Coronary reserve and arteriolosclerosis in hypertensive heart disease.
Hypertensive heart disease leads to left ventricular hypertrophy, structural and functional alterations of the myocardium, and to wall thickening and sclerosis of intramural coronary arteries and arterioles, called arteriolosclerosis, that increase myocardial stiffness and cause diastolic dysfunction right from the beginning. Especially, increased content of collagen in the periarteriolar region contributes to impaired coronary reserve that predisposes to myocardial ischemia even in the absence of coronary artery disease and may be an important factor for diastolic and finally systolic dysfunction. Antihypertensive therapy should additionally aim at inducing repair of myocardial and vascular structure.
Schwartzkopff
B
B
Medical Clinic and Policlinic B, University of Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
Strauer
B E
BE
D000818:Animals; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D001160:Arterioles / Q000473:pathology / Q000503:physiopathology; D001341:Autonomic Nervous System / Q000502:physiology; D001794:Blood Pressure; D002986:Clinical Trials as Topic; D003326:Coronary Circulation; D006321:Heart / Q000187:drug effects / Q000503:physiopathology; D006331:Heart Diseases / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D008833:Microcirculation / Q000502:physiology; D009206:Myocardium / Q000378:metabolism; D010100:Oxygen / Q000378:metabolism; D051381:Rats; D012598:Sclerosis; D013997:Time Factors; D014655:Vascular Resistance / Q000502:physiology; D014664:Vasodilation
D000959:Antihypertensive Agents; D010100:Oxygen