Figure 1.

Hypothesized mechanism for cerebrovascular impairment caused by greater large artery stiffness. Top: the distension of the arterial wall dampens the pulse wave as it travels through the large arteries. When large arteries become less compliant (more stiff), as with advancing age, this dampening of pulse pressure is reduced. Middle: the highest mean blood pressure and widest pulse pressure are found in the large elastic and muscular arteries. Moving through the arterial tree, the mean blood pressure and pulse pressure are diminished to the extent that the pressure is constant (not pulsatile) in capillaries. However, with increased stiffness of the large arteries, the pulse pressure is widened throughout the arterial tree, including greater pulse pressure in small arteries, arterioles, and capillaries. Bottom: the small arteries, arterioles, and capillaries in the brain are thin-walled and do not have the structure to cope with the increased pulse pressure that results from greater large artery stiffness. This increased pulse pressure in the cerebral circulation potentially leads to cerebrovascular damage and dysfunction. Created with Biorender with permission.