Antihypertensive therapy and atherosclerosis

Hypertension and atherosclerosis make independent contributions to the pathogenesis of cardiovascular disease. Diuretics and beta adrenergic blockers, effective antihypertensive medications, exhibit some untoward effects on lipid metabolism, while most other antihypertensive medications tend not to exhibit such effects. In animal models, beta adrenergic blockers, angiotensin converting enzyme (ACE) inhibitors, and calcium antagonists have anti-atherogenic effects. A vascular biological approach to therapy for the patient with both hypertension and atherosclerosis is recommended. This includes effective reduction of blood pressure--preferably with agents that do not adversely affect lipid metabolism--and treatment of lipid metabolism disorders.