Abstract
Purpose of Review: Since in hypertensive populations, concentration on peripheral blood pressure only does not achieve 100% of blood pressure-attributable risk reduction, taking into consideration other hemodynamic parameters than peripheral blood pressure could perhaps improve cardiovascular prevention. The main purpose of this review is to analyse the scientific data in favour of considering arterial stiffness parameters as interesting intermediate cardiovascular endpoints in order to optimise risk assessment and risk reduction strategies. Summary: Aortic pulse wave velocity (PWV), a marker of aortic stiffness, has been shown to be a strong independent predictor of cardiovascular morbid events, cardiovascular and all-cause mortality in numerous studies in different populations. Furthermore, it has been shown in a therapeutic trial that the lack of aortic PWV attenuation despite significant drug-induced reduction in mean blood pressure was a significant predictor of cardiovascular death in subjects with end-stage renal disease. In essential hypertension, the Reason Study has shown that, despite a similar decrease in peripheral diastolic blood pressure, different effects on central hemodynamic parameters were observed between blockade of the renin-angiotensin system and atenolol. Novel therapeutic approaches available to reduce the increase of pulse pressure and arterial stiffness with age involve converting enzyme inhibitors in association with diuretic compounds; nitrate derivatives; agents acting on collagen cross-linking; and finally spironolactone and vasopeptidase inhibitors. Conclusion: These results support the hypothesis that measurement of aortic PWV could then help, not only in risk assessment strategies but also in risk reduction strategies by monitoring arterial stiffness under different pharmacological regimens.
Keywords: arterial stiffness, antihypertensive agents, cardiovascular risk, renin-angiotensin system, nitrates, collagen crosslinking, spironolactone, vasopeptidase inhibitors
Current Pharmaceutical Design
Title: Large Artery Stiffness and Antihypertensive Agents
Volume: 11 Issue: 25
Author(s): J. Blacher, Athanase D. Protogerou and M. E. Safar
Affiliation:
Keywords: arterial stiffness, antihypertensive agents, cardiovascular risk, renin-angiotensin system, nitrates, collagen crosslinking, spironolactone, vasopeptidase inhibitors
Abstract: Purpose of Review: Since in hypertensive populations, concentration on peripheral blood pressure only does not achieve 100% of blood pressure-attributable risk reduction, taking into consideration other hemodynamic parameters than peripheral blood pressure could perhaps improve cardiovascular prevention. The main purpose of this review is to analyse the scientific data in favour of considering arterial stiffness parameters as interesting intermediate cardiovascular endpoints in order to optimise risk assessment and risk reduction strategies. Summary: Aortic pulse wave velocity (PWV), a marker of aortic stiffness, has been shown to be a strong independent predictor of cardiovascular morbid events, cardiovascular and all-cause mortality in numerous studies in different populations. Furthermore, it has been shown in a therapeutic trial that the lack of aortic PWV attenuation despite significant drug-induced reduction in mean blood pressure was a significant predictor of cardiovascular death in subjects with end-stage renal disease. In essential hypertension, the Reason Study has shown that, despite a similar decrease in peripheral diastolic blood pressure, different effects on central hemodynamic parameters were observed between blockade of the renin-angiotensin system and atenolol. Novel therapeutic approaches available to reduce the increase of pulse pressure and arterial stiffness with age involve converting enzyme inhibitors in association with diuretic compounds; nitrate derivatives; agents acting on collagen cross-linking; and finally spironolactone and vasopeptidase inhibitors. Conclusion: These results support the hypothesis that measurement of aortic PWV could then help, not only in risk assessment strategies but also in risk reduction strategies by monitoring arterial stiffness under different pharmacological regimens.
Export Options
About this article
Cite this article as:
Blacher J., Protogerou D. Athanase and Safar E. M., Large Artery Stiffness and Antihypertensive Agents, Current Pharmaceutical Design 2005; 11 (25) . https://dx.doi.org/10.2174/138161205774424654
DOI https://dx.doi.org/10.2174/138161205774424654 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Hypertensive Versus HIV-infected Patients: Who Has the Greatest Target Organ Damage? Comparison of Carotid Plaque Prevalence, Intima Media Thickness and Renal Resistive Index in the Two Groups of Patients
Current Hypertension Reviews Review of Evidence that Epidemics of Type 1 Diabetes and Type 2 Diabetes/ Metabolic Syndrome are Polar Opposite Responses to Iatrogenic Inflammation
Current Diabetes Reviews Signs and Related Mechanisms of Ethanol Hepatotoxicity
Current Drug Abuse Reviews Changes in Phenolic Compounds Profiles in Tea Extracts and the Composition of these Phenolic Compounds in Yogurt
Recent Patents on Food, Nutrition & Agriculture Molecular and Pathophysiological Mechanisms of Diabetic Retinopathy in Relation to Adhesion Molecules
Current Diabetes Reviews Modulation of Fatty Acids Oxidation in Heart Failure by Selective Pharmacological Inhibition of 3-Ketoacyl Coenzyme-A Thiolase
Current Clinical Pharmacology Impact of Oral 1,25-Dihydroxy Vitamin D (Calcitriol) Replacement Therapy on Coronary Artery Risk Factors in Type 2 Diabetic Patients
Endocrine, Metabolic & Immune Disorders - Drug Targets Is there Evidence to Support the Use of Direct Factor Xa Inhibitors in Coronary Artery Disease?
Reviews on Recent Clinical Trials Tumor Necrosis Factor: Renaissance as a Cancer Therapeutic?
Current Cancer Drug Targets Chronic Cerebral Hypoperfusion Protects Against Acute Focal Ischemia,Improves Motor Function, and Results in Vascular Remodeling
Current Neurovascular Research Current Pharmaceutical Design on Adhesive Based Transdermal Drug Delivery Systems
Current Pharmaceutical Design Comparison of the Determinants of the Health Service System and the Health Status of the People in the Greater Mekong Subregion (GMS)
Current Psychiatry Reviews Heart Failure in Acute Ischemic Stroke
Current Cardiology Reviews Current Therapeutic Approaches for Targeting Inflammation in Depression and Cardiovascular Disease
Current Drug Metabolism Antithrombotic Treatment Management in Patients with Intracerebral Hemorrhage: Reversal and Restart
Current Pharmaceutical Design Passive Smoking, Endothelial Dysfunction and Related Markers in Healthy Individuals: An Update
Current Hypertension Reviews Moving Troponin Testing into the 21st Century: Will Greater Sensitivity Be Met with Greater Sensibility?
Cardiovascular & Hematological Disorders-Drug Targets Hydrogen Sulphide: Biopharmacological Roles in the Cardiovascular System and Pharmaceutical Perspectives
Current Medicinal Chemistry Cytochrome P450 2C8 and Drug Metabolism
Current Topics in Medicinal Chemistry Chemical and Medicinal Versatility of Substituted 1,4-Dihydropyridines
Current Bioactive Compounds