engleski

The role of new antihypertensive drugs in stroke prevention

Summary Recently published data from large, randomized clinical trials show that lowering of blood pressure and elevated cholesterol reduction is associated with significant decrease in stoke risk. Besides blood pressure and cholesterol lowering it seems that the use of angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), calcium antagonists (CA) and statins could provide some additional beneficial effects. ACEI and ARB could improve endothelial function, cardiac and vascular remodeling, thus retarding progression of atherosclerosis. CA, especially the highly lipophilic ones, may have some antioxidant properties. They reduce the oxidation of LDL and its influx into the arterial wall. Amlodipine, lacidipine or nifedipine suppress platelet production in hypertensive patients. Statins could have beneficial effects such as improvement of endothelial-dependent flow-mediated vasodilatation, modulating the inflammatory response, decreasing clot formation, and decreasing the adherence of platelets to the ruptured plaque thus stabilizing the atherosclerotic plaque. Other antiatherosclerotic properties of statins include reducing of accumulation of inflammatory cells in atherosclerotic plaques, inhibiting vascular smooth muscle cell proliferation, inhibiting platelet function, and improving of vascular endothelial function.

treatment of hypertension; antihypertensives; treatment of hypercholesterolemia; statins

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