title: Vascular remodeling, macro- and microvessels: therapeutic implications.
abstract: Macrovasculature and microvasculature are deeply interrelated, since microvascular structure is not only the site of vascular resistance but probably also the origin of most of the wave reflections generating increased central systolic blood pressure. In fact, preliminary data suggest that some index of large artery stiffness is related with the media to lumen ratio of subcutaneous small resistance arteries of hypertensive patients. Microvascular structural alterations and changes in the mechanical properties of the macrovessels represent potent predictors of prognosis. Hypertension-related damage to the micro- and macrovascular system may be corrected by pharmacological agents. Among them, beta-blocking agents and diuretics have a negligible effect on microvascular structure, while renin-angiotensin system antagonists and calcium entry blockers have favorable actions, improving large artery mechanics and possibly reducing central wave reflections.
authors.affiliation: Clinica Medica, Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy. rizzoni@med.unibs.it
authors.forename: Damiano
authors.initials: D
authors.lastname: Rizzoni
authors.forename: Maria Lorenza
authors.initials: ML
authors.lastname: Muiesan
authors.forename: Enzo
authors.initials: E
authors.lastname: Porteri
authors.forename: Carolina
authors.initials: C
authors.lastname: De Ciuceis
authors.forename: Gianluca E M
authors.initials: GE
authors.lastname: Boari
authors.forename: Massimo
authors.initials: M
authors.lastname: Salvetti
authors.forename: Anna
authors.initials: A
authors.lastname: Paini
authors.forename: Enrico Agabiti
authors.initials: EA
authors.lastname: Rosei
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001808:Blood Vessels / Q000473:pathology / Q000503:physiopathology; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D014655:Vascular Resistance
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers