Analysis of the impact of pharmacological treatment on arterial stiffness in patients with connective tissue diseases

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  Fig. 1. Pathophysiological process of chronic inflammation and endothelial dysfunction in connective tissue diseases and the vascular impact of immunomodulatory treatments. Connective tissue diseases (CTDs) share a common pathophysiological basis characterized by systemic chronic inflammation, which contributes to endothelial dysfunction, vascular wall remodeling, and a progressive increase in arterial stiffness. The diagram illustrates the principal immunological mechanisms implicated in the pathogenesis of each CTD examined. Surrounding the vascular schematic, immunomodulatory treatments are positioned according to their most frequent clinical use in the respective diseases. Solid black lines denote associations with arterial stiffness supported by current scientific evidence, whereas dashed lines indicate putative mechanisms of action or hypothetical effects that remain insufficiently documented. The color coding of the drug-encapsulating ovals reflects their vascular profile: green ovals identify therapies with a beneficial impact on arterial stiffness, while yellow ovals represent dual-action agents, whose vascular effects may vary depending on clinical context and treatment…