Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Typ-2-Diabetes und Adipositas Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Die Highlights vom Kongress des American College of Cardiology 2024

Im April diskutierten die Herz-Kreislauf-Spezialisten aus der ganzen Welt auf dem  Kongress des American College of Cardiology (ACC) u.a. neue Therapieansätze bei akutem Myokardinfarkt, koronarer Herzerkrankung, kardiogenem Schock oder Aortenklappenstenose. In unserem Kongress-Dossier haben wir für Sie Berichte über die „Late-Breaking Trials“ und andere wichtige Studien zusammengestellt. 
Erweiterte Suche
Anmelden
nach oben
Current Hypertension Reports
Erschienen in: Current Hypertension Reports 1/2013

01.02.2013 | Hypertension and the Kidney (RM Carey and A Mimran, Section Editors)

Treatment of Arterial Remodeling in Essential Hypertension

verfasst von: Marie Briet, Ernesto L. Schiffrin

Erschienen in: Current Hypertension Reports | Ausgabe 1/2013

Einloggen, um Zugang zu erhalten

Abstract

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.
Literatur
1.
Czernichow S, Zanchetti A, Turnbull F, Barzi F, Ninomiya T, Kengne AP, et al. The effects of blood pressure reduction and of different blood pressure-lowering regimens on major cardiovascular events according to baseline blood pressure: meta-analysis of randomized trials. J Hypertens. 2011;29(1):4–16.PubMedCrossRef
2.
Summary of the 2007 European Society of Hypertension (ESH) and European Society of Cardiology (ESC) guidelines for the management of arterial hypertension. Vasc Health Risk Manag. 2007;3(6):783–95.
3.
Rizzoni D, Porteri E, Boari GEM, De Ciuceis C, Sleiman I, Muiesan ML, et al. Prognostic significance of small-artery structure in hypertension. Circulation. 2003;108(18):2230–5.PubMedCrossRef
4.
•• Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol. 2010;55(13):1318–27. This meta-analysis showed the robustness of aortic pulse wave velocity as a marker of CV risk.PubMedCrossRef
5.
Park JB, Schiffrin EL. Small artery remodeling is the most prevalent (earliest?) form of target organ damage in mild essential hypertension. J Hypertens. 2001;19(5):921–30.PubMedCrossRef
6.
De Ciuceis C, Porteri E, Rizzoni D, Rizzardi N, Paiardi S, Boari GEM, et al. Structural alterations of subcutaneous small-resistance arteries may predict major cardiovascular events in patients with hypertension. Am J Hypertens. 2007;20(8):846–52.PubMedCrossRef
7.
Boari GEM, Rizzoni D, De Ciuceis C, Porteri E, Avanzi D, Platto C, et al. Structural alterations in subcutaneous small resistance arteries predict changes in the renal function of hypertensive patients. J Hypertens. 2010;28(9):1951–8.PubMedCrossRef
8.
Rizzoni D, Porteri E, Guelfi D, Muiesan ML, Valentini U, Cimino A, et al. Structural alterations in subcutaneous small arteries of normotensive and hypertensive patients with non-insulin-dependent diabetes mellitus. Circulation. 2001;103(9):1238–44.PubMedCrossRef
9.
Rizzoni D, Porteri E, Guefi D, Piccoli A, Castellano M, Pasini G, et al. Cellular hypertrophy in subcutaneous small arteries of patients with renovascular hypertension. Hypertension. 2000;35(4):931–5.PubMedCrossRef
10.
Rizzoni D, Porteri E, De Ciuceis C, Rodella LF, Paiardi S, Rizzardi N, et al. Hypertrophic remodeling of subcutaneous small resistance arteries in patients with Cushing’s syndrome. J Clin Endocrinol Metab. 2009;94(12):5010–8.PubMedCrossRef
11.
Schiffrin EL, Deng LY, Larochelle P. Morphology of resistance arteries and comparison of effects of vasoconstrictors in mild essential hypertensive patients. Clin Invest Med. 1993;16(3):177–86.PubMed
12.
Harazny JM, Ritt M, Baleanu D, Ott C, Heckmann J, Schlaich MP, et al. Increased wall:lumen ratio of retinal arterioles in male patients with a history of a cerebrovascular event. Hypertension. 2007;50(4):623–9.PubMedCrossRef
13.
Ritt M, Harazny JM, Ott C, Schlaich MP, Schneider MP, Michelson G, et al. Analysis of retinal arteriolar structure in never-treated patients with essential hypertension. J Hypertens. 2008;26(7):1427–34.PubMedCrossRef
14.
Ritt M, Harazny JM, Ott C, Schneider MP, Schlaich MP, Michelson G, et al. Wall-to-lumen ratio of retinal arterioles is related with urinary albumin excretion and altered vascular reactivity to infusion of the nitric oxide synthase inhibitor N-monomethyl-L-arginine. J Hypertens. 2009;27(11):2201–8.PubMedCrossRef
15.
