Modification of cardiovascular risk factors during antihypertensive treatment: current and new approach trends. The urapidil experience.

Arterial hypertension is a well known risk factor for atherosclerosis and its complications. Lowering of blood pressure significantly reduces the incidence of cerebrovascular events and to a minor extent that of ischemic heart disease. Interference of antihypertensive drugs on lipoproteins, glucose and electrolytes metabolism has been suggested as a hypothesis for the lower than expected protection against cardiac events. The new antihypertensive agents such as calcium antagonists, angiotensin converting enzyme inhibitors and post-synaptic alpha-1 receptor antagonists have proved to be neutral or to have positive effect on metabolic disturbances. Urapidil, a multifactorial antihypertensive agent, has been shown to significantly lower blood pressure and to have a favorable impact on the metabolic profile in adult and elderly hypertensive patients and in patients with diabetes mellitus and elevated blood pressure. Although arterial hypertension is a risk factor for atherosclerosis, the clinical events at the cerebral and coronary levels are secondary to thrombo-embolic complications. On the other hand it has been shown that abnormalities in coagulation factor has a prognostic value. Therefore, new and old antihypertensive agents should be investigated not only for their effects on hypertension, metabolic profile and quality of life but also on coagulation, in order to improve the therapeutic profile.