Skip to main content
Download PDF

Inflammation and arterial function

Artery Research volume 1, pages 32–38 (2007)Cite this article

Summary

During the last decade, several studies have documented the unfavourable effects of inflammation on cardiovascular function and its role in the pathophysiology of atherosclerotic disease. The interplay between inflammation and arterial system is multifaceted. On the one hand, the endothelium contributes to the initiation and the perpetuation of vascular wall inflammation. On the other hand, the inflammatory cascade affects adversely the endo-thelium-dependent processes and the mechanical properties of the arteries. These effects give rise to impaired vasomotion, arterial stiffening and increased wave reflections and thus result in an unfavourable haemodynamic loading of the heart. Chronic inflammatory diseases (such as rheumatoid arthritis, and others) as well as acute inflammatory stimuli (such as acute infections) may adversely influence the arterial performance. Moreover, systemic subclinical low-grade inflammation, as expressed by high circulating levels of inflammatory markers/mediators, is a common denominator of most cardiovascular risk factors (hypertension, diabetes, etc.) and importantly, it is closely related to impaired arterial elastic properties. In addition, vasculogenic erectile dysfunction, which comprises an alternative phenotype of arterial dysfunction and an emerging cardiovascular risk predictor, is accompanied by low-grade inflammatory activation. Among the several inflammatory markers/mediators, level of C-reactive protein has been consistently associated with indices of arterial function in several populations. However, data regarding a possible direct etiological role of C-reactive protein in arterial dysfunction and atherosclerosis, if any, are yet inconclusive. Current evidence suggests that anti-inflammatory strategies benefit arterial function in several clinical settings. Further research is needed to elucidate whether inflammation may comprise a worthwhile treatment target with regard to the cardiovascular system.

References

  1. Vlachopoulos C, Aznaouridis K, Stefanadis C. Clinical appraisal of arterial stiffness: the Argonauts in front of the Golden Fleece. Heart 2006;92:1544–50.

    Google Scholar 

  2. Brunner H, Cockcroft JR, Deanfield J, Donald A, Ferrannini E, Halcox J, et al. Endothelial function and dysfunction. Part II: Association with cardiovascular risk factors and diseases. A statement by the working group on endothelins and endothelial factors of the European society of hypertension. J Hypertens 2005;23:233–46.

    Google Scholar 

  3. Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001;37:1236–41.

    Google Scholar 

  4. London GM, Blacher J, Pannier B, Guerin AP, Marchais SJ, Safar ME. Arterial wave reflections and survival in end-stage renal failure. Hypertension 2001;38:434–8.

    Google Scholar 

  5. Williams B, Lacy PS, Thom SM, Cruickshank K, Stanton A, Collier D, et al. Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study. Circulation 2006;113:1213–25.

    Google Scholar 

  6. McEniery CM, Yasmin, Hall IR, Qasem A, Wilkinson IB, Cockcroft JR, on behalf of the ACCT Investigators. Normal vascular aging: differential effects on wave reflection and aortic pulse wave velocity. The Anglo-Cardiff Collaborative Trial (ACCT). J Am Coll Cardiol 2005;46:1753–60.

    Google Scholar 

  7. Wojciechowska W, Staessen JA, Nawrot T, Cwynar M, Seidlerova J, Stolarz K, et al. Reference values in white Europeans for the arterial pulse wave recorded by means of the SphygmoCor device. Hypertens Res 2006;29:475–83.

    Google Scholar 

  8. Hansson GK. Inflammation, Atherosclerosis, and Coronary Artery Disease. N Engl J Med 2005;352:1685–95.

    Google Scholar 

  9. Wakabayashi I, Masuda H. Association of acute-phase reactants with arterial stiffness in patients with type 2 diabetes mellitus. Clin Chim Acta 2006;365:230–5.

    Google Scholar 

  10. Diamant M, Lamb HJ, van de Ree MA, Endert EL, Groeneveld Y, Bots ML, et al. The association between abdominal visceral fat and carotid stiffness is mediated by circulating inflammatory markers in uncomplicated type 2 diabetes. J Clin Endocrinol Metab 2005;90:1495–501.

    Google Scholar 

  11. Ferreira I, Henry RM, Twisk JW, van Mechelen W, Kemper HC, Stehouwer CD. The metabolic syndrome, cardiopulmonary fitness, and subcutaneous trunk fat as independent determinants of arterial stiffness. The Amsterdam growth and health longitudinal study. Arch Intern Med 2005;165:875–82.

