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Effect of angiotensin II blockade on central blood pressure and arterial stiffness in subjects with hypertension.

Safar ME - Int J Nephrol Renovasc Dis (2010)

Bottom Line: The angiotensin-converting enzyme (ACE) inhibitor perindopril not only reduces mean arterial pressure but also acts specifically on pulse pressure.In hypertensive subjects, perindopril and other ACE inhibitors seem to predict more consistently the reduction of cardiovascular events, mainly of cardiac origin, than standard β-blockers alone.This effect is associated with the important biochemical finding that mechanotransductions of angiotensin and β-blockade are markedly different, acting in the former specifically on the α5β1 integrin complex and on the fibronectin ligand of arterial vessels.

View Article: PubMed Central - PubMed

Affiliation: Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Hôtel-Dieu Centre de Diagnostic et de Thérapeutique, Paris, France. michel.safar@htd.aphp.fr

No MeSH data available.


Related in: MedlinePlus

A classical and simple model for the definition of arterial stiffness and wave reflections. Top: a normal youthful arterial tree. Bottom: a stiffened arterial tree of an older person. The reflection of the pressure wave is represented by the diastolic wave in the first case (A) and by the late systolic wave in the second case (B). Coronary arteries are represented by hooks. PWV is an index of arterial stiffness and is dependent on degree of rigidity (thin line or thick line) of the arterial wall.1–4Abbreviation: PWV, pulse wave velocity.
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f3-ijnrd-3-167: A classical and simple model for the definition of arterial stiffness and wave reflections. Top: a normal youthful arterial tree. Bottom: a stiffened arterial tree of an older person. The reflection of the pressure wave is represented by the diastolic wave in the first case (A) and by the late systolic wave in the second case (B). Coronary arteries are represented by hooks. PWV is an index of arterial stiffness and is dependent on degree of rigidity (thin line or thick line) of the arterial wall.1–4Abbreviation: PWV, pulse wave velocity.

Mentions: It is widely accepted nowadays1 that the aortic BP curve represents the mathematical summation of an incident pressure wave, coming from the heart through ventricular ejection, and a reflected wave depending on a given arterial or arteriolar site characterized by three independent parameters, ie, the value of reflection coefficients, the degree of arterial stiffening, and the distance between the heart and the site of reflecting points (Figure 3). Under normal conditions, the complex interaction between these parameters is responsible for the physiologic amplification of the pressure pulse observed between central and peripheral arteries, whereas mean arterial pressure remains almost constant along the arterial tree. Under pathologic conditions, as frequently observed in elderly people, particularly those with hypertension, both increased arterial stiffening and reflection sites closer to the heart (ie, reflection sites at the level of arteriolar or arterial bifurcations) cause the backward pressure wave to return sooner (ie, during the systolic component of the aortic BP curve), resulting in a greater summation between the forward and backward waves and consequently a higher aortic pulse pressure and systolic peak.2,3 In older subjects with hypertension, such changes are responsible for a peculiar hemodynamic pattern involving a disproportionate increase of systolic BP over diastolic BP, with potentially a loss in pulse pressure amplification.


Effect of angiotensin II blockade on central blood pressure and arterial stiffness in subjects with hypertension.

Safar ME - Int J Nephrol Renovasc Dis (2010)

A classical and simple model for the definition of arterial stiffness and wave reflections. Top: a normal youthful arterial tree. Bottom: a stiffened arterial tree of an older person. The reflection of the pressure wave is represented by the diastolic wave in the first case (A) and by the late systolic wave in the second case (B). Coronary arteries are represented by hooks. PWV is an index of arterial stiffness and is dependent on degree of rigidity (thin line or thick line) of the arterial wall.1–4Abbreviation: PWV, pulse wave velocity.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3108785&req=5

f3-ijnrd-3-167: A classical and simple model for the definition of arterial stiffness and wave reflections. Top: a normal youthful arterial tree. Bottom: a stiffened arterial tree of an older person. The reflection of the pressure wave is represented by the diastolic wave in the first case (A) and by the late systolic wave in the second case (B). Coronary arteries are represented by hooks. PWV is an index of arterial stiffness and is dependent on degree of rigidity (thin line or thick line) of the arterial wall.1–4Abbreviation: PWV, pulse wave velocity.
Mentions: It is widely accepted nowadays1 that the aortic BP curve represents the mathematical summation of an incident pressure wave, coming from the heart through ventricular ejection, and a reflected wave depending on a given arterial or arteriolar site characterized by three independent parameters, ie, the value of reflection coefficients, the degree of arterial stiffening, and the distance between the heart and the site of reflecting points (Figure 3). Under normal conditions, the complex interaction between these parameters is responsible for the physiologic amplification of the pressure pulse observed between central and peripheral arteries, whereas mean arterial pressure remains almost constant along the arterial tree. Under pathologic conditions, as frequently observed in elderly people, particularly those with hypertension, both increased arterial stiffening and reflection sites closer to the heart (ie, reflection sites at the level of arteriolar or arterial bifurcations) cause the backward pressure wave to return sooner (ie, during the systolic component of the aortic BP curve), resulting in a greater summation between the forward and backward waves and consequently a higher aortic pulse pressure and systolic peak.2,3 In older subjects with hypertension, such changes are responsible for a peculiar hemodynamic pattern involving a disproportionate increase of systolic BP over diastolic BP, with potentially a loss in pulse pressure amplification.

Bottom Line: The angiotensin-converting enzyme (ACE) inhibitor perindopril not only reduces mean arterial pressure but also acts specifically on pulse pressure.In hypertensive subjects, perindopril and other ACE inhibitors seem to predict more consistently the reduction of cardiovascular events, mainly of cardiac origin, than standard β-blockers alone.This effect is associated with the important biochemical finding that mechanotransductions of angiotensin and β-blockade are markedly different, acting in the former specifically on the α5β1 integrin complex and on the fibronectin ligand of arterial vessels.

View Article: PubMed Central - PubMed

Affiliation: Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Hôtel-Dieu Centre de Diagnostic et de Thérapeutique, Paris, France. michel.safar@htd.aphp.fr

No MeSH data available.


Related in: MedlinePlus