Current vascular pharmacology最新文献

{"title":"Clinical Importance of Albuminuria Reduction in Multimorbid Older Adults with Cardiovascular Disease: SGLT2 Inhibitor Therapy and Implications for Polypharmacy.","authors":"Francisco Epelde","doi":"10.2174/0115701611487581260727114319","DOIUrl":"https://doi.org/10.2174/0115701611487581260727114319","url":null,"abstract":"<p><strong>Background: </strong>Albuminuria is a marker of kidney microvascular injury and systemic endothelial dysfunction, linked to kidney and cardiovascular outcomes, particularly Heart Failure (HF). In adults aged ≥75 years with multimorbidity and Cardiovascular Disease (CVD), albuminuria identifies a high-risk cardiorenal phenotype and may be a therapeutic target.</p><p><strong>Objective: </strong>To review the clinical significance of albuminuria reduction in multimorbid older adults with cardiopathy and nephropathy, emphasizing mechanistic rationale, prognostic implications, sodium-glucose cotransporter-2 (SGLT2) inhibitor evidence, and polypharmacy-aware implementation, with canagliflozin discussed as an evidence-based example rather than as a preferred agent.</p><p><strong>Methods: </strong>Narrative review of Chronic Kidney Disease (CKD), diabetes, and HF guidance; observational cohorts; Randomized Controlled Trials (RCTs); and meta-analyses evaluating albuminuria as a risk marker, its association with HF, and albuminuria-lowering therapies with outcome evidence.</p><p><strong>Results: </strong>Albuminuria predicts mortality, CKD progression, and HF events across estimated Glomerular Filtration Rate (eGFR) strata, including high-normal Urinary Albumin-to-Creatinine Ratio (UACR) ranges. SGLT2 inhibitors reduce HF hospitalization and slow CKD progression. Canagliflozin- specific evidence derives mainly from the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial and the Canagliflozin Cardiovascular Assessment Study (CANVAS) Program, while dapagliflozin and empagliflozin trials provide important class-context evidence.</p><p><strong>Conclusions: </strong>In older multimorbid adults with CVD, HF, and CKD, albuminuria reduction with outcome-proven therapies may support kidney protection and HF risk reduction. SGLT2 inhibitors are evidence-based options when individualized monitoring and polypharmacy-aware implementation are applied; canagliflozin is one such option with substantial evidence in albuminuric diabetic CKD, but no superiority over other SGLT2 inhibitors is implied.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticoagulation in the Aging Brain: Navigating the Intersection of Dementia, Cerebrovascular Risk, and Therapeutic Uncertainty.","authors":"Antonella Mameli, Francesco Marongiu, Doris Barcellona","doi":"10.2174/0115701611457906260714113521","DOIUrl":"https://doi.org/10.2174/0115701611457906260714113521","url":null,"abstract":"<p><strong>Background: </strong>The progressive aging of the global population has been accompanied by a parallel increase in both dementia and atrial fibrillation (AF), two conditions that frequently coexist and are linked through complex cerebrovascular and systemic mechanisms. Beyond overt ischemic stroke, AF has been increasingly associated with subclinical brain injury and cognitive decline.</p><p><strong>Objective: </strong>This review examines the relationship between AF, oral anticoagulation, and cognitive outcomes, with a particular focus on elderly patients and those with cognitive impairment.</p><p><strong>Methods: </strong>Study Design and Literature Search Strategy: This article is a narrative review based on a structured literature search conducted in PubMed/MEDLINE, Scopus, and relevant guideline databases. The search focused on studies addressing atrial fibrillation, oral anticoagulation, cognitive decline, dementia, silent cerebral infarction, cerebral microbleeds, and neurovascular injury. Priority was given to systematic reviews, meta-analyses, randomized controlled trials, observational cohort studies, and current international guidelines. Relevant English-language articles published up to 2025 were considered. We performed a narrative synthesis of the current evidence addressing the biological pathways connecting AF and neurodegeneration, as well as clinical studies evaluating the impact of oral anticoagulant therapy on cognitive trajectories.</p><p><strong>Results: </strong>Oral anticoagulation remains central to stroke prevention in AF, yet its role in modulating cognitive decline remains incompletely defined. Observational data suggest that direct oral anticoagulants (DOACs) may be associated with a lower incidence of dementia, potentially through the reduction of microembolism and silent cerebral ischemia. However, these findings are not conclusive and should be interpreted with caution. Concerns regarding bleeding risk, particularly intracerebral hemorrhage, continue to influence treatment decisions, especially in frail and cognitively impaired populations.</p><p><strong>Conclusion: </strong>Managing anticoagulation in patients with AF and cognitive impairment requires a careful balance between preventing blood clots and minimizing bleeding risk. A comprehensive, patientfocused approach, supported by multidisciplinary collaboration, may improve clinical decisionmaking. More research is needed to understand the long-term cognitive effects of anticoagulant treatments in this vulnerable group.