title: Small artery remodeling in hypertension and diabetes.
abstract: The development of structural changes in the systemic vasculature is the end result of established hypertension. In essential hypertension, small artery smooth muscle cells are restructured around a smaller lumen, and there is no net growth of the vascular wall, whereas in some secondary forms of hypertension and in non-insulin-dependent diabetes mellitus, a hypertrophic remodeling may be detected. Indices of small resistance artery structure, such as the tunica media to internal lumen ratio, may have a strong prognostic significance in hypertensive patients. Various antihypertensive drugs seem to have different effects on vascular structure. A complete normalization of small resistance artery structure was demonstrated in hypertensive patients, after prolonged and effective therapy with angiotensin-converting enzyme inhibitors, angiotensin II-receptor blockers, and calcium antagonists. Few data are available in diabetic hypertensive patients; however, blockade of the renin-angiotensin system seems to be effective in this regard.
authors.affiliation: Department of Medical and Surgical Sciences, University of Brescia, c/o 2a Medicina Spedali Civili di Brescia, Piazza Spedali Civili 1, 25100 Brescia, Italy. rizzoni@med.unibs.it
authors.forename: Damiano
authors.initials: D
authors.lastname: Rizzoni
authors.forename: Enrico
authors.initials: E
authors.lastname: Agabiti Rosei
mesh_terms: D001158:Arteries / Q000473:pathology* / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000473:pathology* / Q000503:physiopathology; D018450:Disease Progression; D006801:Humans; D006973:Hypertension / Q000473:pathology* / Q000503:physiopathology; D006984:Hypertrophy; D009131:Muscle, Smooth, Vascular / Q000473:pathology / Q000503:physiopathology; D014661:Vasoconstriction / Q000502:physiology