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[Hypertension and arteriosclerosis]
A C Pessina1, P Pauletto, G P Rossi
1Cattedra di Medicina Interna, Università degli Studi di Padova.
Insights
Arterial hypertension contributes to atherosclerosis through hemodynamic changes and humoral factors. Emerging evidence highlights hyperinsulinemia and potential antiatherogenic effects of antihypertensive drugs.
Area of Science:
- Cardiovascular Medicine
- Pathophysiology
Context:
- Arterial hypertension is a primary risk factor for atherosclerosis.
- Hemodynamic factors like elevated blood pressure and turbulent flow contribute but don't fully explain the link.
- Humoral factors, including catecholamines, renin-angiotensin-aldosterone system, serotonin, endothelin, platelets, and growth factors, play significant roles.
Purpose:
- To explore the multifaceted mechanisms linking arterial hypertension to atherosclerosis.
- To investigate the role of humoral factors and hyperinsulinemia in this relationship.
- To review recent findings on the antiatherogenic potential of antihypertensive agents.
Summary:
- Hypertension accelerates atherosclerosis via elevated blood pressure, increased wave velocity, and flow turbulence.
- Humoral factors (catecholamines, RAAS, serotonin, endothelin, platelets, growth factors) are crucial.
- Hyperinsulinemia, often co-occurring with hypercholesterolemia and hypertriglyceridemia in hypertensive patients, is increasingly recognized.
Impact:
- Understanding these mechanisms can lead to targeted therapies for atherosclerosis in hypertensive individuals.
- Recent findings suggest some antihypertensive agents may possess antiatherogenic properties, slowing lesion progression.
- This research highlights the complex interplay between hypertension, metabolic factors, and cardiovascular disease progression.
Abstract:
Arterial hypertension is a major risk factor for atherosclerosis. The mechanisms involved include elevation of blood pressure, increased velocity of the sphygmic wave and increased blood flow turbulence. These hemodynamic features however do not fully explain the link between hypertension and atherosclerosis. An important role is also played by humoral factors including catecholamines, the renin-angiotensin-aldosterone system, serotonin, endothelin, platelets and endothelium-derived growth factors. Furthermore in the last few years great relevance has been attributed to hyperinsulinemia (accompanied by hypercholesterolemia and hypertriglyceridemia) that is frequently found in hypertensive subjects. Several recent reports on the antiatherogenic effect of some antihypertensive agents that could slow down the progression of atherosclerotic lesions in hypertensive subjects are promising.