Savoia Carmine, Schiffrin Ernesto L
Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, McGill University, Montreal, QC, Canada.
Vasc Health Risk Manag. 2007;3(6):975-83.
Inflammatory processes are increasingly recognized as important participants in the pathophysiology of hypertension and cardiovascular disease. Angiotensin II may be to a large degree responsible for triggering vascular inflammation by inducing oxidative stress, resulting in up-regulation of inflammatory mediators. Inflammatory markers such as C-reactive protein are increased in the blood of patients with hypertension and predict the development of cardiovascular disease. Moreover, C-reactive protein may be a pro-inflammatory molecule under certain circumstances. C-reactive protein and high blood pressure in combination have additional predictive value for cardiovascular outcomes, as they contribute as independent determinants of cardiovascular risk. Therapeutic intervention aimed to reduce vascular inflammation in hypertensive patients has been proposed. Recent lines of evidence suggest that lifestyle modification and pharmacological approaches may reduce blood pressure and inflammation in patients with hypertension. Antagonism of the renin-angiotensin system with the selective angiotensin receptor blockers may improve cardiovascular outcome beyond blood pressure control, by reducing vascular inflammation and remodeling.
炎症过程日益被认为是高血压和心血管疾病病理生理学中的重要参与者。血管紧张素II在很大程度上可能通过诱导氧化应激来引发血管炎症,从而导致炎症介质上调。诸如C反应蛋白等炎症标志物在高血压患者血液中升高,并可预测心血管疾病的发展。此外,C反应蛋白在某些情况下可能是一种促炎分子。C反应蛋白与高血压相结合对心血管结局具有额外的预测价值,因为它们作为心血管风险的独立决定因素发挥作用。已有人提出针对降低高血压患者血管炎症的治疗干预措施。最近的一系列证据表明,生活方式改变和药物治疗方法可能降低高血压患者的血压和炎症。使用选择性血管紧张素受体阻滞剂拮抗肾素-血管紧张素系统,可能通过减少血管炎症和重塑,在控制血压之外改善心血管结局。