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Targeting mechanisms of hypertensive vascular disease with dual calcium channel and renin-angiotensin system blockade.
J Hum Hypertens. 2007 Oct; 21(10):770-9.JH

Abstract

Patients with hypertension, particularly those with diabetes mellitus, are at heightened risk for cardiovascular and renal disease. Accumulated evidence indicates that the majority of hypertensive patients at high risk will require more than one antihypertensive agent to reach their blood pressure (BP) target. A reasonable strategy is to use agents with complementary mechanisms of action to enhance BP-lowering efficacy and prevent target organ damage. In experimental models, the combination of a calcium channel blocker (CCB) with an agent that blocks the renin-angiotensin system (RAS), an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker, improves measures of endothelial function, inflammation, ventricular remodelling and renal function to a greater degree than these classes given as monotherapy. In clinical trials, calcium channel/RAS blockade combination therapy has been shown to provide greater BP reductions and improve renal function in patients with diabetic and nondiabetic renal disease earlier and to a greater extent than monotherapy. In addition, dual calcium channel/RAS blockade increases arterial compliance, arterial distensibility and flow-mediated vasodilation. Expanding upon extensive research on the benefits of calcium channel blockade and RAS blockade for the prevention of vascular events and preclinical and clinical trial evidence suggests added effects of combination therapy by targeting the underlying mechanisms of hypertensive vascular disease.

Authors+Show Affiliations

Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD, USA. mweir@medicine.umaryland.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17597800

Citation

Weir, M R.. "Targeting Mechanisms of Hypertensive Vascular Disease With Dual Calcium Channel and Renin-angiotensin System Blockade." Journal of Human Hypertension, vol. 21, no. 10, 2007, pp. 770-9.
Weir MR. Targeting mechanisms of hypertensive vascular disease with dual calcium channel and renin-angiotensin system blockade. J Hum Hypertens. 2007;21(10):770-9.
Weir, M. R. (2007). Targeting mechanisms of hypertensive vascular disease with dual calcium channel and renin-angiotensin system blockade. Journal of Human Hypertension, 21(10), 770-9.
Weir MR. Targeting Mechanisms of Hypertensive Vascular Disease With Dual Calcium Channel and Renin-angiotensin System Blockade. J Hum Hypertens. 2007;21(10):770-9. PubMed PMID: 17597800.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Targeting mechanisms of hypertensive vascular disease with dual calcium channel and renin-angiotensin system blockade. A1 - Weir,M R, Y1 - 2007/06/28/ PY - 2007/6/29/pubmed PY - 2008/1/8/medline PY - 2007/6/29/entrez SP - 770 EP - 9 JF - Journal of human hypertension JO - J Hum Hypertens VL - 21 IS - 10 N2 - Patients with hypertension, particularly those with diabetes mellitus, are at heightened risk for cardiovascular and renal disease. Accumulated evidence indicates that the majority of hypertensive patients at high risk will require more than one antihypertensive agent to reach their blood pressure (BP) target. A reasonable strategy is to use agents with complementary mechanisms of action to enhance BP-lowering efficacy and prevent target organ damage. In experimental models, the combination of a calcium channel blocker (CCB) with an agent that blocks the renin-angiotensin system (RAS), an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker, improves measures of endothelial function, inflammation, ventricular remodelling and renal function to a greater degree than these classes given as monotherapy. In clinical trials, calcium channel/RAS blockade combination therapy has been shown to provide greater BP reductions and improve renal function in patients with diabetic and nondiabetic renal disease earlier and to a greater extent than monotherapy. In addition, dual calcium channel/RAS blockade increases arterial compliance, arterial distensibility and flow-mediated vasodilation. Expanding upon extensive research on the benefits of calcium channel blockade and RAS blockade for the prevention of vascular events and preclinical and clinical trial evidence suggests added effects of combination therapy by targeting the underlying mechanisms of hypertensive vascular disease. SN - 0950-9240 UR - https://www.unboundmedicine.com/medline/citation/17597800/Targeting_mechanisms_of_hypertensive_vascular_disease_with_dual_calcium_channel_and_renin_angiotensin_system_blockade_ L2 - https://doi.org/10.1038/sj.jhh.1002254 DB - PRIME DP - Unbound Medicine ER -