Overview: Hypertension and atherosclerosis

Many large-scale trials of drug treatment for hypertension have shown an apparent lack of benefit with regard to the incidence of complications related to atherosclerosis. Recent experimental evidence has contributed to an understanding of the pathogenesis of hypertensive vascular disease, although exact mechanisms by which hypertension and antihypertensive drugs influence the atherosclerotic process are still poorly defined. In animal models, hypertension appears to induce a sequence of changes in endothelial cells, smooth muscle cells, and endothelial permeability. However, increased lipid deposition in the intima and acceleration of atherosclerosis appear to require elevation of plasma lipid levels. Some beta-blockers have been found to retard the development of atherosclerosis in the cholesterol-fed rabbit model. The clinical applicability of these interesting research findings awaits further investigation.