Anti hypertensive agents and arterial stiffness: relevance to reducing cardiovascular risk in the chronic kidney disease patient

被引：0

作者：

Agarwal, Rajiv ^{[1
]}

机构：

[1] Indiana Univ, Sch Med, Richard L Roudebush VA Med Ctr, Indianapolis, IN 46202 USA

来源：

CURRENT OPINION IN NEPHROLOGY AND HYPERTENSION | 2007年 / 16卷 / 05期

关键词：

ageing; arterial stiffness; central pressure; chronic kidney disease; endothelial dysfunction; pulse wave velocity;

D O I：

暂无

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

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 anti hypertensive 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. Angiotensinconverting 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 anti hypertensive agents on cardiovascular outcomes needs well designed clinical trials.

引用

页码：409 / 415

页数：7

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