A comparison of angiotensin-converting enzyme inhibitors, calcium antagonists, beta-blockers and diuretic agents on reactive hyperemia in patients with essential hypertension: a multicenter study

Abstract

These findings suggest that ACE inhibitors augment reactive hyperemia, an index of endothelium-dependent vasorelaxation, in patients with essential hypertension. This augmentation may be due to increases in NO.

Acute effects of renin-angiotensin system blockade on arterial function in hypertensive patients

“…8,9,[11][12][13][14]39 Recent data support that quinapril and captopril are equally efficient in modifying important surrogate end points with prognostic significance, such as left ventricular mass. 11 On the other hand, some studies have underscored that an improvement of arterial function in hypertensives may benefit prognosis, 5,7 but there are no trials to directly compare different ACEIs with regard to outcomes.…”

“…7 Drugs that block the renin-angiotensin system (RAS), such as angiotensin converting enzyme (ACE) inhibitors (ACEIs), may improve cardiovascular structure and function, [8][9][10][11][12][13] and this effect is not fully explained by the respective BP change. [8][9][10]12,14 However, different ACEIs may not confer a same degree of organoprotection, and this is perhaps due to dissimilarities in their propensity to penetrate vascular tissue and inhibit the tissue ACE. 15,16 Although the notion of a class effect of ACEIs has been proposed, this is not fully documented or universally accepted.…”

Endothelial dysfunction and hypertension in aging

“…Endothelial function is restored by appropriate interventions, including pharmacological therapy, such as renin-angiotensin system inhibitors and statins, supplementation therapy and lifestyle modifications. 11,[31][32][33][34][35] ASSESSMENT OF ENDOTHELIAL FUNCTION In experimental studies, methods for assessment of endothelial function have been established by using a ring experiment protocol, endothelial functional alteration in expression of transcriptional factors and genes and genetic ablation of endothelial NO synthase (eNOS) in animal models. 36,37 It is clinically important to estimate the degree of endothelial dysfunction.…”

“…Recently, several investigators, including us, have evaluated the effects of intra-arterial infusion of NO agonists, such as acetylcholine, methacholine and bradykinin, and intra-arterial infusion of NO antagonists on forearm blood flow using a mercury-filled Silastic strain-gauge plethysmography and the effects on coronary blood flow using a Doppler flow guide wire. [9][10][11]17,26,27,35 The responses to intraarterial infusion of vasoactive agents should be most suitable for assessing endothelial function, because the use of agonists to stimulate NO release and the use of antagonists of NO allow us to draw more specific conclusions concerning the role of basal and stimulated NO release. However, the invasive methods are time consuming and are a burden for patients.…”

“…37 In hypertensive patients also, endothelium-dependent vascular relaxation in coronary, forearm and renal arteries was found to be impaired, and endothelial dysfunction, which is involved in the development of atherosclerosis, was found to increase the risk of cardiovascular and cerebrovascular diseases. [9][10][11][12][13][14][15]27,35 As Panza et al 9 reported for the first time in 1990 that the dose-response curve obtained by acetylcholine in patients with hypertension was smaller than the curve in normal controls and that the dose-response curves obtained by sodium nitropreside were similar in the two groups, suggesting that endothelial function, but not smooth muscle function, is selectively impaired in patients with hypertension, a large number of studies have shown that hypertension is associated with endothelial dysfunction.…”