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Antihypertensive therapy and de-stiffening of the arteries

Michel E Safar1, Piotr Jankowski

  • 1Centre de Diagnostic et de Thérapeutique, Hôtel-Dieu, 1 place du Parvis Notre-Dame, 75181 Paris Cedex 04 France. michel.safar@htd.aphp.fr

Expert Opinion on Pharmacotherapy
|October 28, 2010
PubMed

Insights

Reducing aortic stiffness and wave reflections can lower central pulse pressure, a key factor in cardiovascular risk. Pharmacologic interventions, often involving renin-angiotensin system blockers, are effective in achieving this de-stiffening therapy.

Area of Science:

  • Cardiovascular Physiology
  • Pharmacology
  • Hypertension Research

Background:

  • Pulsatile blood pressure significantly impacts cardiovascular risk.
  • Systolic blood pressure normalization is crucial for risk reduction in hypertension.
  • Central aortic pressure exceeds brachial pressure, highlighting the importance of central hemodynamics.

Purpose of the Study:

  • To review pharmacologic interventions targeting aortic stiffness and wave reflections.
  • To explore 'de-stiffening therapy' for cardiovascular risk management.

Main Methods:

  • Systematic review of scientific data on pharmacologic interventions.
  • Analysis of clinical trial protocols for arterial de-stiffening.

Main Results:

  • Most de-stiffening protocols utilize renin-angiotensin system blockers.
  • These agents are often combined with diuretics or calcium antagonists.
  • Such combinations aim to reduce arterial stiffness and wave reflections.

Conclusions:

  • Pharmacologic strategies can selectively reduce arterial stiffness and wave reflections.
  • This leads to a long-term reduction in both brachial and central pulse pressure.
  • Targeting central hemodynamics offers significant potential for cardiovascular event risk reduction.
Abstract

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