• Rizzoni D, Porteri E, Duse S, De Ciuceis C, Rosei CA, La Boria E, et al. Relationship between media-to-lumen ratio of subcutaneous small arteries and wall-to-lumen ratio of retinal arterioles evaluated noninvasively by scanning laser Doppler flowmetry. J Hypertens. 2012;30(6):1169–75. This study validated the non invasive evaluation of media-to-lumen ratio measured by scanning laser doppler flowmetry by comparison with the gold standard method using subcutaneous arteries mounted on a wire myograph.PubMedCrossRef
16.
Laurent S, Cockcroft J, Van Bortel L, Boutouyrie P, Giannattasio C, Hayoz D, et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J. 2006;27(21):2588–605.PubMedCrossRef
17.
•• Reference Values for Arterial Stiffness C. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: ‘establishing normal and reference values’. Eur Heart J. 2010;31(19):2338–50. This multicentric clinical study involving 16867 subjects established the normal values of aortic PWV for each group of age. This is a prerequisite for the use of aortic PWV in clinical practice.
18.
Briet M, Boutouyrie P, Laurent S, London GM. Arterial stiffness and pulse pressure in CKD and ESRD. Kidney Int. 2012;82(4):388–400.PubMedCrossRef
19.
Karras A, Haymann JP, Bozec E, Metzger M, Jacquot C, Maruani G, et al. Large artery stiffening and remodeling are independently associated with all-cause mortality and cardiovascular events in chronic kidney disease. Hypertension. 2012;60(6):1451–7.PubMedCrossRef
20.
Blacher J, Guerin AP, Pannier B, Marchais SJ, Safar ME, London GM. Impact of aortic stiffness on survival in end-stage renal disease. Circulation. 1999;99(18):2434–9.PubMedCrossRef
21.
Henskens LHG, Kroon AA, van Oostenbrugge RJ, Gronenschild EHBM, Fuss-Lejeune MMJJ, Hofman PAM, et al. Increased aortic pulse wave velocity is associated with silent cerebral small-vessel disease in hypertensive patients. Hypertension. 2008;52(6):1120–6.PubMedCrossRef
22.
Poels MMF, Zaccai K, Verwoert GC, Vernooij MW, Hofman A, van der Lugt A, et al. Arterial stiffness and cerebral small vessel disease: the Rotterdam scan study. Stroke. 2012;43(10):2637–42.PubMedCrossRef
23.
Mitchell GF, van Buchem MA, Sigurdsson S, Gotal JD, Jonsdottir MK, Kjartansson O, et al. Arterial stiffness, pressure and flow pulsatility and brain structure and function: the age, gene/environment susceptibility--Reykjavik study. Brain. 2011;134(Pt 11):3398–407.PubMedCrossRef
24.
Briet M, Collin C, Karras A, Laurent S, Bozec E, Jacquot C, et al. Arterial remodeling associates with CKD progression. J Am Soc Nephrol. 2011;22(5):967–74.PubMedCrossRef
25.
Bouchi R, Babazono T, Mugishima M, Yoshida N, Nyumura I, Toya K, et al. Arterial stiffness is associated with incident albuminuria and decreased glomerular filtration rate in type 2 diabetic patients. Diabetes Care. 2011;34(12):2570–5.PubMedCrossRef
26.
Hashimoto J, Ito S. Central pulse pressure and aortic stiffness determine renal hemodynamics: pathophysiological implication for microalbuminuria in hypertension. Hypertension. 2011;58(5):839–46.PubMedCrossRef
27.
Muiesan ML, Salvetti M, Rizzoni D, Paini A, Agabiti-Rosei C, Aggiusti C et al. Pulsatile Hemodynamics and Microcirculation: Evidence for a Close Relationship in Hypertensive Patients. Hypertension. 2012.
28.
Ait-Oufella H, Collin C, Bozec E, Laloux B, Ong K-T, Dufouil C, et al. Long-term reduction in aortic stiffness: a 5.3-year follow-up in routine clinical practice. J Hypertens. 2010;28(11):2336–41.PubMedCrossRef
29.
Ong K-T, Delerme S, Pannier B, Safar ME, Benetos A, Laurent S, et al. Aortic stiffness is reduced beyond blood pressure lowering by short-term and long-term antihypertensive treatment: a meta-analysis of individual data in 294 patients. J Hypertens. 2011;29(6):1034–42.PubMedCrossRef
30.
Boutouyrie P, Lacolley P, Briet M, Regnault V, Stanton A, Laurent S, et al. Pharmacological modulation of arterial stiffness. Drugs. 2011;71(13):1689–701.PubMedCrossRef
31.
Boutouyrie P, Achouba A, Trunet P, Laurent S, Group ET. Amlodipine-valsartan combination decreases central systolic blood pressure more effectively than the amlodipine-atenolol combination: the EXPLOR study. Hypertension. 2010;55(6):1314–22.PubMedCrossRef
32.
Shahin Y, Khan JA, Chetter I. Angiotensin converting enzyme inhibitors effect on arterial stiffness and wave reflections: a meta-analysis and meta-regression of randomised controlled trials. Atherosclerosis. 2012;221(1):18–33.PubMedCrossRef
33.
Mackenzie IS, McEniery CM, Dhakam Z, Brown MJ, Cockcroft JR, Wilkinson IB. Comparison of the effects of antihypertensive agents on central blood pressure and arterial stiffness in isolated systolic hypertension. Hypertension. 2009;54(2):409–13.PubMedCrossRef
34.
