Hypertension and atherosclerotic cardiovascular disease represent major global health problems. Practising physicians are challenged daily by patients suffering adverse cardiovascular events, such as myocardial infarction, stroke, heart failure and sudden cardiac death. Major risk factors have been identified of which the most important is left ventricular hypertrophy. In recent years, growth factors, regulatory peptides and effector hormones of the renin-angiotensin-aldosterone system have been identified as important modulators of cell growth and behaviour. It therefore follows that a major emphasis has been placed on the importance of abnormalities in organ structure as the primary basis for impaired function of the heart and vasculature, including large and medium sized arteries and resistance vessels, or arterioles. The concept of reparation recognizes the importance of abnormalities in tissue structure to the functional basis of disease. It suggests that the structurally remodelled heart and vasculature can be restored to, or toward, normal structure and function by suitable therapy. Experimental and clinical trials which address this premise are reviewed herein.
Bibliographical noteFunding Information:
The meeting from which this review was derived was made possible by an educational grant from ICI Pharmaceuticals. We acknowledge Adelphi Communications for their editorial services and the following for their contributions to the symposium: Edward Barin, Javier Diez, Concepcion Laviades, Lorenza Muiesan, Michel Pathe, Ole Lederballe Pedersen, Jorg Slany, Otto A. Smiseth, Giuseppe Specchia, Ulf Thilen, Jean Varin, Wolfgang Waas.
- Angiotensin-converting enzyme inhibitors
- Congestive heart failure
- Left ventricular hypertrophy
- Left ventricular remodelling
- Myocardial infarction