Aortic diameter, aortic stiffness, and wave reflection increase with age and isolated systolic hypertension.

The October 2004 High Blood Pressure Research Council meeting of the American Heart Association included a debate on the proposition that “aortic diameter, aortic stiffness, and wave reflection all increase with age and in isolated systolic hypertension.” This was stimulated by a series of articles1–5 that took a contrary position to change in aortic diameter and wave reflection and placed emphasis on aortic stiffness over wave reflection with aging and isolated systolic hypertension. The purpose of this review is to summarize the conventional view that has evolved over decades6–12 but is not precisely argued in recent literature. According to this view, early wave reflection from peripheral arteries is the dominant ill effect of aging and the most logical target for therapy.12–14