Hypertension (HTN) is a major risk factor for atherosclerosis. Flow-mediated vasodilation (FMD) is
an ultrasonic method used to evaluate endothelial function, which is associated with HTN and related complications.
We summarized clinical trials focusing on the effects of non-antihypertensive drugs on endothelial function,
as evaluated by FMD, in patients with HTN. Hypercholesterolemic patients with HTN who used the cholesterol-
lowering drugs HMG-CoA reductase inhibitors (statins) had improved FMD with a reduction in cholesterol
levels and no significant change in blood pressure (BP). Non-diabetic patients with HTN who used the insulinsensitizing
drug pioglitazone had improved FMD with a reduction in insulin resistance. Obese patients with HTN who
used the anti-obesity drug orlistat had improved FMD with a reduction in BP and weight, and the improvement in FMD
was correlated with weight reduction. Patients with HTN who used the selective cyclocxygenase-2 inhibitor celecoxib had
improved FMD with no significant change in BP. Hypercholesterolemic patients with HTN who used aspirin added to a
statin had improved FMD with a reduction in BP. Patients with HTN who used the advanced glycation endproduct
crosslink breaker alagebrium had improved FMD with no significant change in BP. Postmenopausal women with HTN
who used estrogen-replacement therapy had improved FMD. The possibility of improvement in FMD levels has, therefore,
been suggested with several non-antihypertensive drugs. In addition to the direct effects of antihypertensive drugs on
endothelial function, use of these non-antihypertensive drugs may give important insights into HTN management.
Keywords: Alagebrium, atherosclerosis, celecoxib, estrogen, orlistat, pioglitazone, sildenafil, statin.
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