Disease-associated vascular abnormalities

In addition to hypertension, there are a number of diseases with abnormalities of the vasculature that contribute to patient morbidity and mortality. The vascular abnormality, possible mechanisms as well as therapies and potential new, novel targets for therapy are listed and discussed in detail in the text.

DiseaseAbnormalityPossible MechanismsTreatments
Heart FailureResting Vasoconstriction,Defect in NO/cGMP mediated vasodilatation; ?Decrease in LZ+ MYPT1Vasodilators (ACE inhibitors, ARBs, hydralazine, nitrates)
Decrease in sensitivity to NO
Idiopathic Pulmonary HypertensionPulmonary Vascular Vasoconstriction &Proliferation of pulmonary SMCs, Defect in NO/cGMP mediated vasodilatation. ?Decrease in LZ+ MYPT1 and increase in NM myosinProstaglandins (Epoprostenol), Phosphodiesterase inhibitors (Sildenafil), Guanylate cyclase stimulators (Riocigaut), Endothelin antagonists (Bosentan), NO inhalation & Rho kinase inhibitors (Fasudil)
Decrease in sensitivity to NO
Portal HypertensionSensitivity to vasodilators increased & to vasoconstrictors decreased?Changes in isoform expression of contractile proteins which influence both smooth muscle activation and relaxationManagement of fluid status
Raynaud’s PhenomenonTransient vasospasm of digital vesselsAltered reactivity of vascular smooth muscleKeeping digits warm, CCBs
Pre-eclampsia/Pregnancy Induced HypertensionIncrease in vascular toneAltered reactivity to RhoA, PKC & Ca2+, decrease NOAntihypertensives (non-fetotoxic)