title: In silico analysis of the anti-hypertensive drugs impact on myocardial oxygen balance.
abstract: Hypertension is a very common pathology, and its clinical treatment largely relies on different drugs. Some of these drugs exhibit specific protective functions in addition to those resulting from blood pressure reduction. In this work, we study the impact of commonly used anti-hypertensive drugs (RAAS, [Formula: see text] and calcium channel blockers) on myocardial oxygen supply-consumption balance, which plays a crucial role in type 2 myocardial infarction. To this aim, 42 wash-out hypertensive patients were selected, a number of measured data were used to set a validated multi-scale cardiovascular model to subject-specific conditions, and the administration of different drugs was suitably simulated. Our results ascribe the well-known major cardioprotective efficiency of [Formula: see text] blockers compared to other drugs to a positive change of myocardial oxygen balance due to the concomitant: (1) reduction in aortic systolic, diastolic and pulse pressures, (2) decrease in left ventricular work, diastolic cavity pressure and oxygen consumption, (3) increase in coronary flow and (4) ejection efficiency improvement. RAAS blockers share several positive outcomes with [Formula: see text] blockers, although to a reduced extent. In contrast, calcium channel blockers seem to induce some potentially negative effects on the myocardial oxygen balance.
authors.affiliation: DIATI, Politecnico di Torino, Turin, Italy. andrea.guala86@gmail.com.|Vall D'Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain. andrea.guala86@gmail.com.
authors.forename: A
authors.identifier: http://orcid.org/0000-0002-5006-8164
authors.initials: A
authors.lastname: Guala
authors.affiliation: Department of Medical Sciences, Hypertension Unit, University of Torino, Turin, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Leone
authors.affiliation: Department of Medical Sciences, Hypertension Unit, University of Torino, Turin, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Milan
authors.affiliation: DIATI, Politecnico di Torino, Turin, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Ridolfi
mesh_terms: D000959:Antihypertensive Agents / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000494:pharmacology; D003198:Computer Simulation; D006801:Humans; D006973:Hypertension; D008955:Models, Cardiovascular; D010100:Oxygen / Q000378:metabolism; D010101:Oxygen Consumption / Q000187:drug effects*
chemical_list: D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D010100:Oxygen
keywords: Anti-hypertensive drugs; Aortic pressure; Calcium channel blockers; Coronary circulation; Hypertension; Myocardial oxygen balance; RAAS blockers; blockers