**5. Conclusions**

Pulse pressure, mean arterial pressure, pulse pressure waveform and arterial wall elasticity were found to affect transmural stress and strain in pig aortas subjected to a variety of haemodynamic stresses *in vitro*. Moderate rises in mean arterial pressure across and above the physiological range gave rise to exponential increases in wall stiffness and transmural stress. Transmural stress is implicated in both atherogenesis and plaque separation. It is proposed that atherosclerosis should be seen as a disease of mechanical-inflammatory origin whereby repeated excess mechanical stress gives rise to a state of sustained inflammatory healing in the vessel wall akin to a repetition strain injury. The way in which statins impair this inflammatory response is discussed. These studies suggest that preventative and therapeutic measures should target mean arterial pressure, pulse pressure, arterial pressure waveform and emphasises the importance of maintaining arterial wall elasticity in capacitance vessels. The

*Role of Arterial Pressure, Wall Stiffness, Pulse Pressure and Waveform in Arterial Wall… DOI: http://dx.doi.org/10.5772/intechopen.100048*

possible link between mechanical transmural stress and inflammatory signalling in the vessel wall requires further evaluation. This study provides theoretical support for the central role of blood pressure management in the control of cardiovascular risk.
