Effects of Antihypertensive Drugs on Arterial Stiffness

Dudenbostel, Tanja; Glasser, Stephen P.

doi:10.1097/crd.0b013e31825d0a44

Cited by 110 publications

(100 citation statements)

References 51 publications

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“…Furthermore, there was a greater effect on central than brachial BP, illustrating improvements in arterial stiffness 69,124 . Acute improvements in arterial stiffness, augmentation index, central and brachial BP have been observed 5 hours after administration of ramipril in patients with high cardiovascular risk 69,123 .…”

Section: Ace Inhibitors and Angiotensin II Receptor Blockersmentioning

confidence: 95%

“…Most studies of ACE inhibitors in hypertension demonstrate greater lowering of central aortic than brachial artery BP, suggesting a beneficial effect on arterial compliance 69,122 . This may in part relate to reduced oxidative stress and increased vasodilatation through inhibition of angiotensin II and increased smooth muscle relaxation 69,123 .…”

Section: Ace Inhibitors and Angiotensin II Receptor Blockersmentioning

confidence: 99%

“…This may in part relate to reduced oxidative stress and increased vasodilatation through inhibition of angiotensin II and increased smooth muscle relaxation 69,123 . In a randomized, placebocontrolled crossover study enalapril and perindopril both led to significant improvements in peripheral and central BP as well as augmentation index after 4 weeks of treatment.…”

Section: Ace Inhibitors and Angiotensin II Receptor Blockersmentioning

confidence: 99%

“…Increased PWV occurs mainly in the pre-hypertensive phase, suggesting that vascular changes may precede the onset of established hypertension 6 . Increased PWV predicts increased risk of cardiovascular morbidity and mortality in patients with hypertension, diabetes mellitus and end-stage renal 69,66 . PWV may therefore be a useful marker to identify patients in the early pre-hypertensive phase and allow lifestyle changes to be implemented, alongside blood pressure lowering medication if necessary, to prevent worsening high blood pressure and the development of hypertension.…”

mentioning

confidence: 99%

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Drug Treatment of Hypertension: Focus on Vascular Health

Cameron

Lang

Touyz

2016

Drugs

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Hypertension, the most common preventable risk factor for cardiovascular disease and death, is a growing health burden. Serious cardiovascular complications result from target organ damage including cerebrovascular disease, heart failure, ischaemic heart disease and renal failure. While many systems contribute to blood pressure elevation, the vascular system is particularly important, because vascular dysfunction is a cause and consequence of hypertension. Hypertension is characterised by a vascular phenotype of endothelial dysfunction, arterial remodelling, vascular inflammation and increased stiffness. Antihypertensive drugs that influence vascular changes associated with high blood pressure have greater efficacy for reducing cardiovascular risk than drugs that reduce blood pressure but have little or no effect on the adverse vascular phenotype. Angiotensin converting enzyme Key Points• Hypertension is characterized by a vascular phenotype of endothelial dysfunction and structural remodeling.• Anti-hypertensive drugs that target the vascular changes associated with hypertension appear to be most efficacious• New anti-hypertensive drugs should promote vascular health as well as reducing blood pressure 3

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Section: Ace Inhibitors and Angiotensin II Receptor Blockersmentioning

confidence: 95%

Section: Ace Inhibitors and Angiotensin II Receptor Blockersmentioning

confidence: 99%

Section: Ace Inhibitors and Angiotensin II Receptor Blockersmentioning

confidence: 99%

mentioning

confidence: 99%

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Drug Treatment of Hypertension: Focus on Vascular Health

Cameron

Lang

Touyz

2016

Drugs

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“…Currently available antihypertensives classes have differential effects on aortic stiffness as measured by pulse wave velocity, with beta-blockers and diuretics being less effective than angiotensin-converting enzyme inhibitor (ACE-I), calcium channel blockers, direct renin inhibitors, and aldosterone antagonists. 41 Although further work is necessary to fully elucidate the contribution of arterial stiffness to treatment Vemulapalli et al resistance, novel therapies directed at reversing arterial stiffness may hold promise in the treatment of resistant hypertension. 42 Role of the SNS in aTRH Recent animal and human studies have advanced our understanding of the role of the SNS in the pathogenesis of hypertension.…”

Section: Volume Expansionmentioning

confidence: 99%

Apparent Treatment-Resistant Hypertension and Chronic Kidney Disease: Another Cardiovascular-Renal Syndrome?

Vemulapalli

Tyson

Svetkey

2014

Advances in Chronic Kidney Disease

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To identify patients at increased risk of cardiovascular (CV) outcomes, apparent treatment-resistant hypertension (aTRH) is defined as having a blood pressure above goal despite the use of 3 or more antihypertensive therapies of different classes at maximally tolerated doses, ideally including a diuretic. Recent epidemiologic studies in selected populations estimated the prevalence of aTRH as 10% to 15% among patients with hypertension and that aTRH is associated with elevated risk of CV and renal outcomes. Additionally, aTRH and CKD are associated. Although the pathogenesis of aTRH is multifactorial, the kidney is believed to play a significant role. Increased volume expansion, aldosterone concentration, mineralocorticoid receptor activity, arterial stiffness, and sympathetic nervous system activity are central to the pathogenesis of aTRH and are targets of therapies. Although diuretics form the basis of therapy in aTRH, pathophysiologic and clinical data suggest an important role for aldosterone antagonism. Interventional techniques, such as renal denervation and carotid baroreceptor activation, modulate the sympathetic nervous system and are currently in phase III trials for the treatment of aTRH. These technologies are as yet unproven and have not been investigated in relationship to CV outcomes or in patients with CKD.

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Coronary artery disease and its impact on the pulsatile brain: A functional NIRS study

Mohammadi

Thomas

Peng

et al. 2021

Human Brain Mapping

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Recent studies have reported that optical indices of cerebral pulsatility are associated with cerebrovascular health in older adults. Such indices, including cerebral pulse amplitude and the pulse relaxation function (PRF), have been previously applied to quantify global and regional cerebral pulsatility. The aim of the present study was to determine whether these indices are modulated by cardiovascular status and whether they differ between individuals with low or high cardiovascular risk factors (LCVRF and HCVRF) and coronary artery disease (CAD). A total of 60 older adults aged 57-79 were enrolled in the study. Participants were grouped as LCVRF, HCVRF, and CAD. Participants were asked to walk freely on a gym track while a near-infrared spectroscopy (NIRS) device recorded hemodynamics data. Low-intensity, short-duration walking was used to test whether a brief cardiovascular challenge could increase the difference of pulsatility indices with respect to cardiovascular status. Results indicated that CAD individuals have higher global cerebral pulse amplitude compared with the other groups. Walking reduced global cerebral pulse amplitude and PRF in all groups but did not increase the difference across the groups. Instead, walking extended the spatial distribution of cerebral pulse amplitude to the anterior prefrontal cortex when CAD was compared to the CVRF groups. Further research is needed to determine whether cerebral pulse amplitude extracted from data acquired with NIRS, which is a noninvasive, inexpensive method, can provide an index to characterize the cerebrovascular status associated with CAD.

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Effects of Antihypertensive Drugs on Arterial Stiffness

Cited by 110 publications

References 51 publications

Drug Treatment of Hypertension: Focus on Vascular Health

Drug Treatment of Hypertension: Focus on Vascular Health

Apparent Treatment-Resistant Hypertension and Chronic Kidney Disease: Another Cardiovascular-Renal Syndrome?

Coronary artery disease and its impact on the pulsatile brain: A functional NIRS study

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