Hypertension, vascular remodeling

Elevated peripheral arterial resistance is a hallmark of primary hypertension. The increase in peripheral resistance typically observed may be due to a reduction in the arterial lumen size as a result of vascular remodeling. This remodeling, or change in vascular tone, may be modulated by various endothelium-derived vasoactive substances, growth factors, and cytokines. This increase in arterial stiffness or reduced compliance results in the observed increase in systolic blood pressure.9... 

Touyz RM. Intracellular mechanisms involved in vascular remodelling of resistance arteries in hypertension role of angiotensin II. Exp Physiol. 2005 90 449-455. 

Taraseviciene-Stewart L, Nicolls MR, Kraskauskas. Absence of T cells confers increased pulmonary arterial hypertension and vascular remodeling. Am J Respir Crit Care Med 2007 175 1280-9. 

Frank, D. B., A. Abtahi, D. J. Yamaguchi et al. 2005. Bone morphogenetic protein 4 promotes pulmonary vascular remodeling in hypoxic pulmonary hypertension. Circ Res 97(5) 496-504. 

Budts W, Pokreisz P, Nong Z, Van PeltN, et al. Aerosol gene transfer with inducible nitric oxide synthase reduces hypoxic pulmonary hypertension and pulmonary vascular remodeling in rats. Circulation 2000 102 2880-2885. 

Pulmonary hypertension develops late in the course of COPD, usually after the development of severe hypoxemia. It is the most common cardiovascular complication of COPD and can result in cor pulmonale, or right-sided heart failure. Hypoxemia plays the primary role in the development of pulmonary hypertension by causing vasoconstriction of the pulmonary arteries and by promoting vessel wall remodeling. Destruction of the pulmonary capillary bed by emphysema further contributes by increasing the pressure required to perfuse the pulmonary vascular bed. Cor pulmonale is associated with venous stasis and thrombosis that may result in pulmonary embolism. Another important systemic effect is the progressive loss of skeletal muscle mass, which contributes to exercise limitations and declining health status. 

Similarly to carotenoids, flavonoids also show considerable biological activity. Their beneficial effect in cancer and heart diseases has been proven many times [86-89], It has further been established that flavonoids improve cardiovascular remodelling and vascular function in NO-deficient hypertension [90], Moreover, flavonoid intake reduces the risk of chronic diseases [91], and beneficially influences inflammations [92], and ulcer formation [93,94],... 

I. Bernatova, O. Pechanova, P. Babal, S. Kysela, S. Stvrtina and R. Andriantsitohaina, Wine polyphenols improve cardiovascular remodelling and vascular function in NO-deficient hypertension. Am. J. Physiol. Heart Circ. Physiol. 282 (2002) H942-H951. 

ACE-inhibitors are known to cause regression of left ventricular and vascular hypertrophy. This phenomenon is important in the long-term treatment of hypertension, where cardiac hypertrophy is known to be an important, virtually independent risk factor. Data that are beginning to emerge, which indicate that ACE-inhibitors may be beneficial as secondary prevention in postinfarct patients, especially if signs of heart failure occur. This favourable influence of the ACE-inhibitors may be the result of haemodynamic effects, a favourable effect on neuroendocrine mechanisms, and also a beneficial influence on the process of remodeling of the heart, secondary to a myocardial infarction. 

This is one of the currently most active areas of toxicological research interest, and it is one with many different research thrusts. There is much current interest, for example, in the mechanisms of regulation of apoptosis, programmed cellular death. Production of apoptosis when it should not occur, or its lack when it normally should occur, can each be mechanisms of toxicity. Part of the adverse remodeling of cardiac and vascular tissue can occur because of hypertension-induced apoptosis of cardiac and vascular cells [31]. Apoptotic processes also have been implicated in alcoholic hepatotoxicity [32],... 

Ishibashi, M., Hiasa, K., Zhao, Q., Inoue, S., Ohtani, K., Kitamoto, S., Tsuchihashi,M., Sugaya, T., Charo, I. F., Kura, S., Tsuzuki, T., Ishibashi, T., Takeshita, A., and Egashira, K. (2004). Critical role of monocyte chemoattractant protein-1 receptor CCR2 on monocytes in hypertension-induced vascular inflammation and remodeling. Circ. Res. 94,1203-1210. 

Bematova 1, Pechanova O, Babal P, Kysela S, Stvrtina S, Andriantsitohaina R (2002) Wine polyphenols improve cardiovascular remodeling and vascular function in NO-deficient hypertension. Am J Physiol Heart Circ Physiol 282(3) H942-H948... 

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