Effect of nitroglycerin on peripheral large arteries in hypertension.

Simon, Alain; Levenson, Jaime; Bi, Long; Bouthier, J.; Peronneau, P.; Safar, Michel E.

doi:10.1111/j.1365-2125.1982.tb01968.x

Cited by 79 publications

(29 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…16 Finally, our confirmatory observations that GTN produces a dose-dependent reduction in PWV independently of changes in MAP may help explain why NO donors such as isosorbide dinitrate produce sustained reductions in blood pressure in subjects with hypertension. 33 Together, our observations indicate that the NO pathway may be an effective therapeutic target in the treatment of conditions associated with increased arterial stiffness, such as isolated systolic hypertension.…”

Section: Perspectivesmentioning

confidence: 62%

Nebivolol Increases Arterial Distensibility In Vivo

et al. 2004

View full text Add to dashboard Cite

Abstract-Arterial stiffness is a key determinant of cardiovascular risk in hypertensive patients. ␤-Blockers appear to be less effective than other drugs in improving outcome in hypertensive patients, and a potential explanation may be that ␤-blockers are less effective in reducing arterial stiffness. The aim of this study was to assess the direct effect of ␤-blockade on pulse wave velocity (PWV), a robust measure of arterial distensibility, using a local, ovine, hind-limb model. In addition, we hypothesized that the vasodilating ␤-blocker nebivolol, but not atenolol, would increase arterial distensibility in vivo. All studies were conducted in anesthetized sheep. PWV was recorded in vivo using a dual pressure-sensing catheter placed in the common iliac artery. Intraarterial infusion of nebivolol reduced PWV by 6Ϯ3% at the higher dose (PϽ0.001), but did not alter mean arterial pressure (change of Ϫ1Ϯ3 mm Hg, Pϭ0.1). In contrast, atenolol had no effect on PWV (Pϭ0.11) despite a small drop in mean pressure (change of Ϫ5Ϯ3 mm Hg, PϽ0.01). Infusion of glyceryl trinitrate led to a dose-dependent fall in PWV, and 2 nmol/min produced a similar reduction in PWV to the higher dose of nebivolol (500 nmol/min). The effect of nebivolol on PWV was significantly attenuated during coinfusion of N G -monomethyl-L-arginine (Pϭ0.003) and also during coinfusion of butoxamine (Pϭ0.02). These results demonstrate that nebivolol, but not atenolol, increases arterial distensibility. This effect of nebivolol is mediated through the release of NO via a ␤ 2 adrenoceptor-dependent mechanism. Thus, nebivolol may be of benefit in conditions of increased large artery stiffness, such as isolated systolic hypertension. Key Words: blood pressure Ⅲ nitric oxide Ⅲ arteries Ⅲ hemodynamics Ⅲ receptors, adrenergic ␤ A rterial stiffness is an important independent predictor of mortality in a number of patient populations, including hypertensive patients. 1-4 Therefore, a better understanding of the structural and functional factors regulating large artery stiffness may lead to the development of specific therapies to reduce cardiovascular risk. Although the use of ␤-blockers in the treatment of hypertension is widespread, the precise effect of these agents on arterial stiffness is controversial. [5][6][7][8][9][10][11] This is partly because concomitant reductions in mean arterial pressure (MAP) also lead to a decrease in stiffness, making interpretation of any direct effects of ␤-blockers on the large arteries more difficult.Nebivolol is a relatively new vasodilating highly-selective ␤ 1 adrenoceptor antagonist. It differs from conventional nonvasodilating ␤-blockers, such as atenolol, in that it stimulates NO production, which leads to vasodilatation. Indeed, we have shown previously that nebivolol, but not atenolol, causes vasodilatation in the human forearm vascular bed and that this effect can be blocked by inhibitors of NO synthase. 12 More recently, we 13 and others 14 have shown that NO is an important regulator of arterial distensibility. The...

