Resistance and Conduit Arteries following Converting Enzyme Inhibition in Hypertension

Safar, Michel E.; Bortel, L.M.A.B. Van; Struijker‐Boudier, Harry A.J.

doi:10.1159/000159204

Cited by 63 publications

(36 citation statements)

References 90 publications

(162 reference statements)

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“…28 Inhibition of angiotensin-converting enzyme has been shown to reduce arterial stiffness, 29 as has a low-salt diet. 30 Additionally, we have previously shown in this same population a strong relationship between obesity and larger arterial diameters and wall thickening.…”

Section: Discussionmentioning

confidence: 99%

Weight Change Is Associated With Change in Arterial Stiffness Among Healthy Young Adults

et al. 2005

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Abstract-Risk factors for arterial stiffness progression have not been well characterized. We examined the relationship between arterial stiffness progression and body weight and weight gain in a group of healthy young adults. Aortic pulse-wave velocity was assessed at 2 time points approximately 2 years apart in 152 white and black adults aged 20 to 40 years, and was standardized by the time between visits to obtain annualized pulse-wave velocity changes. Blacks had 15.5 cm/s per year larger annual pulse-wave velocity increases compared with whites (Pϭ0.02), even after multivariable adjustment for weight and blood pressure changes. Larger annual pulse-wave velocity increases were also associated with larger baseline body weight (Pϭ0.02), waist girth (Pϭ0.003), and body mass index (PϽ0.001), and greater annual weight gain (Pϭ0.02), after adjustment for baseline pulse-wave velocity. After multivariable adjustment that included blood pressure changes, larger baseline waist girth (Pϭ0.009), baseline body mass index (Pϭ0.001), body mass index increase (Pϭ0.037), and weight gain (Pϭ0.017) remained significantly associated with larger annual pulse-wave velocity progression. Weight change showed a direct relationship with pulse-wave velocity change; mean annual pulse-wave velocity changes were Ϫ29.9 cm/s per year (regression) for those with Ն4.5 kg annual weight loss and 18.2 cm/s per year (progression) for those with Ն4.5 kg annual weight gain. These data show strong associations between weight gain and arterial stiffness progression, as well as between weight loss and arterial stiffness regression. These data greatly underscore the vascular benefit of weight loss. Successful weight loss programs in young adults, particularly blacks, are needed.

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Section: Discussionmentioning

confidence: 99%

Weight Change Is Associated With Change in Arterial Stiffness Among Healthy Young Adults

et al. 2005

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“…1,2 Several arguments have suggested that the antihypertensive agents related to the renin-angiotensin system act, to a large extent, not only on arterioles but also on the large arterial wall. 3 Angiotensin II (Ang II), the main effector peptide of the reninangiotensin system has long been known to play a major role in the regulation of BP and body fluid homeostasis. Moreover, Ang II has been reported to induce hyperplasia and/or hypertrophy in cultured aortic smooth muscle cells [4][5][6][7] in small resistance arteries 8 and in cardiomyocytes.…”

Section: Introductionmentioning

confidence: 99%

The potential role of angiotensin II in the vasculature

Levy

1998

J Hum Hypertens

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Arterial hypertension is associated with marked changes in the structure of both resistance and large arteries. The renin-angiotensin system is largely involved in these alterations; chronic blockade of the renin-angiotensin system prevents and/or reverses most of the alterations of the vasculature in experimental and clinical hypertension. In this review we have analysed the differential role of AT 1 and AT 2 receptors in the response of the vessels to arterial hypertension. It emerges that the relative involvement of each receptor

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“…2,3,6 -8 In genetic models of hypertension in rats, the ACEI ϩ D combination was shown to induce a significantly more pronounced pressure-independent decrease in arterial stiffness and reduction of aortic collagen accumulation than that of each component given alone. 9,10 In middle-aged patients with hypertension, although D induces only minor changes in large artery diameter and stiffness, ACEIs and, mostly, the DϩACEI combination are able to normalize arterial stiffness and wall thickness. 10 Thus, it is relevant to evaluate whether a fixed ACEIϩD combination is a suitable therapy for selectively reducing SBP and PP by improving arterial stiffness.…”

mentioning

confidence: 99%

“…9,10 In middle-aged patients with hypertension, although D induces only minor changes in large artery diameter and stiffness, ACEIs and, mostly, the DϩACEI combination are able to normalize arterial stiffness and wall thickness. 10 Thus, it is relevant to evaluate whether a fixed ACEIϩD combination is a suitable therapy for selectively reducing SBP and PP by improving arterial stiffness.…”

