Antihypertensive agents and arterial stiffness: Relevance to reducing cardiovascular risk in the chronic kidney disease patient

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Abstract

PURPOSE OF REVIEW: Arterial stiffness is a sign of diffuse adventitial macrovascular disease. The purpose of the present review is to discuss, in patients with chronic kidney disease, the pathophysiology of increased arterial stiffness, the role of antihypertensive therapy on reduction of arterial stiffness, and the clinical ways by which the prognostication of cardiovascular disease in patients with chronic kidney disease can be refined using arterial stiffness monitoring. RECENT FINDINGS: Arterial stiffness is increased with increasing prevalence of traditional cardiovascular risk factors. In patients with chronic kidney disease some unique factors further increase the risk of arterial stiffness, and include volume overload, activation of the renin-angiotensin system, anemia, and dysregulated mineral metabolism. Arterial stiffness is increased even in patients with early-stage chronic kidney disease. Blood pressure reduction when accompanied by a reduction in arterial stiffness is associated with improved prognosis. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers can preferentially improve arterial stiffness, which may be an additional mechanism of cardiovascular protection with these agents. SUMMARY: The impact of improvement in arterial stiffness with antihypertensive agents on cardiovascular outcomes needs well designed clinical trials.

Original languageEnglish
Pages (from-to)409-415
Number of pages7
JournalCurrent Opinion in Nephrology and Hypertension
Volume16
Issue number5
DOIs
StatePublished - Sep 2007

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Vascular Stiffness
Chronic Renal Insufficiency
Antihypertensive Agents
Adventitia
Angiotensin Receptor Antagonists
Renin-Angiotensin System
Angiotensin-Converting Enzyme Inhibitors
Minerals
Anemia
Cardiovascular Diseases
Clinical Trials
Blood Pressure

Keywords

  • Ageing
  • Arterial stiffness
  • Central pressure
  • Chronic kidney disease
  • Endothelial dysfunction
  • Pulse wave velocity

ASJC Scopus subject areas

  • Nephrology
  • Internal Medicine

Cite this

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abstract = "PURPOSE OF REVIEW: Arterial stiffness is a sign of diffuse adventitial macrovascular disease. The purpose of the present review is to discuss, in patients with chronic kidney disease, the pathophysiology of increased arterial stiffness, the role of antihypertensive therapy on reduction of arterial stiffness, and the clinical ways by which the prognostication of cardiovascular disease in patients with chronic kidney disease can be refined using arterial stiffness monitoring. RECENT FINDINGS: Arterial stiffness is increased with increasing prevalence of traditional cardiovascular risk factors. In patients with chronic kidney disease some unique factors further increase the risk of arterial stiffness, and include volume overload, activation of the renin-angiotensin system, anemia, and dysregulated mineral metabolism. Arterial stiffness is increased even in patients with early-stage chronic kidney disease. Blood pressure reduction when accompanied by a reduction in arterial stiffness is associated with improved prognosis. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers can preferentially improve arterial stiffness, which may be an additional mechanism of cardiovascular protection with these agents. SUMMARY: The impact of improvement in arterial stiffness with antihypertensive agents on cardiovascular outcomes needs well designed clinical trials.",
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KW - Ageing

KW - Arterial stiffness

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KW - Endothelial dysfunction

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