show abstract

Section: Perspectivesmentioning

confidence: 62%

Nebivolol Increases Arterial Distensibility In Vivo

et al. 2004

View full text Add to dashboard Cite

show abstract

“…12,14,35 Nitrates may actively increase arterial compliance by a reduction in the vascular smooth muscle tone of large arteries. In comparison to other vasoactive drugs, nitrates are additionally capable of a reduction in reflected pressure waves 10,14,15,36 and therefore could offer further advantages in the treatment of ISH.…”

Section: Discussionmentioning

confidence: 99%

Treatment of elderly patients with isolated systolic hypertension with isosorbide dinitrate in an asymmetric dosing schedule

Starmans-Kool

Kleinjans²,

Lustermans

et al. 1998

J Hum Hypertens

View full text Add to dashboard Cite

Nitrates decrease pulse pressure more than mean arterial pressure (MAP) and are advocated for the treatment of isolated systolic hypertension (ISH). Nitrates show drug tolerance during chronic treatment so an asymmetric dosing regimen may prevent loss of effect of nitrates. This study investigates the anti-hypertensive effect of isosorbide dinitrate (ISDN) given in a twice daily asymmetric dosing regimen in elderly patients with ISH.After a 6-week placebo run-in period, patients entered the double-blind study. Ten patients received placebo and 11 patients ISDN 20 mg b.i.d. for 8 weeks. This dose could be doubled once. Office systolic and diastolic blood pressures (SBP/DBP) and ambulatory BP were measured. Pulse pressure was calculated as SBP-DBP.Office pulse pressure was more reduced during ISDN

show abstract

“…Sodium excess and b-blocking agents may increase SBP through increase in arterial stiffness and disturbed wave reflections, whereas nitrates and angiotensin-converting enzyme inhibitors (ACEI) have an opposite effect. 12,[16][17][18] Third, stenoses of renal artery are relatively frequent in subjects with PAD and favour the presence of systolic-diastolic hypertension. 19 Finally, clinical studies have shown that increased arterial stiffness and disturbed wave reflections are not only frequent in subjects with PAD but also are significantly associated with reduced walking distance and impaired vasodilating arteriolar properties.…”

Section: Discussionmentioning

confidence: 99%

Peripheral arterial disease and isolated systolic hypertension: The ATTEST Study

Priollet²,

Luizy

et al. 2008

J Hum Hypertens

View full text Add to dashboard Cite

Hypertension is a risk factor for cardiovascular (CV) diseases, either coronary artery disease (CAD), peripheral artery disease (PAD) or cerebrovascular disease (CVD). The relationships between those different localizations of CV disease and the haemodynamic features of hypertension have been poorly evaluated in the past. In the ATTEST study, a geographically representative panel of 3020 general practitioners recruited 8316 consecutive patients with CV diseases (PAD, CAD or CVD, alone or in association). Blood pressure, which was not an inclusion criterion, was then measured and related to the different forms of CV diseases. Blood pressure classification involved 20% normotensive subjects, 24% subjects with controlled hypertension, 42% subjects with isolated systolic hypertension and 14% subjects with systolic-diastolic hypertension, all hypertensives with or without antihypertensive therapy. From multiple regression analysis, it appeared that subjects with systolic hypertension were characterized by the presence of PAD, with little or no presence of CAD and/or CVD. Subjects with systolic-diastolic hypertension were characterized by the presence of CAD and/or CVD, but without PAD. Although the former was only influenced by age, dyslipidaemia and diabetes mellitus influenced the latter. This study confirms the high prevalence of hypertension (80%) in a large population of patients with CV diseases selected in primary care. Analysis of different features of hypertension revealed that isolated systolic hypertension was the most prevalent form of hypertension in this treated population. Finally, one of the predominant goals of secondary prevention in subjects with PAD should be the treatment of isolated systolic hypertension.

show abstract

Effect of nitroglycerin on peripheral large arteries in hypertension.

Cited by 79 publications

References 12 publications

Nebivolol Increases Arterial Distensibility In Vivo

Nebivolol Increases Arterial Distensibility In Vivo

Treatment of elderly patients with isolated systolic hypertension with isosorbide dinitrate in an asymmetric dosing schedule

Peripheral arterial disease and isolated systolic hypertension: The ATTEST Study

Contact Info

Product

Resources

About