title: Effects of PDE type 5 inhibitors on left ventricular diastolic dysfunction in resistant hypertension.
abstract: Resistant hypertension (RHTN) is a multifactorial disease characterized by blood pressure (BP) levels above goal (140/90 mmHg) in spite of the concurrent use of three or more antihypertensive drugs of different classes. Moreover, it is well known that RHTN subjects have high prevalence of left ventricular diastolic dysfunction (LVDD), which leads to increased risk of heart failure progression. This review gathers data from studies evaluating the effects of phosphodiesterase-5 (PDE-5) inhibitors (administration of acute sildenafil and short-term tadalafil) on diastolic function, biochemical and hemodynamic parameters in patients with RHTN. Acute study with sildenafil treatment found that inhibition of PDE-5 improved hemodynamic parameters and diastolic relaxation. In addition, short-term study with the use of tadalafil demonstrated improvement of LVDD, cGMP and BNP-32 levels, regardless of BP reduction. No endothelial function changes were observed in the studies. The findings of acute and short-term studies revealed potential therapeutic effects of IPDE-5 drugs on LVDD in RHTN patients.
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, São Paulo, SP, Brazil.
authors.forename: Ana Paula Cabral de
authors.initials: AP
authors.lastname: Faria
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, São Paulo, SP, Brazil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Modolo
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, São Paulo, SP, Brazil.
authors.forename: Beatriz Vaz Domingues
authors.initials: BV
authors.lastname: Moreno
authors.affiliation: Faculdade de Ciências Médicas, Universidade Estadual de Campinas, São Paulo, SP, Brazil.
authors.forename: Heitor
authors.initials: H
authors.lastname: Moreno
mesh_terms: D002243:Carbolines / Q000627:therapeutic use; D003971:Diastole / Q000187:drug effects; D004351:Drug Resistance; D054144:Heart Failure, Diastolic / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008488:Medical Illustration; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use; D011687:Purines / Q000627:therapeutic use; D000068677:Sildenafil Citrate; D013449:Sulfonamides / Q000627:therapeutic use; D000068581:Tadalafil; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D002243:Carbolines; D058986:Phosphodiesterase 5 Inhibitors; D010879:Piperazines; D011687:Purines; D013449:Sulfonamides; D000068581:Tadalafil; D000068677:Sildenafil Citrate