To the Editor:
Endothelial dysfunction is an early stage in the pathogenesis of atherosclerosis and has been shown to be present in patients with essential hypertension. In fact, arterial stiffness parameters (ASPs) represent the viscoelastic properties of the vessel wall. Increased arterial stiffness is a common finding of atherosclerotic involvement of the vascular system.1 Arterial stiffness has high cardiovascular predictive value, reproducibility, cost‐effectiveness, and availability in many healthcare facilities and is suggested within additional tests in the evaluation of hypertensive patients according to current hypertension guidelines.2 We read the article “Role of Aliskiren on Arterial Stiffness and Endothelial Function in Patients With Primary Hypertension” by Bonadei and coworkers with great interest.3 They investigated the addition of aliskiren to antihypertensive drug treatment for arterial stiffness and endothelial function. They concluded that aliskiren exerted a beneficial effect on values of ASPs and a measure of endothelial function. However, increased arterial stiffness is an indicator of coronary artery disease, cerebrovascular disease, and peripheral arterial disease.4, 5 ASPs can also change with known atherosclerotic risk factors such as smoking, hypercholesterolemia, diabetes mellitus, and aging. It can also be affected by alcohol consumption, hypercholesterolemia, hypothyroidism, and inflammatory diseases.6 Furthermore, some medications such as antihypertensive treatment including angiotensin‐converting enzyme inhibitors, angiotensin receptor blockers, and statins may influence ASPs.7 We believe that these findings will guide further studies about the role of aliskiren on ASPs in hypertensive patients.
Finally, hypertension is related to increased arterial stiffness and mortality rates. The present study, which measured arterial stiffness, revealed the detection of atherosclerosis in early stages, wherein aliskiren exerted a beneficial effect on values of ASPs. These parameters will provide useful results for both research and clinical use in cases of all of the related factors evaluated in future studies.
References
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