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Treatment of Arterial Remodeling in Essential Hypertension

  • Hypertension and the Kidney (RM Carey and A Mimran, Section Editors)
  • Published:
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Abstract

Essential hypertension is associated with large and small vascular remodeling that impacts cardiovascular prognosis. Longitudinal follow-up of hypertensive patients has shown that large arterial stiffness decreases partly independently of blood pressure reduction, suggesting specific pharmacological effects of antihypertensive therapy. Inhibitors of the renin-angiotensin-aldosterone system are among the agents that have been shown to affect vascular remodeling to a greater degree. Lifestyle modifications, including exercise and weight reduction, also improve large and small vascular remodeling. New antihypertensive drugs, including neprilysin inhibitors associated with an angiotensin receptor blocker, aldosterone synthase inhibitors and new devices such as renal denervation and baroreceptor stimulation, may exert beneficial effects on vascular remodeling and are currently under evaluation.

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Acknowledgments

Work of the authors was supported by Canadian Institutes of Health Research (CIHR) grants 13570, 37917, 82790, and 102606; a Canada Research Chair (CRC) on Hypertension and Vascular Research from the CRC/CIHR Program of the Government of Canada; and a Canada Fund for Innovation grant, all to E.L. Schiffrin. M. Briet was supported by the Heart and Stroke Foundation of Canada.

Disclosure

M. Briet: none; E.L. Schiffrin: in the past year, compensation for speaking engagement at symposium sponsored by Daiichi-Sankyo; advisory board member of Novartis US; and Discovery research grant unrelated to antihypertensive agents from Servier France.

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Authors and Affiliations

  1. Assistance Publique des Hôpitaux de Paris, Hôpital européen Georges Pompidou and INSERM CIC 9201, Faculté de médecine, Université Paris Descartes, Paris, 75015, France

    Marie Briet

  2. Department of Medicine, Sir Mortimer B. Davis-Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, PQ, Canada

    Ernesto L. Schiffrin

  3. Sir Mortimer B. Davis-Jewish General Hospital, #B-127, 3755 Côte-Ste-Catherine Rd., Montreal, PQ, Canada, H3T 1E2

    Ernesto L. Schiffrin

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  1. Marie Briet
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Correspondence to Ernesto L. Schiffrin.

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Briet, M., Schiffrin, E.L. Treatment of Arterial Remodeling in Essential Hypertension. Curr Hypertens Rep 15, 3–9 (2013). https://doi.org/10.1007/s11906-012-0325-0

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