    Google Scholar 

  12. Pirro M, Schillaci G, Savarese G, Gemelli F, Mannarino MR, Siepi D, et al. Low-grade systemic inflammation impairs arterial stiffness in newly diagnosed hypercholesterolaemia. Eur J Clin Invest 2004;34:335–41.

    Google Scholar 

  13. Pietri P, Vyssoulis G, Vlachopoulos C, Zervoudaki A, Gialernios T, Aznaouridis K, et al. Relationship between low-grade inflammation and arterial stiffness in patients with essential hypertension. J Hypertens 2006;24:2231–8.

    Google Scholar 

  14. Mahmud A, Feely J. Arterial stiffness is related to systemic inflammation in essential hypertension. Hypertension 2005;46: 1118–22.

    Google Scholar 

  15. Kampus P, Muda P, Kals J, Ristimae T, Fischer K, Teesalu R, et al. The relationship between inflammation and arterial stiffness in patients with essential hypertension. Int J Cardiol 2006;112:46–51.

    Google Scholar 

  16. Mahmud A, Feely J. Adiponectin and arterial stiffness. Am J Hypertens 2005;18:1543–8.

    Google Scholar 

  17. Vlachopoulos C, Aznaouridis K, Vyssoulis G, Zervoudaki A, Pietri P, Kyvelou SM, et al. Large-artery stiffening is associated with increased fibrinogen level in hypertensive patients. World Congress of Cardiology 2006 [abstract].

  18. Vlachopoulos C, Aznaouridis K, Ioakeimidis N, Rokkas K, Vasiliadou C, Alexopoulos N, et al. Unfavourable endothelial and inflammatory state in erectile dysfunction patients with or without coronary artery disease. Eur Heart J 2006;22: 2640–8.

    Google Scholar 

  19. Vlachopoulos C, Ioakeimidis N, Tsekoura D, Aznaouridis K, Rokkas K, Alexopoulos N, et al. Aortic stiffness and carotid intima media thickness are associated with penile doppler findings in patients with vasculogenic erectile dysfunction. AHA Scientific Sessions; 2006 [abstract].

  20. Kullo IJ, Seward JB, Bailey KR, Bielak LF, Grossardt BR, Sheedy II PF, et al. C-reactive protein is related to arterial wave reflection and stiffness in asymptomatic subjects from the community. Am J Hypertens 2005;18:1123–9.

    Google Scholar 

  21. Yasmin, McEniery CM, Wallace S, Mackenzie IS, Cockcroft JR, Wilkinson IB. C-reactive protein is associated with arterial stiffness in apparently healthy individuals. Arterioscler Thromb Vasc Biol 2004;24:969–74.

    Google Scholar 

  22. Vlachopoulos C, Aznaouridis K, Dima I, Ioakeimidis N, Vasiliadou C, Zervoudaki A, et al. Negative association between serum levels of matrix metalloproteinases-2 and -9 and aortic stiffness in healthy adults. Int J Cardiol 2007 Feb 6 [Epub ahead of print].

  23. Yasmin, Wallace S, McEniery CM, Dakham Z, Pusalkar P, Maki-Petaja K, et al. Matrix metalloproteinase-9 (MMP-9), MMP-2, and serum elastase activity are associated with systolic hypertension and arterial stiffness. Arterioscler Thromb Vasc Biol 2005;25:372–8.

    Google Scholar 

  24. Tronc F, Mallat Z, Lehoux S, Wassef M, Esposito B, Tedgui A. Role of matrix metalloproteinases in blood flow-induced arterial enlargement. Interaction with NO. Arterioscler Thromb Vasc Biol 2000;20: e120–6.

    Google Scholar 

  25. Vlachopoulos C, Aznaouridis K, Pietri P, Ioakeimidis N, Stefanadis C. White blood cell count is a marker of wave reflections and arterial stiffness in healthy individuals. Atherosclerosis 2006;187:218–9.

    Google Scholar 

  26. Volanen I, Jarvisalo MJ, Vainionpaa R, Arffman M, Kallio K, Angle S, et al. Increased aortic intima-media thickness in 11-year-old healthy children with persistent Chlamydia pneumoniae seropositivity. Arterioscler Thromb Vasc Biol 2006;26:649–55.

    Google Scholar 

  27. Roman MJ, Devereux RB, Schwartz JE, Lockshin MD, Paget SA, Davis A, et al. Arterial stiffness in chronic inflammatory diseases. Hypertension 2005;46:194–9.

