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Effects of perindopril on cardiovascular remodeling
1Department of Therapeutics and Pharmacology, The Queen's University of Belfast, Belfast, Northern Ireland, UK. g.mcveigh@qub.ac.uk
Insights
Perindopril erbumine, an angiotensin-converting enzyme inhibitor, improves vascular remodeling in hypertension patients. These blood pressure-lowering effects may reduce cardiovascular risk independently of blood pressure reduction.
Area of Science:
- Cardiology
- Pharmacology
- Vascular Biology
Background:
- Hypertension management aims to lower blood pressure (BP) and mitigate associated cardiovascular risks.
- Ideal antihypertensive agents should address comorbidities and risk factors for cardiovascular morbidity and mortality.
- Vascular and myocardial remodeling are key contributors to cardiovascular risk in hypertensive individuals.
Purpose of the Study:
- To review the effects of perindopril erbumine on vascular and myocardial remodeling in hypertension.
- To assess if perindopril's beneficial effects on remodeling are independent of its BP-lowering action.
Main Methods:
- Review of studies on long-term perindopril erbumine treatment in hypertensive patients.
- Analysis of perindopril's impact on arterial compliance and media-lumen ratio.
- Evaluation of perindopril's effects on left ventricular hypertrophy and afterload.
Main Results:
- Long-term perindopril treatment improves arterial compliance and the media-lumen ratio of resistance vessels.
- These vascular improvements appear partially independent of blood pressure reduction.
- Perindopril therapy reduces or reverses left ventricular hypertrophy, decreasing afterload.
Conclusions:
- Perindopril erbumine effectively reverses hypertension-associated vascular and myocardial remodeling.
- These beneficial effects may be independent of blood pressure lowering, offering additional cardiovascular protection.
- Combining perindopril with early detection of vascular changes can improve outcomes for hypertensive patients.
Abstract:
The primary aim in the medical treatment of hypertension is to lower blood pressure (BP). A wide variety of agents have proved effective for meeting this goal. However, an ideal agent for management of hypertensive patients must also meet a number of additional criteria. It should have a significant positive impact on conditions that are likely to be associated with elevated BP and that are known risk factors for cardiovascular morbidity and mortality. This article reviews effects of the long-acting angiotensin-converting enzyme inhibitor perindopril erbumine on hypertension-associated blood vessel and myocardial remodeling known to be associated with increased cardiovascular risk. Long-term treatment with perindopril improves arterial compliance and increases the media-lumen ratio of peripheral resistance vessels. These effects appear to be at least partially independent of BP lowering. Reversal of hypertension-associated vascular remodeling with perindopril should decrease afterload and reduce or reverse left ventricular hypertrophy. Evaluation of patients who have received long-term perindopril therapy has shown this to be the case. This effect of perindopril on an important predictor of cardiovascular morbidity and mortality may also be partially independent of BP. The combination of treatment with such agents as perindopril and methods that permit early detection of vascular changes contributing to cardiovascular disease has the potential to markedly improve the prognosis for hypertensive patients and others at risk for development of cardiovascular disease.