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Angiogenic growth factors and hypertension

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Abstract

Emerging evidence supports a novel view of hypertension as a disease of inadequate or aberrant responses to angiogenic growth factors (AGF). Patients with hypertension have reduced microvascular density, with some evidence supporting a primary role for rarefaction in causing hypertension. Two clinical models have demonstrated a link between inhibition of AGF activity and hypertension. A major side effect of bevacizumab, a monoclonal antibody to vascular endothelial growth factor (VEGF), is hypertension. Pre-eclampsia is accompanied by high circulating levels of soluble VEGF receptor-1, which forms inactive complexes with VEGF and placental growth factor (PlGF). Paradoxically, early studies have demonstrated high circulating levels of AGF in hypertension. Several mechanisms may account for this finding including increased vascular stretch, tissue ischemia, compensatory responses, decreased clearance or a combination of these mechanisms. High AGF in hypertension could contribute to clinical sequelae such as peripheral and pulmonary edema, microalbuminuria, and progression of atherosclerosis. However, a role for altered angiogenesis in the pathogenesis of hypertension or its sequelae has not been established. Novel studies to understand the roles of AGF in hypertensive patients are warranted.

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Abbreviations

EGFR:

epidermal growth factor receptor

ELISA:

enzyme linked immunosorbent assay

eNOS:

endothelial type nitric oxide synthase

EPC:

endothelial progenitor cells

EPO:

erythropoietin

ERK1/2:

extracellular signal-related kinase 1/2

ET-1:

endothelin-1

ACE(−2):

angiotensin converting enzyme (−2)

AGF:

angiogenic growth factor(s)

AKT:

protein kinase B

AM:

adrenomedullin

ASCOT:

the Anglo Scandinavian Cardiac Outcomes Trial

AT:

angiotensin II receptor

BK:

bradykinin

CHF:

congestive heart failure

FGF-1:

fibroblast growth factor-1 (acidic FGF)

GLUT1:

glucose transporter 1

HGF:

hepatocyte growth factor

HIF1α:

hypoxia inducible factor-1α

IC:

intracoronary

IGF-1:

insulin-like growth factor-1

IV:

intravenous

KDR:

kinase insert domain-containing receptor

LVH:

left ventricular hypertrophy

NEPs:

neutral endopeptidases

PDGF-AB:

platelet derived growth factor-AB

PE:

prolyl endopeptidases

PGI2:

prostacyclin

PKB:

protein kinase B

PlGF:

placental growth factor

SC:

subcutaneous

SHR:

spontaneously hypertensive rats

SU1498:

4-amino-5-(4-cholorophenyl)-7-(t-butyl)pyrazolo; [3,4-d]pyrimidine

SVR:

systemic vascular resistance

TGF-β:

transforming growth factor-beta

VEGF:

vascular endothelial growth factor

VEGFR-2:

VEGF receptor-2

VIVA:

VEGF in Ischemia for Vascular Angiogenesis (clinical trial)

VTI 4:

[(4′-chloro-2′-fluoro)phenylamino]-6,7-dimethoxyquinazoline

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Authors and Affiliations

  1. Department of Internal Medicine, Section of Cardiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1045, USA

    David C. Sane

  2. Hypertension and Vascular Disease Center, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA

    Lauren Anton & K. Bridget Brosnihan

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  1. David C. Sane
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Correspondence to David C. Sane.

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Sane, D.C., Anton, L. & Brosnihan, K.B. Angiogenic growth factors and hypertension. Angiogenesis 7, 193–201 (2004). https://doi.org/10.1007/s10456-004-2699-3

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  • DOI: https://doi.org/10.1007/s10456-004-2699-3

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