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Novel therapeutic strategies targeting vascular endothelium in essential hypertension
Dimitris Tousoulis1, Nikolaos Papageorgiou, Emmanouil Androulakis
1Athens University Medical School, Hippokration Hospital, First Cardiology Unit, Athens, Greece. drtousoulis@hotmail.com
Insights
Essential hypertension is strongly linked to endothelial dysfunction. Novel agents show promise in improving vascular health, but further large-scale studies are needed to confirm their efficacy in treating hypertension.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Pharmacology
Background:
- Hypertension is highly prevalent globally.
- Endothelial dysfunction is closely associated with hypertension.
- Understanding this link is vital for effective treatment.
Purpose of the Study:
- To explore the pathophysiological mechanisms connecting endothelial dysfunction and hypertension.
- To evaluate therapeutic strategies targeting the vascular endothelium in essential hypertension.
Main Methods:
- Review of existing literature on essential hypertension and endothelial function.
- Analysis of classical and novel therapeutic agents.
- Focus on agents impacting endothelial dysfunction.
Main Results:
- A bidirectional relationship exists between essential hypertension and endothelial dysfunction.
- Classical antihypertensives, statins, tetrahydrobiopterin, l-arginine, antioxidants, sildenafil, and NO-related agents show benefits.
- These agents improve endothelial dysfunction in hypertensive states.
Conclusions:
- Essential hypertension and endothelial dysfunction have a significant bidirectional association.
- Novel therapeutic agents demonstrate potential for improving endothelial function in hypertension.
- More extensive research, including large-scale trials, is necessary to validate these findings.
Importance Of The Field:
Several studies have demonstrated the high prevalence of hypertension and the crucial role of the association between endothelial function and hypertension. Thus, in depth investigation of the pathophysiological mechanisms linking endothelial dysfunction and hypertension, as well as evaluation of the efficacy of therapeutic approaches targeting vascular endothelium in states of essential hypertension seems to be of great interest.
Areas Covered In This Review:
The association of essential hypertension and endothelial function are discussed in depth. In addition to the classical anti-hypertensive agents, agents such as statins, tetrahydrobiopterin, l-arginine, antioxidants, sildenafil, third generation beta blockers and NO-release related agents have been found to be beneficial by improving endothelial dysfunction in essential hypertension.
What The Reader Will Gain:
Important aspects regarding the association of hypertension and endothelial dysfunction will be highlighted. In addition, classical and novel agents especially, will be reported thoroughly according to their effects on endothelial function in hypertension.
Take Home Message:
There is a strong bidirectional association between essential hypertension and endothelial dysfunction. Moreover, novel agents appear to be beneficial and promising in improving endothelial function in states of hypertension. However, more studies are required to evaluate their role, as the literature lacks large scale studies.
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