Información del artículo
La reducción de la presión arterial (PA) mediante el tratamiento antihipertensivo reduce la morbimortalidad cardiovascular en pacientes con hipertensión, así como en pacientes no hipertensos con diversos factores de riesgo cardiovascular. La reducción de las cifras de PA parece ser el principal mecanismo por el que este tipo de fármacos ejercen sus efectos beneficiosos, ya que a través de diversos mecanismos disminuyen el desarrollo, la progresión y las complicaciones de la aterosclerosis, base fisiopatológica de la enfermedad vascular y de los accidentes vasculares. Numerosos estudios han puesto de manifiesto que diversas familias de fármacos antihipertensivos, principalmente los inhibidores de la enzima de conversión de la angiotensina y los antagonistas de los repectores de la angiotensina II, algunos antagonistas del cacio, ciertos bloqueadores beta y alfa-antagonistas, tienen efectos antiateroscleróticos y antitrombóticos que son independientes de la reducción de la PA. Los efectos sobre los factores endoteliales, el estrés oxidativo, el proceso inflamatorio vascular y el equilibrio fibrinolítico son algunos de los principales mecanismos antiateroscleróticos de los mencionados fármacos antihipertensivos.
Blood pressure reduction using antihypertensive agents reduces cardiovascular morbidity and mortality in patients with hypertension, as well as in non-hypertensive patients with several cardiovascular risk factors. Lowering of blood pressure seems to be the main mechanism through which these drugs exert their beneficial effects, since, through several mechanisms, they reduce the development, progression and complications of atherosclerosis, the underlying physiopathological basis of vascular disease and stroke. Numerous studies have shown that several families of antihypertensive drugs, mainly angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists, some calcium antagonists, certain beta-blockers, and alphaantagonists, have anti-atherosclerotic and antithrombotic effects that are independent of blood pressure reduction. The effects on endothelial factors, oxidative stress, the process of vascular inflammation, and fibrinolytic balance are some of the main anti-atherosclerotic mechanisms of the above-mentioned antihypertensive agents.
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