Introduction to large artery properties as a target for risk reduction by antihypertensive therapy

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Abstract
Aim To review the effect of antihypertensive drugs on pulsatile stress and shear stress. Results of data review Mortality and morbidity in hypertension are better correlated with systolic than diastolic blood pressure, indicating a pulsatile stress effect. Distensibility and compliance are large artery properties and important determinants of pulsatile stress. β -Blockers with vasodilating properties, several selective β1-blockers, angiotensin converting enzyme inhibitors and calcium antagonists are first-line antihypertensive drugs that improve these properties of large arteries. The impact of shear stress on the ill effects associated with hypertension is not clear. Conclusion Some but not all classes of antihypertensive drugs can improve large artery properties, and thereby alleviate pulsatile stress.

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