hypertension, diabetes mellitus, dyslipidemia, etc.) accelerate the physiological process leading to prema- ture structural and functional alterations that has also been termed early vascular aging (EVA) [3]. From a histological point of view, this process is characterized by a reduction in elastin associated with an increased collagen content that determine an increase in arterial stifness. This is one of the fundamental aspect of the atherosclerotic process since it leads to an increase in the velocity of the refected waves, that are shifted into systole, determining an elevation in central and brachial blood pressure (BP) [4]. BP elevation further increase the stretching of the arterial wall increas- ing collagen deposition leading to a vicious cycle. Beyond extracellular matrix composition change, also smooth mus- cle cells play an important role in stifening process. In fact, these cells regulate actomyosin interaction during the vaso- contraction and mediate the transduction of this mechanical process to the extracellular matrix [5]. These alterations at the vascular level (also called target organ damage—TOD) represent the link between CV risk factors and CV events and, indeed, arterial stifness have been identifed as an important determinant of CV morbidity and mortality [6–12]. TOD evaluation could be clinically important since these alterations precede by many years’ cardiovascular events and so their assessment can predict the onset of more serious and costly events giving the opportunity to prevent CV events by earlier therapeutic intervention. This review will be focused on large artery functional properties and particularly on the role of infammation on the aortic stifening process. This article is part of the topical collection on Vascular Aging and Arterial Stifness. * Cristina Giannattasio cristina.giannattasio@unimib.it; cristina.giannattasio@ospedaleniguarda.it 1 School of Medicine and Surgery, University of Milano- Bicocca, Milan, Italy 2 Cardiology 4, “A. De Gasperis” Department, Niguarda Ca Granda Hospital, Piazza Ospedale Maggiore 3, 20159 Milan, Italy