Highlander Peter, Shaw Graham P
School of Podiatric Medicine, Barry University, Miami Shores, FL, USA.
Ther Adv Cardiovasc Dis. 2010 Feb;4(1):43-54. doi: 10.1177/1753944709354305. Epub 2009 Dec 4.
With the growing worldwide obesity epidemic, obesity, type 2 diabetes mellitus and hypertension leading to premature cardiovascular events, are increasingly prevalent. Diabetes mellitus is a significant public health concern and more aggressive management of the condition and its complications, particularly cardiovascular disease, is warranted. Endothelial cell dysfunction is now known to be present at the earliest stages of metabolic syndrome, and insulin resistance and may precede the clinical diagnosis of type 2 diabetes mellitus by several years. The current focus on endothelial cell function as a potential target of pharmacotherapy in the management of cardiovascular disease in diabetics seems warranted, though not all drugs currently prescribed target endothelial cell function equally. In this review, we consider the six classes of drugs currently prescribed for the treatment of hypertension as they impact endothelial cell function and advocate for the development of novel drugs that can repair the endothelium and enhance nitric oxide availability thus preventing future cardiovascular events.
随着全球肥胖症流行趋势的加剧，肥胖、2型糖尿病和高血压导致的心血管事件过早发生，日益普遍。糖尿病是一个重大的公共卫生问题，对该疾病及其并发症，尤其是心血管疾病，进行更积极的管理是必要的。现在已知内皮细胞功能障碍在代谢综合征的最早阶段就已存在，且存在胰岛素抵抗，可能比2型糖尿病的临床诊断早数年。目前将内皮细胞功能作为糖尿病患者心血管疾病管理中药物治疗的潜在靶点，这似乎是有必要的，尽管目前所开的并非所有药物对内皮细胞功能的靶向作用都相同。在本综述中，我们考虑目前用于治疗高血压的六类药物对内皮细胞功能的影响，并提倡开发能够修复内皮、提高一氧化氮可用性从而预防未来心血管事件的新型药物。
