Antihypertensive drugs and the heart

J. A. Diamond, Robert A. Phillips

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

The main goal of current antihypertensive therapy is to achieve a lowering of intra-arterial pressure by various mechanisms. A plethora of data suggests that this reduces cardiovascular morbidity and mortality due to stroke, heart failure and to a lesser extent, ischemic heart disease. Early cardiac manifestations of chronic hypertension, left ventricular hypertrophy (LVH) and diastolic dysfunction (CHF-D) confer additional risk of cardiovascular morbidity and mortality in patients with hypertension. Regression of left ventricular (LV) mass with antihypertensive therapy is associated with improved diastolic function and overall reduction in cardiovascular events, and this benefit may be independent of actual lowering of arterial pressure. Antihypertensive therapy should therefore be geared to both lower arterial blood pressure and specifically reverse pathophysiologic processes that promote LVH and CHF-D. Emerging therapies accomplish this without specifically affecting blood pressure. Therefore, future treatments for hypertension may require a combination of drugs performing complimentary tasks in lowering arterial pressure and reversing maladaptive physiologic and genetic processes causing hypertensive heart disease. This review summarizes the current and emerging approaches to the treatment of individuals with hypertensive heart disease.

Original languageEnglish (US)
Pages (from-to)247-260
Number of pages14
JournalMinerva Medica
Volume96
Issue number4
StatePublished - Aug 1 2005

Keywords

  • Antihypertensive agents
  • Cardiovascular diseases
  • Heart

ASJC Scopus subject areas

  • Medicine(all)

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