Vol 9, No 6 (2005)
Other materials agreed with the Editors
Published online: 2005-12-13
The regression of vascular changes in hypertension - calcium channel blocker or angiotensin-converting enzyme inhibitor?
Danuta Czarnecka, Katarzyna Styczkiewicz
Nadciśnienie tętnicze 2005;9(6):489-498.
Vol 9, No 6 (2005)
Kontrowersje w nadciśnieniu tętniczym
Published online: 2005-12-13
Abstract
Recent advances in the understanding of vascular disease
genesis suggest that atherosclerosis and hypertension are
associated with changes in structural and functional parameters
of vascular wall. Antihypertensive treatment decreases
the rate of hypertension-related cardiovascular
events and also reduces the development of atherosclerosis.
Endothelial dysfunction is the early event that allows
penetration of lipids and inflammatory cells into the arterial
wall, contributing to the development of the atherosclerotic
lesion. Agents that restore endothelial function
have beneficial anti-atherogenic activities and can improve
cardiovascular outcomes. This has been observed with angiotensin-
converting enzyme inhibitors (ACEI) and certain
dihydropyridine-type calcium channel blockers
(CCB). Moreover, recent clinical trials have provided evidence
that these classes of drugs can remodel the arterial
smooth muscle cell membrane and inhibit the progression
of atherosclerotic disease. There is evidence that ACEI and
CCB exert an antiatherosclerotic action that is at least
partly independent of the blood pressure-decreasing effect.
An important question is whether ACEI and CCB - considered
as the most effective antihypertensive agents with
anti-atherogenic activities - affect atherosclerosis to
a similar extent. Which therapy is more effective in reducing
the progression of atherosclerotic lesions?
This article summarizes our current thinking on the role
of ACEI and CCB on atheroprotection in hypertensive
patients. There are also presented numerous trials measuring
the effects of ACEI and CCB on vascular wall characteristics
especially on the intima-media thickness regarded
as an early sign of atherosclerosis and sensitive predictor
of future cardiovascular complications.
Abstract
Recent advances in the understanding of vascular disease
genesis suggest that atherosclerosis and hypertension are
associated with changes in structural and functional parameters
of vascular wall. Antihypertensive treatment decreases
the rate of hypertension-related cardiovascular
events and also reduces the development of atherosclerosis.
Endothelial dysfunction is the early event that allows
penetration of lipids and inflammatory cells into the arterial
wall, contributing to the development of the atherosclerotic
lesion. Agents that restore endothelial function
have beneficial anti-atherogenic activities and can improve
cardiovascular outcomes. This has been observed with angiotensin-
converting enzyme inhibitors (ACEI) and certain
dihydropyridine-type calcium channel blockers
(CCB). Moreover, recent clinical trials have provided evidence
that these classes of drugs can remodel the arterial
smooth muscle cell membrane and inhibit the progression
of atherosclerotic disease. There is evidence that ACEI and
CCB exert an antiatherosclerotic action that is at least
partly independent of the blood pressure-decreasing effect.
An important question is whether ACEI and CCB - considered
as the most effective antihypertensive agents with
anti-atherogenic activities - affect atherosclerosis to
a similar extent. Which therapy is more effective in reducing
the progression of atherosclerotic lesions?
This article summarizes our current thinking on the role
of ACEI and CCB on atheroprotection in hypertensive
patients. There are also presented numerous trials measuring
the effects of ACEI and CCB on vascular wall characteristics
especially on the intima-media thickness regarded
as an early sign of atherosclerosis and sensitive predictor
of future cardiovascular complications.
Keywords
atherosclerosis; calcium channel blocker; angiotensin-converting enzyme inhibitor
Title
The regression of vascular changes in hypertension - calcium channel blocker or angiotensin-converting enzyme inhibitor?
Journal
Arterial Hypertension
Issue
Vol 9, No 6 (2005)
Article type
Other materials agreed with the Editors
Pages
489-498
Published online
2005-12-13
Page views
628
Article views/downloads
3230
Bibliographic record
Nadciśnienie tętnicze 2005;9(6):489-498.
Keywords
atherosclerosis
calcium channel blocker
angiotensin-converting enzyme inhibitor
Authors
Danuta Czarnecka
Katarzyna Styczkiewicz