Pleiotropic Effects of Calcium Channel Blockers
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- 作者：R. Preston Mason (1)
- 关键词：Calcium channel blockers ; Endothelial function ; Nitric oxide ; Central aortic pressure ; Statins ; Pleiotropic effects ; Mechanisms ; Antihypertensive agents
- 刊名：Current Hypertension Reports
- 出版年：2012
- 出版时间：August 2012
- 年：2012
- 卷：14
- 期：4
- 页码：293-303
- 全文大小：305KB
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1. Cardiovascular Division, Department of Medicine, Brigham and Women鈥檚 Hospital, Harvard Medical School, PO Box 7100, 100 Cummings Center, Suite 135L, Beverly, MA, 01915, USA
文摘
Clinical trials have reported reduced cardiovascular events with certain antihypertensive agents at a rate that could not be predicted by changes in brachial arterial pressure alone. These findings may be explained, in part, by pleiotropic effects of these agents and modulation of central blood pressures. This review focuses on the mechanisms by which calcium channel blockers exert pleiotropic effects, both alone and in combination with statins and inhibitors of the renin-angiotensin system. The essential role of nitric oxide (NO) in maintaining endothelial function and the relationship between NO and reactive oxygen species are discussed in the context of the etiology of hypertension. The importance of managing global cardiovascular risk is emphasized, as hypertension commonly clusters with dyslipidemia and loss of glucose control. From a mechanistic viewpoint, these risk factors contribute to endothelial dysfunction, oxidative stress, and inflammation in a synergistic fashion. A greater understanding of the mechanisms of actions of these cardiovascular agents may lead to more effective drug combinations, to the benefit of individual patients. Furthermore, by elucidating the biological mechanisms by which cardiovascular risk factors lead to vascular injury, we may highlight common pathways and identify novel therapeutic targets.