Prevention of vascular remodelling in cardiovascular disease

The early detection of arterial wall transformations that may further evolve into atherosclerosis may help to identify high-risk patients among the hypertensive population and to select the most appropriate treatment. Intima-media layer thickening that affects a number of hypertensive subjects may potentially represent an indicator of accelerated atherosclerotic transformation of the vessel wall. Diagnosis and quantification of these early changes preceding plaque development should make it possible to determine whether antihypertensive treatment can restore normal wall structures in addition to normalizing the blood pressure. This article reviews some of the new approaches developed in our laboratory to assess both structure and function of conduit vessels. Preliminary data suggest that it is feasible to identify minute geometrical changes in hypertensive subjects long before major vascular lesions occur. This opens a whole new field of investigation into early arterial remodelling, a potential precursor of atherosclerosis.