Combination therapy in hypertension: From effect on arterial stiffness and central haemodynamics to cardiovascular benefits☆
Measures of arterial aging have the potential to improve risk prediction beyond traditional risk scores. Such biomarkers that fulfil most, or some of the strict criteria of a surrogate end-point are aortic stiffness (IIa level of recommendation in European Guidelines and Position Papers) and central...
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| Format: | Article |
| Language: | English |
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BMC
2016-03-01
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| Series: | Artery Research |
| Subjects: | |
| Online Access: | https://www.atlantis-press.com/article/125925022/view |
| _version_ | 1818247467844501504 |
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| author | Charalambos Vlachopoulos |
| author_facet | Charalambos Vlachopoulos |
| author_sort | Charalambos Vlachopoulos |
| collection | DOAJ |
| description | Measures of arterial aging have the potential to improve risk prediction beyond traditional risk scores. Such biomarkers that fulfil most, or some of the strict criteria of a surrogate end-point are aortic stiffness (IIa level of recommendation in European Guidelines and Position Papers) and central haemodynamics (IIb level of recommendation). Early intervention towards improving aortic elastic properties acquires particular importance since evidence suggests that arterial stiffening may occur before the onset of hypertension. Part of the beneficial effects of antihypertensive treatment in risk reduction may be mediated through improvement in aortic stiffness and central haemodynamics. However, not all antihypertensive drugs affect aortic stiffness and central haemodynamics in a similar way. Angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARB) and calcium channel blockers (CCB) have beneficial effects on such parameters. Meta-analytical approaches have shown that ACE inhibitors reduce mortality in hypertension, whereas ARBs do not exhibit such a benefit. Furthermore, ACE inhibitors have been shown to reduce the risk of coronary artery disease, and CCBs to reduce the risk of stroke independently of blood pressure reduction. Combining an ACE inhibitor with a CCB has the potential to reduce cardiovascular risk (synergy at the clinical level) by reducing aortic stiffness and improving central haemodynamics (synergy at the vascular level). |
| first_indexed | 2024-12-12T15:05:10Z |
| format | Article |
| id | doaj.art-44678252ef1349dcb702412fada638bf |
| institution | Directory Open Access Journal |
| issn | 1876-4401 |
| language | English |
| last_indexed | 2024-12-12T15:05:10Z |
| publishDate | 2016-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Artery Research |
| spelling | doaj.art-44678252ef1349dcb702412fada638bf2022-12-22T00:20:45ZengBMCArtery Research1876-44012016-03-011410.1016/j.artres.2016.02.005Combination therapy in hypertension: From effect on arterial stiffness and central haemodynamics to cardiovascular benefits☆Charalambos VlachopoulosMeasures of arterial aging have the potential to improve risk prediction beyond traditional risk scores. Such biomarkers that fulfil most, or some of the strict criteria of a surrogate end-point are aortic stiffness (IIa level of recommendation in European Guidelines and Position Papers) and central haemodynamics (IIb level of recommendation). Early intervention towards improving aortic elastic properties acquires particular importance since evidence suggests that arterial stiffening may occur before the onset of hypertension. Part of the beneficial effects of antihypertensive treatment in risk reduction may be mediated through improvement in aortic stiffness and central haemodynamics. However, not all antihypertensive drugs affect aortic stiffness and central haemodynamics in a similar way. Angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARB) and calcium channel blockers (CCB) have beneficial effects on such parameters. Meta-analytical approaches have shown that ACE inhibitors reduce mortality in hypertension, whereas ARBs do not exhibit such a benefit. Furthermore, ACE inhibitors have been shown to reduce the risk of coronary artery disease, and CCBs to reduce the risk of stroke independently of blood pressure reduction. Combining an ACE inhibitor with a CCB has the potential to reduce cardiovascular risk (synergy at the clinical level) by reducing aortic stiffness and improving central haemodynamics (synergy at the vascular level).https://www.atlantis-press.com/article/125925022/viewAortic stiffnessPulse wave velocityWave reflectionsCentral haemodynamicsHypertensionAngiotensin converting enzyme inhibitors |
| spellingShingle | Charalambos Vlachopoulos Combination therapy in hypertension: From effect on arterial stiffness and central haemodynamics to cardiovascular benefits☆ Artery Research Aortic stiffness Pulse wave velocity Wave reflections Central haemodynamics Hypertension Angiotensin converting enzyme inhibitors |
| title | Combination therapy in hypertension: From effect on arterial stiffness and central haemodynamics to cardiovascular benefits☆ |
| title_full | Combination therapy in hypertension: From effect on arterial stiffness and central haemodynamics to cardiovascular benefits☆ |
| title_fullStr | Combination therapy in hypertension: From effect on arterial stiffness and central haemodynamics to cardiovascular benefits☆ |
| title_full_unstemmed | Combination therapy in hypertension: From effect on arterial stiffness and central haemodynamics to cardiovascular benefits☆ |
| title_short | Combination therapy in hypertension: From effect on arterial stiffness and central haemodynamics to cardiovascular benefits☆ |
| title_sort | combination therapy in hypertension from effect on arterial stiffness and central haemodynamics to cardiovascular benefits☆ |
| topic | Aortic stiffness Pulse wave velocity Wave reflections Central haemodynamics Hypertension Angiotensin converting enzyme inhibitors |
| url | https://www.atlantis-press.com/article/125925022/view |
| work_keys_str_mv | AT charalambosvlachopoulos combinationtherapyinhypertensionfromeffectonarterialstiffnessandcentralhaemodynamicstocardiovascularbenefits |