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The effects of antihypertensive therapy on haemostatic parameters

E S Ganotakis1, J A Papadakis, G E Vrentzos

  • 1Department of Internal Medicine, University of Crete, Greece.

Current Pharmaceutical Design
|October 8, 2003
PubMed

Insights

Antihypertensive drugs offer vascular benefits beyond blood pressure reduction. This review explores their effects on the endothelium, platelets, and coagulation, suggesting these mechanisms contribute to their therapeutic actions.

Area of Science:

  • Cardiovascular Pharmacology
  • Vascular Biology
  • Hemostasis

Background:

  • Antihypertensive medications significantly reduce vascular events and target organ damage.
  • Some observed benefits of these drugs appear independent of blood pressure (BP) reduction.
  • Clinical efficacy varies among antihypertensive agents in specific situations.

Purpose of the Study:

  • To review the multifaceted effects of antihypertensive drugs beyond BP lowering.
  • To explore the impact of these drugs on the endothelium, platelets, fibrinolysis, and coagulation.
  • To investigate potential BP-independent mechanisms of action for antihypertensive therapies.

Main Methods:

  • Literature review of trial-based evidence and pharmacological studies.
  • Analysis of drug effects on endothelial function, including nitric oxide (NO) and angiotensin II pathways.
  • Examination of drug interactions with platelet activity, fibrinolysis, and coagulation systems.

Main Results:

  • Antihypertensive drugs exhibit diverse effects on vascular endothelium, influencing NO and angiotensin II signaling.
  • Many agents can inhibit platelet activity, though clinical significance alongside antiplatelet therapy requires further study.
  • These drugs modulate fibrinolysis and coagulation, potentially via mechanisms like altered insulin sensitivity.

Conclusions:

  • The pleiotropic effects of antihypertensive drugs on vascular and hemostatic systems warrant greater recognition.
  • BP-independent actions may contribute significantly to the overall therapeutic benefits of these medications.
  • Further investigation into the hemostatic actions of antihypertensive drugs is crucial for optimizing cardiovascular risk management.

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