Effects of antihypertensive treatment on endothelial function in postmenopausal hypertensive women. A significant role for aldosterone inhibition

Rossi, Rosario; Nuzzo, Annachiara; Iaccarino, D; Lattanzi, A; Origliani, Giorgia; Monopoli, Daniel; Modena, Maria Grazia

doi:10.1177/1470320311415134

Cited by 8 publications

(5 citation statements)

References 39 publications

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“…18 Antihypertensive therapy has been shown to improve FMD 44 with some suggestion that aldosterone inhibition may improve endothelial function beyond its BP lowering effects in postmenopausal women. 45 The prognostic significance of improved FMD was reported by Modena and colleagues. 43 In this study, hypertensive postmenopausal women whose FMD improved following treatment of clinic BP to target (<140/90mm Hg) for 6 months had a more favorable cardiovascular prognosis compared to treated hypertensive postmenopausal women whose FMD had not improved.…”

Section: Discussionmentioning

confidence: 79%

Endothelial function in postmenopausal women with nighttime systolic hypertension

et al. 2015

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Objective Hypertension becomes more prevalent in women during their postmenopausal years. Nighttime systolic blood pressure (SBP) is especially predictive of adverse cardiac events and the relationship between rising nighttime SBP and cardiovascular risk increases more rapidly in women compared to men. The reasons for the prognostic significance of nighttime SBP are not completely known, but may involve vascular endothelial dysfunction. The purpose of this study was to examine the relationship of nighttime SBP and endothelial function, assessed by brachial artery flow-mediated dilation (FMD) and to determine whether postmenopausal women with nighttime hypertension (SBP≥120 mm Hg) evidenced greater endothelial dysfunction compared to women with normal nighttime SBP. Methods One-hundred postmenopausal women (mean age: 65.8 ± 7.5 years, body mass index: 28.3 ± 4.7 kg/m2, hypertension: 47%, coronary artery disease: 51%, mean clinic BP 137 ± 17/67 ± 11 mm Hg, 34 with nighttime hypertension) underwent 24-hour ambulatory BP monitoring, actigraphy, and brachial artery FMD assessments. Results Multivariate regression models showed that higher nighttime SBP and larger baseline artery diameter were inversely related to FMD. Nighttime SBP and baseline artery diameter accounted for 23% of the variance in FMD. After adjusting for baseline artery diameter, women with nighttime hypertension had lower FMD than women with normal nighttime SBP (2.95%±0.65 vs 5.52%±0.46, p = .002). Conclusions In postmenopausal women, nighttime hypertension was associated with reduced endothelial function. Research examining the therapeutic benefits of treating nighttime hypertension on endothelial function and future cardiovascular risk in postmenopausal women is warranted.

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Section: Discussionmentioning

confidence: 79%

Endothelial function in postmenopausal women with nighttime systolic hypertension

et al. 2015

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“…In an investigation of the response rates to different drug regimens, Thoenes and colleagues found a higher use of thiazides and β blockers in women [Thoenes et al 2010]. Another study reported a greater efficacy of aldosterone antagonists in reversing endothelial dysfunction in postmenopausal women [Rossi et al 2011]. A post hoc analysis of the data obtained in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study showed less regression of electrocardiographic indices of left ventricular hypertrophy in women even after correction of cofactors such as treatment effects and blood pressure changes [Okin et al 2008].…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic and hormonal patterns of untreated essential hypertension in men and women

