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Introduction to large artery properties as a target for risk reduction by antihypertensive therapy
L M Van Bortel1, A P Hoeks, M J Kool
1Department of Pharmacology, University of Limburg, Maastricht, The Netherlands.
Insights
Certain antihypertensive drugs can improve large artery properties, reducing pulsatile stress linked to hypertension. This review examines how these medications impact vascular health and arterial stress factors.
Area of Science:
- Cardiovascular Pharmacology
- Hypertension Management
- Arterial Biomechanics
Background:
- Hypertension's mortality and morbidity correlate more strongly with systolic blood pressure, suggesting pulsatile stress is a key factor.
- Large artery properties like distensibility and compliance are crucial determinants of pulsatile stress.
- The specific role of shear stress in hypertension-related adverse effects remains unclear.
Purpose of the Study:
- To evaluate the impact of antihypertensive medications on pulsatile and shear stress.
- To assess how different drug classes affect large artery properties.
Main Methods:
- Literature review of studies on antihypertensive drugs and arterial properties.
- Analysis of drug effects on pulsatile stress determinants (distensibility, compliance).
Main Results:
- Several first-line antihypertensive drugs, including beta-blockers (with vasodilating properties), selective beta 1-blockers, angiotensin-converting enzyme inhibitors, and calcium antagonists, can improve large artery properties.
- These improvements suggest a potential alleviation of pulsatile stress.
Conclusions:
- Not all classes of antihypertensive drugs effectively improve large artery properties.
- Some antihypertensive agents can mitigate pulsatile stress by enhancing arterial distensibility and compliance.
Aim:
To review the effect of antihypertensive drugs on pulsatile stress and shear stress.
Results Of Data Review:
Mortality and morbidity in hypertension are better correlated with systolic than diastolic blood pressure, indicating a pulsatile stress effect. Distensibility and compliance are large artery properties and important determinants of pulsatile stress. beta-Blockers with vasodilating properties, several selective beta 1-blockers, angiotensin converting enzyme inhibitors and calcium antagonists are first-line antihypertensive drugs that improve these properties of large arteries. The impact of shear stress on the ill effects associated with hypertension is not clear.
Conclusion:
Some but not all classes of antihypertensive drugs can improve large artery properties, and thereby alleviate pulsatile stress.