Antihypertensive therapy and de-stiffening of the arteries.
BACKGROUND
There is no doubt as to the existence of a significant relationship between the pulsatile blood pressure component and cardiovascular risk. In hypertensive subjects, cardiovascular event risk reduction is mainly associated with the normalization of systolic blood pressure. Systolic blood pressure and pulse pressure in the ascending aorta exceeds brachial systolic and pulse pressure significantly.


METHODS
The aim was to provide a review of the scientific data on pharmacologic interventions leading to reduction in aortic stiffness and/or wave reflections (de-stiffening therapy).


RESULTS
Most of the protocols used in clinical trials to de-stiffen arteries (i.e., to influence wave reflections and/or arterial wall stiffness) required the administration of agents blocking renin-angiotensin system, which was frequently combined with a diuretic or a calcium antagonist.


CONCLUSIONS
It is possible to obtain a selective and long-term reduction of brachial and - even more importantly - central pulse pressure by decreasing arterial stiffness and/or wave reflections.
Centre de Diagnostic et de Thérapeutique, Hôtel-Dieu, 1 place du Parvis Notre-Dame, 75181 Paris Cedex 04 France. michel.safar@htd.aphp.fr
Michel E
ME
Safar
Piotr
P
Jankowski
D000818:Animals; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001011:Aorta / Q000503:physiopathology; D001794:Blood Pressure / Q000187:drug effects; D001916:Brachial Artery / Q000473:pathology; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D004548:Elasticity; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D012084:Renin-Angiotensin System / Q000187:drug effects
D000959:Antihypertensive Agents