Virdis A, Ghiadoni L, Qasem AA, Lorenzini G, Duranti E, Cartoni G, et al. Effect of aliskiren treatment on endothelium-dependent vasodilation and aortic stiffness in essential hypertensive patients. Eur Heart J. 2012;33(12):1530–8.PubMedCrossRef
35.
de Souza F, Muxfeldt E, Fiszman R, Salles G. Efficacy of spironolactone therapy in patients with true resistant hypertension. Hypertension. 2010;55(1):147–52.PubMedCrossRef
36.
Kass DA, Shapiro EP, Kawaguchi M, Capriotti AR, Scuteri A, De Groof RC, et al. Improved arterial compliance by a novel advanced glycation end-product crosslink breaker. Circulation. 2001;104(13):1464–70.PubMedCrossRef
37.
Rizos EC, Agouridis AP, Elisaf MS. The effect of statin therapy on arterial stiffness by measuring pulse wave velocity: a systematic review. Curr Vasc Pharmacol. 2010;8(5):638–44.PubMedCrossRef
38.
Durga J, Bots ML, Schouten EG, Grobbee DE, Kok FJ, Verhoef P. Effect of 3 y of folic acid supplementation on the progression of carotid intima-media thickness and carotid arterial stiffness in older adults. Am J Clin Nutr. 2011;93(5):941–9.PubMedCrossRef
39.
• Dengo AL, Dennis EA, Orr JS, Marinik EL, Ehrlich E, Davy BM, et al. Arterial destiffening with weight loss in overweight and obese middle-aged and older adults. Hypertension. 2010;55(4):855–61. In this small clinical study, the authors demonstrated the effect of weight loss on arterial stiffness in a pressure-independent fashion.PubMedCrossRef
40.
Guimarães GV, Ciolac EG, Carvalho VO, D’Avila VM, Bortolotto LA, Bocchi EA. Effects of continuous vs. interval exercise training on blood pressure and arterial stiffness in treated hypertension. Hypertens Res. 2010;33(6):627–32.PubMedCrossRef
41.
Vaitkevicius PV, Fleg JL, Engel JH, O’Connor FC, Wright JG, Lakatta LE, et al. Effects of age and aerobic capacity on arterial stiffness in healthy adults. Circulation. 1993;88(4 Pt 1):1456–62.PubMedCrossRef
42.
• Sanders TA, Hall WL, Maniou Z, Lewis F, Seed PT, Chowienczyk PJ. Effect of low doses of long-chain n-3 PUFAs on endothelial function and arterial stiffness: a randomized controlled trial. Am J Clin Nutr. 2011;94(4):973–80. In this interventional well-designed trial the authors were unable to show any effect of long-chain n-3 polyunsaturated fatty acids (PUFAs) on endothelial function or arterial stiffness.PubMedCrossRef
43.
Pase MP, Grima NA, Sarris J. Do long-chain n-3 fatty acids reduce arterial stiffness? A meta-analysis of randomised controlled trials. Br J Nutr. 2011;106(7):974–80.PubMedCrossRef
44.
Rehman A, Schiffrin EL. Vascular effects of antihypertensive drug therapy. Curr Hypertens Rep. 2010;12(4):226–32.PubMedCrossRef
45.
Grassi G, Seravalle G, Brambilla G, Dell’Oro R, Fattori L, Quarti-Trevano F, et al. Structural and functional alterations of subcutaneous small resistance arteries in severe human obesity. Obesity. 2010;18(1):92–8.PubMedCrossRef
46.
De Ciuceis C, Porteri E, Rizzoni D, Corbellini C, La Boria E, Boari GE, et al. Effects of weight loss on structural and functional alterations of subcutaneous small arteries in obese patients. Hypertension. 2011;58(1):29–36.PubMedCrossRef
47.
•• Laurent S, Schlaich M, Esler M. New drugs, procedures, and devices for hypertension. Lancet. 2012;380(9841):591–600. This review provides a full description of current and future drug and device development in hypertension.PubMedCrossRef
48.
Pu Q, Brassard P, Javeshghani DM, Iglarz M, Webb RL, Amiri F, Schiffrin EL. Effects of combined AT1 receptor antagonist/NEP inhibitor on vascular remodeling and cardiac fibrosis in SHRSP. J Hypertens. 2008;26(2):322–33.PubMedCrossRef
49.
Ruilope LM, Dukat A, Bohm M, Lacourcière Y, Gong J, Lefkowitz MP. Blood-pressure reduction with LCZ696, a novel dual-acting inhibitor of the angiotensin II receptor and neprilysin: a randomised, double-blind, placebo-controlled, active comparator study. Lancet. 2010;375(9722):1255–66.PubMedCrossRef
50.
Amar L, Azizi M, Menard J, Peyrard S, Watson C, Plouin PF. Aldosterone synthase inhibition with LCI699: a proof-of-concept study in patients with primary aldosteronism. Hypertension. 2010;56(5):831–8.PubMedCrossRef
51.
Laurent S, Briet M, Boutouyrie P. Arterial stiffness as surrogate end point: needed clinical trials. Hypertension. 2012;60(2):518–22.PubMedCrossRef
Metadaten
Titel
Treatment of Arterial Remodeling in Essential Hypertension
verfasst von
Marie Briet
Ernesto L. Schiffrin
Publikationsdatum
01.02.2013
Verlag
Current Science Inc.
Erschienen in
Current Hypertension Reports / Ausgabe 1/2013
Print ISSN: 1522-6417
Elektronische ISSN: 1534-3111
DOI
https://doi.org/10.1007/s11906-012-0325-0

