Vascular Ageing Flashcards
What is vascular ageing, simply?
How your blood vessels change as you age = structure and function
When does vascular damage typically start?
40s
What happens to people with many risk factors for vascular ageing?
Premature vascular ageing
Give examples of risk factors for vascular ageing
Modifiable v non-modifiable risk factors
Obesity, diabetes, drugs for cancer, gender
Lifestyle factors = smoking, blood pressure, inactivity, poor diet, stress, lack of sleep
Broadly define cardiovascular disease (CVD)
Stroke, coronary artery disease (CAD), heart failure and cardiac arrest
What are non-modifiable risk factores for CVD?
Chronological age
Gender
Medical history of CVD or diabetes
Family history of CVD or diabetes
What can vascular dysfunction indicate?
Advancing age and may be a precursor to the development of clinical CVDs
What is the microcirculation?
Circulation of blood in the smallest blood vessels (capillaries)
What other diseases does the structural and functional alteration of the microcirculation contribute to?
Vascular cognitive impairment
Alzheimer’s
Sarcopenia a musculoskeletal disease
Kidney and eye disease
Structure of the aterial layers
Tunica intima = endothelium, subendothelial layer and CT basement memrbane
Tunica media = smooth muscle and elastic fibres
Tunica externa = collagen and vasa vasorum
What produces collagen?
Fibroblasts are developmentally programmed to produce collagen matrix, which is the main structural component of connective tissue.
Difference between arteries and veins?
Veins have a larger lumen, thinner layer of smooth muscle and valves
What is the vasa vasorum?
Blood vessels of the blood vessels = small capillaries bringing nutrients to the blood vessels
What else is found in the tunica adventitia?***
Nerve fibers and lymphtic vessels
What is the structure of capillaries?
Only endothelium and basement membrane
No smooth muscle cells covering these vessel = no contraction
What are the functions of endothelial cells?
Semi-permeable membrane = tight junctions allow transport of molecules from blood to tissue
Regulate thrombosis, thrombolysis and platelet adherence = release of factors
Influence vascular tone and blood flow
Regulate immune and inflammatory reactions
Regualte growth of other cell types (SMCs)
Name the two types of SMCs
Dedifferentiated (synthetic) SMCs
Differentiated (contractile) SMCs
What is the relationship between the synthetic and contractile SMCs?***
SMCs found in different states in blood vessels
What are the features of the dedifferentiated SMC?
Proliferating and migrating cells
Non-contractile
Secretory = synthesize extracellular matrix
Rhomboid shape
How do dedifferentiated/synthetic SMCs affect arterial wall?
Can cause thickening because they can proliferate
Can move from one layer to another from tunica media to intima
What are the features of the differentiated SMC?
Non-proliferating and non-migrating
Contractile
Focal adhesions and integrin receptors connect contractile fibres to ECM
Spindle shape
Why are they called synthetic SMCs?***
Because they release factors for making EMC
Most arteries carry oxygenated blood, which don’t?
Umbilical and pulmonary arteries
They carry deoxygenated blood to placenta and lungs, respectively
What are the 3 different artery categories, give examples?
Elastic arteries = aorta, carotid, common illiac
ac as pressure reservoirs
Muscular arteries = radial, splenic, femoral
Distal to elastic arteies = deliver blood to body organs
Arterioles = found all over the body
Control flow into capillary beds via vasodilation and vasoconstriction
What function and morphological characteristics of arteries alter with age? ***
Increased size of large arteries
Blunted angiogenesis
Loss of vascular density
Diminished endothelial glycocalyx
Two specific age-associated arterial phenotypes?
Endothelial dysfunction
Arterial stiffening of large elastic arteries
What is disrupted in a dysfunctional endothelium?
Loss of homeostasis between oxidants/antioxidants, vasodilators/vasoconstrictors, pro-/anti-inflammatory molecules and pro-/anti-thrombotic signals
What is age-related dysfunction of vascular endothelium defined as?
Impairment in flow- or vasodilation
and/or
Reduction in endothelium-derived vasodilator = NO and oxidative stress
Young v Old endothelial cells***
In ageing ECs, reduced eNOS expression
Increased iNOS, means NO produced in response to oxidative stress
Excess NO reacts with ROS to form peroxynitrite (ONOO-)
This causes more damage in the cell and makes it dysfunctional
What causes arterial stiffness?
Depends on structural elements within the wall = smooth muscle cells, elastin and collagen
What structural and functional changes occur in arterial stiffening?
Endothelial function is impaired
Vascular media is thickened
Tunica adventia ECM undergoes remodelling = increased collagen deposition, reduced elastin content, and increased pro-inflammatory cells
What is vascular fibrosis?
Vascular fibrosis is the excessive buildup of extracellular matrix components, such as collagen, in the blood vessel walls. It typically results from chronic inflammation, injury, or high blood pressure.
This fibrosis stiffens the vessels, impairing their function, reducing elasticity, and contributing to vascular diseases like atherosclerosis and hypertension.
What happens to elastin with age?
Progressive fraying and fragmentation of elastin with age
Can elastin be degraded?
Some immune cells can degrade elastin = macrophages and neutrophils
SMCs can produce proteases that degrade elastin
What happens when elastin decreases?
We are born with a certain amount of elastin = not synthesized that much
Fibroblasts compensate by making more collagen
What effect does rigid arteries have on our body?***
Increased speed at which the pressure wave moves through the system