Arterial stiffness or endothelial dysfunction as a surrogate marker of vascular risk

The understanding of the pathophysiology of atherosclerosis has advanced greatly in the past decade. Cardiovascular risk factors increase the likelihood of an adverse event by having a detrimental effect on the blood vessel wall. Abnormal interactions among cholesterol, inflammatory mediators, platelets and the vascular wall lead to atherogenesis and cardiac events. In an effort to better understand this process, develop surrogate end points for clinical trials and, ultimately, better risk stratify individuals, a variety of measures of arterial function have been studied. These include measures of endothelial health and arterial compliance. The current paper reviews the various techniques available for the study of vascular health. While not yet routinely used for clinical care, these measurements provide important insights into the pathophysiology and treatment of atherosclerosis.