The link between large artery aging and cerebral small vessel disease

Heterogeneity of the arterial system: When we were students of medicine, we learned that the fundamental law of static fluid dynamics is a variant of Ohm’s law: where the determinants of blood pressure (P) are peripheral resistance (R) and cardiac output (Q). For decades we have based our conceptualization of blood pressure therapy and prevention of cardiovascular (CV) events in terms of peripheral resistance and cardiac output [1]. According to Ohm’s Law, arterial properties between the center (heart) and the periphery (tissue) are not taken into account. In other terms, central elastic arteries play only the passive role of conduit tubes, delivering the blood from the center to the periphery. The microcirculation, in contrast, i.e., the peripheral arterial district whose diameter is around 300 μm and characterized by high resistance, governs a steady blood flow [2].