REVERSAL of Endothelial Dysfunction: An Attractive Clinical Target

Scientific Update on Endothelial Function
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Is reversal of endothelial dysfunction still an attractive target in modern cardiology?

Ify Mordi and Nikolaos Tzemos
Institute of Cardiovascular and Medical Sciences, University of Glasgow, British Heart Foundation Glasgow Cardiovascular Research Centre, Glasgow G12 8TA, United Kingdom


“DOES REVERSAL OF ENDOTHELIAL DYSFUNCTION HAVE ANY PROGNOSTIC IMPACT?

Given that several classes of drugs do seem to lead to an improvement in endothelial function, the next step is to consider whether these effects are translated into a prognostic benefit. There are however only a few studies which address this issue. Modena et al[124] evaluated 400 post-menopausal women with hypertension and endothelial dysfunction in an attempt to assess whether an improvement in FMD using antihypertensive drugs would predict a better prognosis. The authors found that improvement in endothelial function after 6 mo of therapy was associated with a much reduced event rate (6% vs 21.3% in those patients with persistently impaired endothelial dysfunction). One problem might perhaps be the fact that therapeutic options which improve endothelial function also have other beneficial effects on the cardiovascular system independent of their vasodilatory contribution. A recent study in patients with heart failure showed that patients in whom endothelial function improved following institution of optimal medical therapy had a much better prognosis than those in whom there was no improvement (hazard ratio 3.0 for those with persistently impaired endothelial function)[78].”

 

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By the same authors:

Journal of Hypertension 2016 May 19

Endothelial dysfunction in human essential hypertension.

 

Abstract

Although the endothelium has a number of important functions, the term endothelial dysfunction is commonly used to describe impairment in its vasodilatory capacity. It is increasingly recognized that this is related to hypertension, although whether it predates essential hypertension or is a consequence of it is still unknown. In this review, we explore the mechanisms of endothelial dysfunction in essential hypertension, its prognostic significance and methods of pharmacological reversal.

 

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