Role of Antihypertensive Drugs in Arterial ‘De-Stiffening’ and Central Pulsatile Hemodynamics

Abstract

Arterial stiffness is an independent predictor of cardiovascular (CV) morbidity and mortality in patients with hypertension, as well as a potential therapeutic target. There is increasing awareness that the pulsatile hemodynamics (central blood pressure [CBP], pulse pressure [PP], wave reflections [augmentation index or AIx] and pulse wave velocity [PWV]) may provide better insight into the pathophysiology of CV disorders and target organ damage related to hypertension. Different antihypertensive drugs produce diverse effects on arterial stiffness variables, despite similar effects on peripheral (brachial) blood pressure. Identifying the pharmacologic interventions that can improve arterial stiffness ('de-stiffening' treatment) is a promising field of research.

Pulse wave analysis and diabetes mellitus. A systematic review

“…Arterial stiffness is an independent predictor of CV morbidity and mortality in patients with hypertension, as well as a potential therapeutic target 69 . A large number of studies reports the association between hypertension and arterial stiffness (SBP, PP, AIx and PWV) (ref.…”

“…Their common features are likely arterial dilating capacity and the ability to reduce pressure wave reflections, such as expressed by the augmentation index 69 . These topics are extensively discussed in other reviews and exceed the focus of this article.…”

The Drugs Used for Panic Disorders May Affect the Circadian Variation in Blood Pressure Measurements and Autonomic System

“…There are recent studies about the relationship between the BP and the autonomic nervous system. 2,3 In the present study, 1 the authors concluded that the patients with PD who received treatment previously had significantly higher nighttime diastolic BP than those who did not receive treatment. However, the drugs used by the patients with PD were not reported by Alici et al 1 Therefore, it would be useful to specify which drugs were used because some drugs like antidepressants and b-blockers may affect the circadian variation in BP measurements and autonomic system.…”

Can We Tackle with Vascular Calcification and Arterial Stiffness in Patients with Chronic Kidney Disease?

“…Therefore, the probable beneficial effect of several antihypertensive and other agents, known to affect arterial function, on markers of arterial stiffness has been investigated [32]. Antihypertensive drugs, particularly renin-angiotensin-aldosterone system inhibitors, were shown to exert favourable effects on arterial stiffness and central blood pressure indices [33]. A study in end-stage CKD patients demonstrated that the absence of pulse wave velocity decrease in response to blood pressure decrease was an independent predictor of all-cause and cardiovascular mortality.…”