ABSTRACT
Pioneers of vascular and cardiac physiology, including the Nobel Laureate AV Hill, were well aware of the progressive stiffening of arteries with age, and the ill effects that such stiffening has on cardiac metabolism and function (Roy, 1880; Bramwell and Hill, 1922a; Bramwell and Hill, 1922b). Relevance to deterioration in physical fitness from early adulthood was acknowledged by Mackenzie (1902). Regrettably, studies on this subject lapsed in the 1920s with clinical acceptance of the cuff sphygmomanometer, perhaps on account of preoccupation with diastolic pressure, and with the emergence of the view that peripheral resistance provided a complete picture of left ventricular (LV) load (Mackenzie and Orr, 1926). Such studies have only recently been rekindled by epidemiological evidence that has confirmed the sinister implications of rising systolic blood pressure with age (see Chapter 21) (Amery et al., 1985; Nichols et al., 1985a; Rutan et al., 1986; Kannel and Belanger, 1991; SHEP, 1991; Folkow and
Svanborg, 1993; Franklin et al., 2001; Nichols and Singh, 2002; O’Rourke 2002a; Lakatta and Levy 2003a; Lakatta and Levy 2003b; O’Rourke and Hashimoto, 2007; McEniery et al., 2010b; Mitchell et al., 2010).