Ferrario

Jessup

Smith

2013

Therapeutic Advances in Cardiovascular Disease

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Background Knowledge of hemodynamic factors accounting for the development of hypertension should help to tailor therapeutic approaches and improves blood pressure control. Few data exist regarding sex differences of hemodynamic factors contributing to hypertension progression among untreated non-diabetic prehypertensive (PreHyp), Stage I and II subjects as define by the Joint National Commission-7 guidelines (JNC-7). Methods We utilized non-invasive impedance cardiography, applanation tonometry, and plasma measures of angiotensin II, angiotensin-(1-7), serum aldosterone, hs-C reactive protein, and cytokine biomarkers of inflammation to characterize the hemodynamic and hormonal profile of 100 untreated hypertensive subjects (39 females). Results Despite there being no differences between females and males in terms of office blood pressure, heart rate, and body mass index, males demonstrated lower values of pulse pressure, systemic vascular resistance, brachial artery pulse wave velocity, and augmentation index. In each of the three hypertension categories, the increased blood pressure in males was associated with significant augmentations in stroke volume and cardiac output when compared to females. Sex related hemodynamic differences were associated in females with higher plasma levels of leptin, hs-C-reactive protein, plasma angiotensin II, and serum aldosterone and no differences in the serum concentrations of cytokinins. In women but not men, hs-C reactive protein correlated with plasma concentrations of TGF-β1 and body weight, in addition, plasma TGF-β1 correlated with levels of serum VCAM-1. Conclusions The impact of sex differences in the hemodynamic factors accounting for the elevation in arterial pressure in essential hypertensive subjects has been poorly characterized or this information is not available. We suggest that this gap in knowledge may adversely influence choices of drug-treatment since our study shows for the first time significant differences in the hemodynamic and hormonal mechanisms accounting for the increased blood pressure in women compared to men.

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“…antagonists (in conjunction with routine anti-hypertensive therapy) was the only drug class independently associated with improvement in FMD after 6 months. 98 Aliskiren, a novel direct renin inhibitor, has been recently studied in humans by Virdis in a comparative study against ramipril. 99 Aliskiren produced a significantly greater reduction in augmentation index and improved the vasodilatory response to acetylcholine, however blood pressure and pulse wave velocity reduction was the same in both groups.…”

Section: The Renin-angiotensin-aldosterone Systemmentioning

confidence: 99%

Endothelial dysfunction in human essential hypertension

Mordi

Delles

et al. 2016

Journal of Hypertension

123

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Abstract:Although the endothelium has a number of important functions, the term endothelial dysfunction is commonly used to describe impairment in its vasodilatory capacity. It is increasingly recognised that this is related to hypertension, although whether it predates hypertension or is a consequence of it is still unknown. In this review we explore the mechanisms of endothelial dysfunction in hypertension, its prognostic significance and methods of pharmacological reversal. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation CONDENSED ABSTRACTEndothelial dysfunction is prevalent in hypertension and has a recognised association with the condition. In this article we review the pathophysiology of endothelial dysfunction in human hypertension, its prognostic significance and methods of pharmacological reversal. We appreciate the opportunity to revise this manuscript again and particularly would like to thank Reviewer whose constructive criticism has certainly improved the manuscript. We have addressed the minor comments suggested as attached to this letter.We are extremely grateful once again to the reviewers and the editors for their detailed critique which has undoubtedly improved the quality of the manuscript.We thank you once again for the opportunity to resubmit our manuscript and look forward to your decision. Yours sincerely Dr Ify Mordi Submission letterReviewer #2:I thank you the author for their last revision: the paper improved quite a lot! Just few points should be still addressed:We thank the reviewer for their positive appraisal of our revised manuscript -we agree that the comments provided have substantially improved the review. We agree with the reviewer that this sentence is out of place. Given the length of the review and the fact that this is covered elsewhere we have now deleted the sentence.-Please move the description of micromyography to the invasive methods as tissue biopsies are necessary.We thank the reviewer for pointing out this error. We have now moved the description of myography to the invasive methods section (page 5). We have no conflict of interest. Endothelial Dysfunction in Human Essential Hypertension Manuscript 2 ABSTRACTAlthough the endothelium has a number of important functions, the term endothelial

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Effects of antihypertensive treatment on endothelial function in postmenopausal hypertensive women. A significant role for aldosterone inhibition

Cited by 8 publications

References 39 publications

Endothelial function in postmenopausal women with nighttime systolic hypertension

Endothelial function in postmenopausal women with nighttime systolic hypertension

Hemodynamic and hormonal patterns of untreated essential hypertension in men and women

Endothelial dysfunction in human essential hypertension

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