Document Detail


Antihypertensive agents and arterial stiffness: relevance to reducing cardiovascular risk in the chronic kidney disease patient.
MedLine Citation:
PMID:  17693754     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: Arterial stiffness is a sign of diffuse adventitial macrovascular disease. The purpose of the present review is to discuss, in patients with chronic kidney disease, the pathophysiology of increased arterial stiffness, the role of antihypertensive therapy on reduction of arterial stiffness, and the clinical ways by which the prognostication of cardiovascular disease in patients with chronic kidney disease can be refined using arterial stiffness monitoring. RECENT FINDINGS: Arterial stiffness is increased with increasing prevalence of traditional cardiovascular risk factors. In patients with chronic kidney disease some unique factors further increase the risk of arterial stiffness, and include volume overload, activation of the renin-angiotensin system, anemia, and dysregulated mineral metabolism. Arterial stiffness is increased even in patients with early-stage chronic kidney disease. Blood pressure reduction when accompanied by a reduction in arterial stiffness is associated with improved prognosis. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers can preferentially improve arterial stiffness, which may be an additional mechanism of cardiovascular protection with these agents. SUMMARY: The impact of improvement in arterial stiffness with antihypertensive agents on cardiovascular outcomes needs well designed clinical trials.
Authors:
Rajiv Agarwal
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review    
Journal Detail:
Title:  Current opinion in nephrology and hypertension     Volume:  16     ISSN:  1062-4821     ISO Abbreviation:  Curr. Opin. Nephrol. Hypertens.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-13     Completed Date:  2007-11-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9303753     Medline TA:  Curr Opin Nephrol Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  409-15     Citation Subset:  IM    
Affiliation:
Indiana University School of Medicine, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana 46202, USA. ragarwal@iupui.edu
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MeSH Terms
Descriptor/Qualifier:
Anemia / pathology
Antihypertensive Agents / pharmacology*
Arteries / drug effects,  pathology*
Cardiovascular Diseases / pathology*
Chronic Disease
Clinical Trials as Topic
Enzyme Inhibitors / pharmacology
Humans
Hypertension / drug therapy,  pathology
Inflammation / pathology
Kidney Diseases / diagnosis,  epidemiology,  pathology*
Renin-Angiotensin System
Risk Factors
Sodium Chloride / pharmacology
Grant Support
ID/Acronym/Agency:
5R01-062030//PHS HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Enzyme Inhibitors; 7647-14-5/Sodium Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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