Vascular remodeling is alterations in the structure of resistance vessels contributing to elevated systemic vascular resistance in hypertension. In this review, physiopathology of vascular remodeling is discussed, and the impact of antihypertensive drug treatment on remodeling is described, emphasizing on human data, fundamentally as an independent predictor of cardiovascular risk in hypertensive patients. Then we discussed a vascular repair by endothelial progenitor cells (EPCs) that play important roles in the regeneration of the vascular endothelial cells (ECs). The normal arterial vessel wall is mostly composed of ECs, vascular smooth muscle cells (VSMCs), and macrophages. Endothelial impairment is a major contributor to atherosclerosis and restenosis after percutaneous coronary intervention (PCI). Reendothelialization can effectively inhibit VSMC migration and proliferation and decrease neointimal thickening.
Part of the book: Physiologic and Pathologic Angiogenesis
Cardiovascular diseases (CVDs) such as ischemic heart disease (IHD), stroke, and peripheral artery disease (PAS) are the leading causes of mortality and morbidity around the world; about 30% of global deaths and 10% of global disease burden a year are due to CVDs. In this chapter, we will analyze the classic concepts of vascular remodeling, to later expand the concepts and physiopathological mechanisms of vascular inflammation. The role of immunomodulation from IL-6R alpha and the JAK/STAT3 intracellular cascade, will be proposed as an activator of vascular remodeling mechanisms. In addition, the role of new drugs such as LCZ696 and immunomodulators involved in the local inflammatory response will also be analyzed. The concept of remodeling and vascular inflammation, which a decade ago was only important at the level of basic research, step-by-step has proven crucial in the appearance of atherosclerosis, called subclinical atherosclerosis. Even though much progress has been made in the treatment and discovery of pathophysiological mechanisms, it has not been possible to reduce of cardiovascular risk, this is perhaps, it the decade in which we can advance in this.
Part of the book: Ultimate Guide to Insulin