Book ChapterDOI
Decreasing Arterial Stiffness and/or Wave Reflections Independently of Mean Arterial Pressure: Effect of Non-antihypertensive Drugs (Part 2)
Hélène Beaussier,Stéphane Laurent,Pierre Boutouyrie +2 more
- pp 475-485
TLDR
Mechanistic pharmacological studies are required to demonstrate that novel pharmacological classes have true “de-stiffening” properties, and further reduction of aortic stiffness would require arterial structural changes, including reduction in collagen density and rearrangement of the wall materials.Abstract:
Change in arterial stiffness with drugs is a major end point in clinical trials, although evidence for arterial stiffness as a therapeutic target still needs to be confirmed. Drugs which affect arterial stiffness include antihypertensive drugs, mostly blockers of the renin–angiotensin–aldosterone system. Other drugs will be addressed in Chap. 40. Whether the reduction in arterial stiffness after antihypertensive treatment is only due to the blood pressure (BP) lowering which unloads the stiff components of the arterial wall such as collagen, or additional BP-independent effects are involved, has been largely debated. Currently, an increasing body of evidence, including theoretical aspects of arterial mechanics, long-term observational studies in humans and recent meta-analyses of double-blind, randomized, controlled trials, suggests that only part of aortic stiffness could be reduced through the normalization of BP by pharmacological treatment, and further reduction of aortic stiffness would require arterial structural changes, including reduction in collagen density and rearrangement of the wall materials. Mechanistic pharmacological studies are required to demonstrate that novel pharmacological classes have true “de-stiffening” properties.read more
References
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Journal ArticleDOI
Expert consensus document on arterial stiffness: methodological issues and clinical applications
Stéphane Laurent,John R. Cockcroft,Luc M. Van Bortel,Pierre Boutouyrie,Cristina Giannattasio,Daniel Hayoz,Bruno Pannier,Charalambos Vlachopoulos,Ian B. Wilkinson,Harry A.J. Struijker-Boudier +9 more
TL;DR: This paper summarizes the proceedings of several meetings of the European Network for Non-invasive Investigation of Large Arteries and is aimed at providing an updated and practical overview of the most relevant methodological aspects and clinical applications in this area.
Journal Article
Expert consensus document on arterial stiffness : methodological issues and clinical applications. Commentary
Michael F. O'Rourke,Stanley S. Franklin,Stéphane Laurent,John R. Cockcroft,Luc M. Van Bortel,Pierre Boutouyrie,Cristina Giannattasio,Daniel Hayoz,Bruno Pannier,Charalambos Vlachopoulos,Ian B. Wilkinson,Harry A.J. Struijker-Boudier +11 more
TL;DR: In this paper, the authors summarized the proceedings of several meetings of the European Network for Non-invasive Investigation of Large Arteries and aimed at providing an updated and practical overview of the most relevant methodological aspects and clinical applications in this area.
Journal ArticleDOI
Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis.
TL;DR: Aortic stiffness expressed as aortic PWV is a strong predictor of future CV events and all-cause mortality and the predictive ability of arterial stiffness is higher in subjects with a higher baseline CV risk.
Journal ArticleDOI
Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study.
Bryan Williams,Peter S. Lacy,Simon M Thom,Kennedy Cruickshank,Alice Stanton,David Collier,Alun D. Hughes,H. Thurston,Michael F. O'Rourke +8 more
TL;DR: The CAFE study as mentioned in this paper examined the impact of two different BP lowering-regimens (atenolol±thiazide-based versus amlodipine±perindopril-based) on derived central aortic pressures and hemodynamics.
Journal ArticleDOI
Aortic pulse wave velocity improves cardiovascular event prediction: an individual participant meta-analysis of prospective observational data from 17,635 subjects
Yoav Ben-Shlomo,Melissa Spears,Chris Boustred,Margaret T May,Simon G. Anderson,Emelia J. Benjamin,Pierre Boutouyrie,James D. Cameron,Chen Huan Chen,J. Kennedy Cruickshank,Shih-Jen Hwang,Edward G. Lakatta,Stéphane Laurent,João Maldonado,Gary F. Mitchell,Samer S. Najjar,Anne B. Newman,Mitsuru Ohishi,Bruno Pannier,Telmo Pereira,Ramachandran S. Vasan,Tomoki Shokawa,Kim Sutton-Tyrell,Francis Verbeke,Kang Ling Wang,David J. Webb,Tine W. Hansen,Sophia Zoungas,Carmel M. McEniery,John R. Cockcroft,Ian B. Wilkinson +30 more
TL;DR: In this paper, aortic pulse wave velocity (aPWV) improves prediction of cardiovascular disease (CVD) events beyond conventional risk factors, but they have been underpowered to examine whether this is true for different subgroups.