Arterial stiffness, ageing and cardiovascular risk

Dr Barry J. McDonnell PhD

Reader in Cardiovascular Physiology, Cardiff Metropolitan University, Cardiff, UK

In many people, systolic blood pressure increases as we age, rising exponentially after the age of 55. Whilst this is true on a population level, we can see very different relationships (changes in blood pressure across age) on an individual level.

The variability in blood pressure changes associated with ageing is predominantly due to an individual’s biological age or stiffness of their arteries. We regularly see people in their 80s with an artery stiffness of a 50-year-old and normal blood pressure.

In contrast, we also see a 50-year-old presenting with the artery stiffness of an 80-year-old with high blood pressure. Therefore, it is the individual’s biological age or their artery stiffness (health) that increases their risk of high blood pressure.

The arterial system deteriorates and becomes stiffer as we age. Whilst we cannot stop time, we can influence our lifestyle through things like increased physical activity to help maintain a healthy arterial system. 

Maintaining healthy and elastic arteries has been shown to delay the rate and development of increased systolic blood pressure as people get older.

Whilst we cannot stop time, we can influence our lifestyle through things like increased physical activity to help maintain a healthy arterial system.

Impact of the aorta

We know that artery stiffness increases more rapidly after 55-60 years because the aorta (the largest and most elastic artery in our body) can no longer expand and buffer the blood ejected from the heart. This inability of the aorta to stretch repeatedly and buffer the blood flow leaving the heart increases the resistance experienced by the cardiac muscle. This excessive strain on the heart leads to the heart muscle increasing its size to deal with the increased resistance, resulting in a greater risk of future heart disease.

Furthermore, the increased aortic pressure is also transmitted as excessive pulsatile pressure downstream into delicate end organs, causing irreversible microvascular damage including stroke, dementia and kidney failure.

Thankfully, Croí, the heart and stroke charity, is currently undertaking a pilot cardiovascular prevention programme in County Mayo to address such health issues. The Croí Third Age Mayo programme message is ‘Own it’, ‘Check it’, ‘Sort it’ – targeting those over 55 years of age to be proactive with their heart health.