TY - JOUR
T1 - Antiatherosclerotic effects of antihypertensive drugs
T2 - Recent evidence and ongoing trials
AU - Zanchetti, A.
PY - 1996
Y1 - 1996
N2 - The issue as to whether antihypertensive drugs may exert some antiatherosclerotic effect, at least partly independent of blood pressure lowering, has been explored in several experimental models of atherosclerosis, and a large body of evidence has been obtained in favor of a specific antiatherosclerotic action of calcium antagonists and ACE-inhibitors. On the clinical side, several studies are investigating the problem in hypertensive patients in whom progression of carotid intima-media thickness (IMT) and atherosclerotic plaques is explored by sensitive quantitative B-mode ultrasound techiques. The MIDAS has indicated a slower progression, at least in the first six months, of carotid plaques in isradipine treated patients than in diuretic-treated ones. However, MIDAS as a pioneer study has been particularly valuable in giving information on the rate of growth of IMT in hypertensive patients and on the best end-point to use in carotid ultrasound trials. Baseline data of the ongoing studies ELSA and VHAS have so far provided evidence of the very high prevalence of carotid atherosclerosis among hypertensive patients, an observation that makes the evaluation of the antiatherosclerotic action of some antihypertensive agents even more important. Finally, the PHYLLIS trial using a factorial design, beside exploring the antiatherosclerotic action of an ACE-inhibitor vs a diuretic, intends to evaluate the possible benefits of associating antihypertensive therapy with lipid lowering by a statin on the progression of carotid atherosclerosis.
AB - The issue as to whether antihypertensive drugs may exert some antiatherosclerotic effect, at least partly independent of blood pressure lowering, has been explored in several experimental models of atherosclerosis, and a large body of evidence has been obtained in favor of a specific antiatherosclerotic action of calcium antagonists and ACE-inhibitors. On the clinical side, several studies are investigating the problem in hypertensive patients in whom progression of carotid intima-media thickness (IMT) and atherosclerotic plaques is explored by sensitive quantitative B-mode ultrasound techiques. The MIDAS has indicated a slower progression, at least in the first six months, of carotid plaques in isradipine treated patients than in diuretic-treated ones. However, MIDAS as a pioneer study has been particularly valuable in giving information on the rate of growth of IMT in hypertensive patients and on the best end-point to use in carotid ultrasound trials. Baseline data of the ongoing studies ELSA and VHAS have so far provided evidence of the very high prevalence of carotid atherosclerosis among hypertensive patients, an observation that makes the evaluation of the antiatherosclerotic action of some antihypertensive agents even more important. Finally, the PHYLLIS trial using a factorial design, beside exploring the antiatherosclerotic action of an ACE-inhibitor vs a diuretic, intends to evaluate the possible benefits of associating antihypertensive therapy with lipid lowering by a statin on the progression of carotid atherosclerosis.
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M3 - Article
C2 - 8743037
AN - SCOPUS:0030004901
VL - 18
SP - 489
EP - 499
JO - Clinical and Experimental Hypertension
JF - Clinical and Experimental Hypertension
SN - 1064-1963
IS - 3-4
ER -