Treatment of Arterial Remodeling in Essential Hypertension
Treatment of Arterial Remodeling in Essential Hypertension
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DOI：
10.1007/s11906-012-0325-0
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发表时间：
2013-02-01
影响因子：
5.6
通讯作者：
Schiffrin, Ernesto L.
中科院分区：
文献类型：
--
作者：
Briet, Marie;Schiffrin, Ernesto L.
原发性高血压与影响心血管预后的大血管和小血管重构相关。对高血压患者的纵向随访显示，大动脉硬度的降低部分独立于血压的降低，提示抗高血压治疗的特定药理作用。肾素-血管紧张素-醛固酮系统的抑制剂是已显示在更大程度上影响血管重塑的药剂之一。生活方式的改变，包括运动和减肥，也可以改善大血管和小血管的重塑。新的抗高血压药物，包括与血管紧张素受体阻滞剂相关的脑啡肽酶抑制剂，醛固酮合成酶抑制剂和新的装置，如肾脏去神经支配和压力感受器刺激，可能对血管重塑产生有益的影响，目前正在评估中。
Essential hypertension is associated with large and small vascular remodeling that impacts cardiovascular prognosis. Longitudinal follow-up of hypertensive patients has shown that large arterial stiffness decreases partly independently of blood pressure reduction, suggesting specific pharmacological effects of antihypertensive therapy. Inhibitors of the renin-angiotensin-aldosterone system are among the agents that have been shown to affect vascular remodeling to a greater degree. Lifestyle modifications, including exercise and weight reduction, also improve large and small vascular remodeling. New antihypertensive drugs, including neprilysin inhibitors associated with an angiotensin receptor blocker, aldosterone synthase inhibitors and new devices such as renal denervation and baroreceptor stimulation, may exert beneficial effects on vascular remodeling and are currently under evaluation.