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confidence: 99%

Improvement in Blood Pressure, Arterial Stiffness and Wave Reflections With a Very-Low-Dose Perindopril/Indapamide Combination in Hypertensive Patient

et al. 2001

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Abstract-International guidelines recommend that antihypertensive drug therapy should normalize not only diastolic (DBP) but also systolic blood pressure (SBP). Therapeutic trials based on cardiovascular mortality have recently shown that SBP reduction requires normalization of both large artery stiffness and wave reflections. The aim of the present study was to compare the antihypertensive effects of the very-low-dose combination indapamide (0.625 mg) and perindopril (2 mg) (Per/Ind) with the ␤-blocking agent atenolol (50 mg) to determine whether Per/Ind decreases SBP and pulse pressure (PP) more than does atenolol and, if so, whether this decrease is predominantly due to reduction of aortic pulse wave velocity (PWV) (automatic measurements) and reduction of wave reflections (pulse wave analysis, applanation tonometry). In a double-blind randomized study, 471 patients with essential hypertension were followed for 12 months. For the same DBP reduction, Per/Ind decreased brachial SBP (Ϫ6.02 mm Hg; 95% confidence interval, Ϫ8.90 to Ϫ3.14) and PP (Ϫ5.57; 95% confidence interval, Ϫ7.70 to Ϫ3.44) significantly more than did atenolol. This difference was significantly more pronounced for the carotid artery than for the brachial artery. Whereas the 2 antihypertensive agents decreased PWV to a similar degree, only Per/Ind significantly attenuated carotid wave reflections, resulting in a selective decrease in SBP and PP. The very-low-dose combination Per/Ind normalizes SBP, PP, and arterial function to a significantly larger extent than does atenolol, a hemodynamic profile that is known to improve survival in hypertensive populations with high cardiovascular risk. Key Words: antihypertensive therapy Ⅲ pulse wave velocity Ⅲ pulse pressure R ecent epidemiological studies and recommendations of hypertension guidelines 1-3 have directed attention to systolic blood pressure (SBP) as a better guide than DBP for evaluating cardiovascular risk. It has been shown that drug therapy of hypertension frequently results in an adequate control of DBP (Յ90 mm Hg), whereas the ability to control SBP (Յ140 mm Hg) is achieved less often. 4,5 Such results have focused attention on hemodynamic factors, such as large artery stiffness and wave reflections, which are important determinants of SBP and pulse pressure (PP) and are strong independent cardiovascular risk predictors in hypertensive populations. Consequently, the role of drugs or regimens that may selectively reduce SBP and PP assumes importance.Very-low-dose combinations involving an ACE inhibitor (ACEI) and a diuretic (D) may be suitable for reducing SBP and PP and, at the same time, for facilitating the compliance with long-term drug treatment. 2,3,6 -8 In genetic models of hypertension in rats, the ACEI ϩ D combination was shown to induce a significantly more pronounced pressure-independent decrease in arterial stiffness and reduction of aortic collagen accumulation than that of each component given alone. 9,10 In middle-aged patients with hypertension, although D induces only mi...

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Resistance and Conduit Arteries following Converting Enzyme Inhibition in Hypertension

Cited by 63 publications

References 90 publications

Weight Change Is Associated With Change in Arterial Stiffness Among Healthy Young Adults

Weight Change Is Associated With Change in Arterial Stiffness Among Healthy Young Adults

The potential role of angiotensin II in the vasculature

Improvement in Blood Pressure, Arterial Stiffness and Wave Reflections With a Very-Low-Dose Perindopril/Indapamide Combination in Hypertensive Patient

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