Decreasing arterial stiffness and/or wave reflections independently of mean arterial pressure: Effect of non-antihypertensive drugs (Part 2)

Abstract

Change in arterial stiffness with drugs is a major endpoint in clinical trials, although evidence for arterial stiffness as a therapeutic target still needs to be confirmed. Although antihypertensive drugs have been the most studied (as developed in Chap. 39), other drug classes have also been assessed, including hormone replacement therapy, lipid-lowering drugs, some antidiabetic agents, and anti-inflammatory drugs. For these drugs which do not directly affect blood pressure, the mechanism by necessity includes direct effect on the arterial wall and the extracellular matrix. We also present some recent evidence of completely different pathways such as interaction with the lamin A pathway which have demonstrated true destiffening properties.