Weitere Artikel der Ausgabe 1/2013

Current Hypertension Reports 1/2013 Zur Ausgabe

Hypertension and the Kidney (RM Carey and A Mimran, Section Editors)

The Renin Angiotensin Aldosterone System and Insulin Resistance in Humans

Hypertension and the Kidney (RM Carey and A Mimran, Section Editors)

Update on the Angiotensin AT2 Receptor

Hypertension and the Kidney (RM Carey and A Mimran, Section Editors)

Direct Activation of ENaC by Angiotensin II: Recent Advances and New Insights

Hypertension and the Kidney (RM Carey and A Mimran, Section Editors)

The “His and Hers” of the Renin-Angiotensin System

Hypertension and the Kidney (RM Carey and A Mimran, Section Editors)

Angiotensinergic Innervation of the Kidney: Present Knowledge and Its Significance

Hypertension and the Kidney (RM Carey and A Mimran, Section Editors)

Pathophysiology of Hypertension in the Absence of Nitric Oxide/Cyclic GMP Signaling

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Mehr Lebenszeit mit Abemaciclib bei fortgeschrittenem Brustkrebs?

24.05.2024 Mammakarzinom Nachrichten

In der MONARCHE-3-Studie lebten Frauen mit fortgeschrittenem Hormonrezeptor-positivem, HER2-negativem Brustkrebs länger, wenn sie zusätzlich zu einem nicht steroidalen Aromatasehemmer mit Abemaciclib behandelt wurden; allerdings verfehlte der numerische Zugewinn die statistische Signifikanz.

ADT zur Radiatio nach Prostatektomie: Wenn, dann wohl länger

24.05.2024 Prostatakarzinom Nachrichten

Welchen Nutzen es trägt, wenn die Strahlentherapie nach radikaler Prostatektomie um eine Androgendeprivation ergänzt wird, hat die RADICALS-HD-Studie untersucht. Nun liegen die Ergebnisse vor. Sie sprechen für länger dauernden Hormonentzug.

„Überwältigende“ Evidenz für Tripeltherapie beim metastasierten Prostata-Ca.

22.05.2024 Prostatakarzinom Nachrichten

Patienten mit metastasiertem hormonsensitivem Prostatakarzinom sollten nicht mehr mit einer alleinigen Androgendeprivationstherapie (ADT) behandelt werden, mahnt ein US-Team nach Sichtung der aktuellen Datenlage. Mit einer Tripeltherapie haben die Betroffenen offenbar die besten Überlebenschancen.

So sicher sind Tattoos: Neue Daten zur Risikobewertung

22.05.2024 Melanom Nachrichten

Das größte medizinische Problem bei Tattoos bleiben allergische Reaktionen. Melanome werden dadurch offensichtlich nicht gefördert, die Farbpigmente könnten aber andere Tumoren begünstigen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise