Risk Factor-induced Cardiovascular Remodeling and the Effects of Angiotensin-Converting Enzyme Inhibitors

Abstract

Cardiovascular (CV) risk factors, primarily arterial hypertension, modify the structural and functional features of the myocardium and the blood vessels, a process known as CV remodeling. Cardiac remodeling refers to changes in left ventricular (LV) geometry, such as concentric LV geometry and LV hypertrophy (LVH), an independent hallmark of CV risk. Vascular remodeling consists of structural changes of the arterial walls, such as increased intima-media thickness, arterial stiffening, and deteriorating endothelial function. CV remodeling is to a large extent a result of compensatory mechanisms, and its pathophysiology is partially mediated by the activation of the renin-angiotensin-aldosterone system and its primary effector peptide angiotensin II, which together play a key role in the progression of CV disease. Angiotensin-converting enzyme (ACE) inhibitors, a class of drugs used in the treatment of arterial hypertension, appear to be effective in controlling or even reversing CV remodeling, independently of simple blood pressure reduction. Evidence shows that ACE inhibitors counteract CV remodeling by reducing LV mass and regressing LVH, attenuating vascular atherosclerosis and improving vascular compliance. ACE inhibitors possessing a sulfhydryl moiety appear to have additional benefits in increasing nitric-oxide release and improving vascular endothelial function.

Cardiovascular changes in spontaneously hypertensive rats are improved by chronic treatment with zofenopril

“…Also zofenopril at the low dose increased the lumen to a similar extent as the antihypertensive dose. Our results agree with those of other authors that ACE inhibitors are effective in controlling and even reversing vascular remodelling, independently of their blood pressure reducing effect (Galderisi and de Divitiis, 2008).…”

Cardiovascular changes in spontaneously hypertensive rats are improved by chronic treatment with zofenopril

“…Also zofenopril at the low dose increased the lumen to a similar extent as the antihypertensive dose. Our results agree with those of other authors that ACE inhibitors are effective in controlling and even reversing vascular remodelling, independently of their blood pressure reducing effect (Galderisi and de Divitiis, 2008).…”

Short-Term Esmolol Improves Coronary Artery Remodeling in Spontaneously Hypertensive Rats through Increased Nitric Oxide Bioavailability and Superoxide Dismutase Activity

“…Our results show hypertrophic outward remodeling (associated with an increase in arterial wall mass and lumen thickness) [1] in intramyocardial arteries in 14-month-old SHR. However, esmolol produced eutrophic outward remodeling (decreases in wall thickness to inner diameter ratio), which is associated with a decrease in vascular resistance and, consequently, a decrease in arterial pressure [29].…”

Racial Differences in Arterial Stiffness and Microcirculatory Function Between Black and White Americans

“…4,7,26 Decreased NO bioavailability can lead to vascular remodeling in experimental models, affecting both large elastic arteries and smaller resistance vessels. 27–28 We and others have shown that NO contributes to the total duration of reactive hyperemia but not to peak hyperemia, and that the RHI is in part NO‐dependent. 12,29 In addition, using invasive techniques, we and others have shown that blacks have reduced NO bioactivity in forearm microcirculation 17–18 coupled with reduced smooth‐muscle vasodilator response to NO donors and thus have more generalized vascular dysfunction than whites.…”

Cardiovascular changes in spontaneously hypertensive rats are improved by chronic treatment with zofenopril

“…Also zofenopril at the low dose increased the lumen to a similar extent as the antihypertensive dose. Our results agree with those of other authors that ACE inhibitors are effective in controlling and even reversing vascular remodelling, independently of their blood pressure reducing effect (Galderisi and de Divitiis, 2008).…”

Short-Term Esmolol Improves Coronary Artery Remodeling in Spontaneously Hypertensive Rats through Increased Nitric Oxide Bioavailability and Superoxide Dismutase Activity

“…Our results show hypertrophic outward remodeling (associated with an increase in arterial wall mass and lumen thickness) [1] in intramyocardial arteries in 14-month-old SHR. However, esmolol produced eutrophic outward remodeling (decreases in wall thickness to inner diameter ratio), which is associated with a decrease in vascular resistance and, consequently, a decrease in arterial pressure [29].…”

Racial Differences in Arterial Stiffness and Microcirculatory Function Between Black and White Americans

“…4,7,26 Decreased NO bioavailability can lead to vascular remodeling in experimental models, affecting both large elastic arteries and smaller resistance vessels. 27–28 We and others have shown that NO contributes to the total duration of reactive hyperemia but not to peak hyperemia, and that the RHI is in part NO‐dependent. 12,29 In addition, using invasive techniques, we and others have shown that blacks have reduced NO bioactivity in forearm microcirculation 17–18 coupled with reduced smooth‐muscle vasodilator response to NO donors and thus have more generalized vascular dysfunction than whites.…”

Cardiovascular changes in spontaneously hypertensive rats are improved by chronic treatment with zofenopril

“…Also zofenopril at the low dose increased the lumen to a similar extent as the antihypertensive dose. Our results agree with those of other authors that ACE inhibitors are effective in controlling and even reversing vascular remodelling, independently of their blood pressure reducing effect (Galderisi and de Divitiis, 2008).…”

Short-Term Esmolol Improves Coronary Artery Remodeling in Spontaneously Hypertensive Rats through Increased Nitric Oxide Bioavailability and Superoxide Dismutase Activity

“…Our results show hypertrophic outward remodeling (associated with an increase in arterial wall mass and lumen thickness) [1] in intramyocardial arteries in 14-month-old SHR. However, esmolol produced eutrophic outward remodeling (decreases in wall thickness to inner diameter ratio), which is associated with a decrease in vascular resistance and, consequently, a decrease in arterial pressure [29].…”

Racial Differences in Arterial Stiffness and Microcirculatory Function Between Black and White Americans

“…4,7,26 Decreased NO bioavailability can lead to vascular remodeling in experimental models, affecting both large elastic arteries and smaller resistance vessels. 27–28 We and others have shown that NO contributes to the total duration of reactive hyperemia but not to peak hyperemia, and that the RHI is in part NO‐dependent. 12,29 In addition, using invasive techniques, we and others have shown that blacks have reduced NO bioactivity in forearm microcirculation 17–18 coupled with reduced smooth‐muscle vasodilator response to NO donors and thus have more generalized vascular dysfunction than whites.…”