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Critical appraisal of the differential effects of antihypertensive agents on arterial stiffness.
MedLine Citation:
PMID:  21949622     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Increased central arterial stiffness, involving accelerated vascular ageing of the aorta, is a powerful and independent risk factor for early mortality and provides prognostic information above and beyond traditional risk factors for cardiovascular disease (CVD). Central arterial stiffness is an important determinant of pulse pressure; therefore, any pathological increase may result in left ventricular hypertrophy and impaired coronary perfusion. Central artery stiffness can be assessed noninvasively by measurement of aortic pulse wave velocity, which is the gold standard for measurement of arterial stiffness. Earlier, it was believed that changes in arterial stiffness, which are primarily influenced by long-term pressure-dependent structural changes, may be slowed but not reversed by pharmacotherapy. Recent studies with drugs that inhibit the renin-angiotensin-aldosterone system, advanced glycation end products crosslink breakers, and endothelin antagonists suggest that blood pressure (BP)-independent reduction and reversal of arterial stiffness are feasible. We review the recent literature on the differential effect of antihypertensive agents either as monotherapy or combination therapy on arterial stiffness. Arterial stiffness is an emerging therapeutic target for CVD risk reduction; however, further clinical trials are required to confirm whether BP-independent changes in arterial stiffness directly translate to a reduction in CVD events.
Authors:
Francesca Kum; Janaka Karalliedde
Publication Detail:
Type:  Journal Article     Date:  2010-06-04
Journal Detail:
Title:  Integrated blood pressure control     Volume:  3     ISSN:  1178-7104     ISO Abbreviation:  Integr Blood Press Control     Publication Date:  2010  
Date Detail:
Created Date:  2011-09-28     Completed Date:  2011-11-10     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101562709     Medline TA:  Integr Blood Press Control     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  63-71     Citation Subset:  -    
Affiliation:
Unit for Metabolic Medicine, Cardiovascular Division, Kings College-Waterloo Campus, King's College London, United Kingdom.
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