Published online before print August 4, 2008, doi: 10.1161/HYPERTENSIONAHA.108.117366
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(Hypertension. 2008;52:452.)
© 2008 American Heart Association, Inc.
Brief Review |
Role of Endothelin-1 in Clinical Hypertension
20 Years On
From the Clinical Pharmacology Unit (N.D., J.G., D.J.W.), University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, United Kingdom; Division of Nephrology (D.E.K.), University of Utah, Salt Lake City; Vascular Biology Center (D.M.P.), Medical College of Georgia, Augusta; and Department of Medicine (E.L.S.), Sir Mortimer B. David-Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Correspondence to Neeraj Dhaun, Queen’s Medical Research Institute, 3rd Floor E, Room E3.23, 47 Little France Crescent, Edinburgh EH16 4TJ, Scotland, United Kingdom. E-mail bean.dhaun@ed.ac.uk
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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Introduction |
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Hypertension is the most common risk factor worldwide for cardiovascular morbidity and mortality.1,2 Currently it is estimated that a quarter of the world’s adult population is hypertensive, and this number is projected to increase to
30% by 2025.1 Although, there exist a number of drug therapies for hypertension, blood pressure (BP) control to target is still only achieved in 30% of patients.3 Over the last 20 years, novel licensed therapies have primarily focused on the renin-angiotensin-aldosterone system. Endothelin (ET) receptor antagonism represents an innovative, but as yet only partially explored, alternative approach in the management of hypertension. A review in Hypertension 10 years ago outlined the potential role that ET-1 may play in the development of hypertension,4 as proposed by Yanagisawa et al in their original Nature article in 1988.5 This largely focused on preclinical data because, at that time, there was only 1 published study of ET receptor antagonism in patients with essential hypertension.6 There were also few data that focused on the relative benefits of selective or mixed ET blockade. Finally, the lack of longer-term data on safety and tolerability for these drugs made their place in the antihypertensive armamentarium unclear. In this review we aim to answer many of these questions and outline some of the key findings in this field from the last decade.
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Biology of the ET System |
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The ET family consists of three 21-amino acid peptides (ET-1, ET-2, and ET-3) with powerful vasoconstrictor and pressor properties.7 Of the 3 peptides, ET-1 is the major vascular isoform and of most
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