    Google Scholar 

  28. Klocke R, Cockcroft JR, Taylor GJ, Hall IR, Blake DR. Arterial stiffness and central blood pressure, as determined by pulse wave analysis, in rheumatoid arthritis. Ann Rheum Dis 2003; 62: 414–8.

    Google Scholar 

  29. Datta D, Ferrell WR, Sturrock RD, Jadhav ST, Sattar N. Inflammatory suppression rapidly attenuates microvascular dysfunction in rheumatoid arthritis. Atherosclerosis 2006 Jun 22 [Epub ahead of print].

  30. Booth AD, Wallace S, McEniery CM, Yasmin, Brown J, Jayne DR, et al. Inflammation and arterial stiffness in systemic vasculitis. A modelofvascular inflammation. Arthr Rheum 2004;50:581–8.

    Google Scholar 

  31. Senzaki H, Chen C-H, Ishido H, Masutani S, Matsunaga T, Taketazu M, et al. Arterial hemodynamics in patients after Kawasaki disease. Circulation 2005;111:2119–25.

    Google Scholar 

  32. Charakida M, Donald AE, Green H, Clare Storry, Margaret Clap-son, Caslake M, et al. Early structural and functional changes of the vasculature in HIV-infected children. Impact of disease and antiretroviral therapy. Circulation 2005;112:103–9.

    Google Scholar 

  33. Protogerou A, Lekakis J, Stamatelopoulos K, Aznaouridis K, Karatzis E, Ikonomidis I, et al. Arterial wall characteristics in patients with Adamantiades-Behcet’s disease. Adv Exp Med Biol 2003;528:399–404.

    Google Scholar 

  34. Protogerou AD, Lekakis J, Ikonomidis I, Stamatelopoulos K, Aznaouridis K, KaratziS EN, et al. Pressure wave reflections, central blood pressure, and aortic stiffness in patients with Adamantiades-Behcet’s disease. A cross-sectional case-control study underlining the role of chronic corticosteroid treatment. Am J Hypertens 2006;19:660–6.

    Google Scholar 

  35. Ikonomidis I, Aznaouridis K, Protogerou A, Stamatelopoulos K, Markomihelakis N, Papamichael C, et al. Arterial wave reflections are associated with left ventricular diastolic dysfunction in Adamantiades-Behcet’s disease. J Card Fail 2006; 12: 458–63.

    Google Scholar 

  36. Smeeth L, Thomas SL, Hall AJ, Hubbard R, Farrington P, Vallance P. Risk of myocardial infarction and stroke after acute infection or vaccination. N Engl J Med 2004;351:2611–8.

    Google Scholar 

  37. Charakida M, Donald AE, Terese M, Leary S, Halcox JP, Ness A, et al. for the ALSPAC (Avon Longitudinal Study of Parents and Children) Study Team. Endothelial dysfunction in childhood infection. Circulation 2005;111:1660–5.

    Google Scholar 

  38. Hingorani AD, Cross J, Kharbanda RK, Mullen M, Bhagat K, Taylor M, et al. Acute systemic inflammation impairs endothe-lium-dependent dilatation in humans. Circulation 2000;102: 994–9.

    Google Scholar 

  39. Kharbanda RK, Walton B, Allen M, Klein N, Hingorani AD, MacAllister RJ, et al. Prevention of inflammation-induced en-dothelial dysfunction. A novel vasculo-protective action of aspirin. Circulation 2002;105:2600–4.

    Google Scholar 

  40. Clapp BR, Hirschfield GM, Storry C, Gallimore JR, Stidwill RP, Singer M, et al. Inflammation and endothelial function. Direct vascular effects of human C-reactive protein on nitric oxide bioavailability. Circulation 2005;111:1530–6.

    Google Scholar 

  41. Vlachopoulos C, Dima I, Aznaouridis K, Vasiliadou C, Ioakeimidis N, Aggeli C, et al. Acute systemic inflammation increases arterial stiffness and decreases wave reflections in healthy individuals. Circulation 2005;112:2193–200.

    Google Scholar 

  42. Wilkinson IB, Franklin SS, Cockcroft JR. Nitric oxide and the regulation of large artery stiffness. From physiology to pharmacology. Hypertension 2004;44:112–6.

    Google Scholar 

  43. McNulty M, Mahmud A, Spiers P, Feely J. Collagen type-I degradation is related to arterial stiffness in hypertensive and nor-motensive subjects. J Hum Hypertens 2006;20:867–73.

