Related Experiment Videos
Cardiac and vascular remodelling: effect of antihypertensive agents
J M Mallion1, J P Baguet, J P Siche
1Medècine Interne et Cardiologie, Grenoble, France.
Insights
Antihypertensive agents can reduce cardiovascular risks. Angiotensin-converting enzyme inhibitors show promise in reversing left ventricular hypertrophy, but further research is needed to confirm links to reduced mortality and vascular changes.
Area of Science:
- Cardiology
- Pharmacology
- Nephrology
Background:
- 1996 World Health Organization (WHO) guidelines emphasized evaluating target-organ lesions in mild hypertension treatment.
- Vascular and cardiac remodeling significantly impact hypertension prognosis.
- Antihypertensive agents are known to reduce morbidity and mortality in hypertensive patients.
Purpose of the Study:
- To investigate the impact of antihypertensive agents on left ventricular hypertrophy (LVH) regression.
- To determine the effect of antihypertensive agents on vascular hypertrophy, measured by intima-media thickness.
- To assess the role of angiotensin II AT1 receptor blockers in managing LVH and vascular hypertrophy.
Main Methods:
- Review of meta-analyses on antihypertensive agents and their effects on LVH.
- Evaluation of studies assessing intima-media thickness changes in response to antihypertensive therapy.
- Analysis of experimental data on angiotensin II's role in cardiac and vascular hypertrophy.
Main Results:
- Angiotensin-converting enzyme inhibitors demonstrated a significant effect on left ventricular hypertrophy regression.
- The direct correlation between drug-induced LVH regression and reduced morbidity/mortality requires further confirmation.
- The impact of antihypertensive agents on vascular hypertrophy and their role in reducing morbid events need further investigation.
Conclusions:
- While ACE inhibitors show potential for LVH regression, their impact on long-term outcomes needs validation.
- Further research is warranted to elucidate the effects of antihypertensive agents on vascular remodeling and clinical events.
- Angiotensin II AT1 receptor blockers represent a potential therapeutic avenue for hypertension-related organ damage.
Abstract:
The 1996 World Health Organization (WHO) recommendations for mild hypertension stressed the need to evaluate target-organ lesions as treatment criteria. The effects of both vascular and heart remodelling on hypertension must to be taken into account, as they adversely influence the prognosis of patients with hypertension. It was previously demonstrated that at least three classes of antihypertensive agents were able to decrease morbidity and mortality in patients with hypertension. Meta-analyses have shown that angiotensin-converting enzyme inhibitors seem to have a marked effect on regression of left ventricular hypertrophy (LVH). However, the relationship between drug-induced LVH regression and reduced morbidity and mortality remains to be confirmed. The effect of antihypertensive agents on vascular hypertrophy, as assessed by intima-media thickness, and their involvement in reducing morbid events, also have to be determined at the vascular level. As experimental data have highlighted the involvement of angiotensin II in animal models of LVH and vascular hypertrophy development, the role of angiotensin II AT1 receptor blockers should also be assessed in this indication.