    Google Scholar 

  44. Verma S, Wang CH, Li SH, Dumont AS, Fedak PW, Badiwala MV, et al. A self-fulfilling prophecy. C-reactive protein attenuates nitric oxide production and inhibits angiogenesis. Circulation 2002;106:913–9.

    Google Scholar 

  45. Taylor KE, Giddings JC, van den Berg CW. C-reactive protein– induced in vitro endothelial cell activation is an artefact caused by azide and lipopolysaccharide. Arterioscler Thromb Vasc Biol 2005;25:1225–30.

    Google Scholar 

  46. Pepys MB, Hirschfield GM, Tennent GA, Gallimore JR, Kahan MC, Bellotti V, et al. Targeting C-reactive protein for the treatment of cardiovascular disease. Nature 2006;440: 1217–21.

    Google Scholar 

  47. Chenevard R, Hu¨rlimann D, Béchir M, Enseleit F, Spieker L, Hermann M, et al. Selective COX-2 inhibition improves endo-thelial function in coronary artery disease. Circulation 2003; 107: 405–9.

    Google Scholar 

  48. Vlachopoulos C, Bratsas A, Aznaouridis K, Ioakeimidis N, Vasiliadou C, Tousoulis D, et al. Celecoxib, a selective cycloox-ygenase-2 inhibitor prevents the inflammatory activation acutely induced by smoking. World Congress of Cardiology 2006 [abstract].

  49. Vlachopoulos C, Bratsas A, Aznaouridis K, Ioakeimidis N, Xaplanteris P, Alexopoulos N, et al. Selective cyclooxygenase-2 inhibition by celecoxib abrogates the acute smoking-induced vascular dysfunction. J Am Coll Cardiol 2006;47(Suppl. 1): 356A [abstract].

    Google Scholar 

  50. Van Doornum S, McColl G, Wicks IP. Tumour necrosis factor antagonists improve disease activity but not arterial stiffness in rheumatoid arthritis. Rheumatology (Oxford) 2005;44: 1428–32.

    Google Scholar 

  51. Maki-Petaja KM, Hall FC, Booth AD, Wallace SM, Yasmin, Bearcroft PW, et al. Rheumatoid arthritis is associated with increased aortic pulse-wave velocity, which is reduced by anti-tumor necrosis factor-a therapy. Circulation 2006;114: 1185–92.

    Google Scholar 

  52. Booth AD, Jayne DRQ, Kharbanda RK, McEniery CM, Mackenzie IS, Brown J, et al. Infliximab improves endothelial dysfunction in systemic vasculitis. A model of vascular inflammation. Circulation 2004;109:1718–23.

    Google Scholar 

  53. Van Doornum S, McColl G, Wicks IP. Atorvastatin reduces arterial stiffness in patients with rheumatoid arthritis. Ann Rheum Dis 2004;63:1571–5.

    Google Scholar 

  54. Tousoulis D, Antoniades C, Bosinakou E, Kotsopoulou M, Pitsavos C, Vlachopoulos C, et al. Effects of atorvastatin on reactive hyperemia and inflammatory process in patients with congestive heart failure. Atherosclerosis 2005;178: 359–63.

    Google Scholar 

  55. Aznaouridis K, Vlachopoulos C, Dagre A, Masoura C, Vasiliadou C, Dima I, et al. Atorvastatin abrogates the deterioration of endothelial function induced by acute inflammation in dyslipidemic patients. J Am Coll Cardiol 2007;49(Suppl. 1): 381A [abstract].

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology, Athens Medical School, Hippokration Hospital, Athens, Greece

    Konstantinos A. Aznaouridis & Christodoulos I. Stefanadis

Authors
  1. Konstantinos A. Aznaouridis
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Christodoulos I. Stefanadis
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Konstantinos A. Aznaouridis.

Additional information

Disclosure of interest: There is no conflict of interest. Source of funding: None.

Rights and permissions

This is an open access article distributed under the CC BY-NC license. https://doiorg.publicaciones.saludcastillayleon.es/creativecommons.org/licenses/by/4.0/

Reprints and permissions

About this article

Cite this article

Aznaouridis, K.A., Stefanadis, C.I. Inflammation and arterial function. Artery Res 1, 32–38 (2007). https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.artres.2007.03.005

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.artres.2007.03.005

Keywords

Artery Research

ISSN: 1876-4401

Contact us