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148600272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pericarditis/Myopericarditis/Pericardial Effusion: A Contemporary Approach to Diagnosis and Management.","authors":"Antonis A Manolis, Theodora A Manolis, Apostolos Vouliotis, Antonis S Manolis","doi":"10.2174/0115701611435345260707064226","DOIUrl":"https://doi.org/10.2174/0115701611435345260707064226","url":null,"abstract":"<p><p>Pericarditis is a common disease caused by various factors such as viral infections, systemic diseases, or drugs. A diagnosis of pericarditis is rendered in up to 5% of Emergency Room (ER) visits for non-ischemic chest pain. It is diagnosed when pleuritic chest pain is present, accentuated in the supine position, accompanied by ECG changes comprising new extensive ST-segment elevation and PR depression, a pericardial friction rub, and new or increased pericardial effusion on echocardiography. In North America and Western Europe, the most common causes of acute pericarditis are idiopathic or viral, followed by post-procedural (iatrogenic) pericarditis, radiation therapy, and cardiac surgery. Tuberculosis is the most common cause of pericarditis in endemic areas and is managed with antituberculosis therapy, with corticosteroids used when there is concurrent constrictive pericarditis. New diagnostic techniques have aided the sampling and analysis of pericardial fluid and in determining its cause. Treatment of pericarditis comprises high-dose Non-Steroidal AntiInflammatory Drugs (NSAIDs) for uncomplicated cases, with doses tapered when symptoms have subsided and C-reactive protein level has normalized, typically over several weeks. Colchicine (often a 3-6-month course) is needed to both alleviate symptoms and decrease recurrences, while glucocorticoids and newer therapies with interleukin-1 blockers are reserved for recurrences and/or failures of prior therapies. Integrated use of new imaging methods facilitates more precise detection and better management of complications such as pericardial effusion or constriction. The diagnostic yield of extensive laboratory evaluation and pericardiocentesis remains low; hence, invasive procedures should be limited mostly to patients in whom a therapeutic intervention is needed. The majority of pericardial effusions can be safely drained with an echo-guided percutaneous technique. Pericardiectomy remains the definitive treatment for constrictive pericarditis and provides symptomatic relief in most cases. Importantly, differentiation of constrictive pericarditis from restrictive cardiomyopathy remains a clinical challenge, but is facilitated by tissue Doppler and colour M-mode echocardiography. All these issues are reviewed herein.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postprandial Triglycerides and Residual Cardiovascular Risk: Rethinking Lipid-Lowering Strategies.","authors":"Ksenija Zecevic Crvenko, Vukasin Stojanovic, Emir Muzurović","doi":"10.2174/0115701611514979260706055757","DOIUrl":"https://doi.org/10.2174/0115701611514979260706055757","url":null,"abstract":"","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Treatment with Renin-Angiotensin System Inhibitors at Hospital Admission is Associated with Improved Reperfusion and Mortality Among STEMI Patients Undergoing Mechanical Reperfusion: Insight from the ISACS-STEMI COVID-19 Registry.","authors":"Giuseppe De Luca, Magdy Algowhary, Berat Uguz, Dinaldo Oliveira, Vladimir Ganyukov, Zan Zimbakov, Miha Cercek, Lisette Okkels Jensen, Poay Huan Loh, Lucian Calmac, Gerard Roura I Ferrer, Alexander Quadros, Marek Malewski, Fortunato Scotto Di Uccio, Clemens Von Birgelen, Francesco Versaci, Jurrien Ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr Kala, Jose Luis Díez Gil, Xavier Carrillo, Maurits Dirksen, Victor Manuel Becerra-Munoz, Michael Kang-Yin Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Roberto Paladino, Davor Milicic, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan Kraaijeveld, Gennaro Galasso, Arpad Lux, Lucia Marinucci, Vincenzo Guiducci, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamac, Kadir Ugur Mert, Xacobe Flores Rios, Tomas Kovarnik, Michal Kidawa, Jose Moreu, Vincent Flavien, Enrico Fabris, Inigo Lozano Martínez-Luengas, Francisco Bosa Ojeda, Carlos Arellano-Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien-Li Kao, Juan Sanchis Forés, Luigi Vignali, Hélder Pereira, Stephane Manzo-Silbermann, Santiago Ordonez, Alev Arat Ozkan, Bruno Scheller, Heidi Lehtola, Rui Teles, Christos Mantis, Antti Ylitalo, João António Brum Silveira, Ivan Bessonov, Rodrigo Zoni, Stefano Savonitto, George Kochiadakis, Dimitrios Alexopoulos, Carlos Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutierrez Barrios, Juan Pablo Bachini, Alex Rocha, Frankie Chor-Cheung Tam, Alfredo Rodriguez, Antonia Anna Lukito, Anne Bellemain-Appaix, Gustavo Pessah, Giuliana Cortese, Guido Parodi, Mohammed Abed Burgadha, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Matteo Nardin, Monica Verdoia","doi":"10.2174/0115701611415264260622061654","DOIUrl":"https://doi.org/10.2174/0115701611415264260622061654","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the large use of renin-angiotensin system inhibitors (RASI) in STSegment Elevation Myocardial Infarction (STEMI) patients, few data have been reported on the prognostic impact of chronic RASI at admission in patients suffering from STEMI, especially during the COVID-19 pandemic. Therefore, the current study investigated the prognostic impact of chronic RASI at admission in patients suffering from STEMI, including both SARS-CoV-2 positive and negative individuals, enrolled before and during the COVID-19 pandemic.</p><p><strong>Methods: </strong>We included STEMI patients who received primary percutaneous coronary intervention (PPCI) and were enrolled in the ISACS-STEMI COVID-19 registry. In the present sub-analysis, patients were allocated according to chronic RASI therapy at admission. The primary study endpoint was the occurrence of in-hospital mortality. Secondary endpoints were postprocedural TIMI 3 flow and mortality at 1 month.</p><p><strong>Results: </strong>The overall population was 15,693 patients, including 6,213 patients pretreated with RASI. Several differences in baseline characteristics were observed between the two groups. No difference was observed in the prevalence of SARS-CoV-2 infection. After correction for all baseline confounders, including procedural features, chronic pretreatment with RASI was independently associated with improved postprocedural TIMI 3 flow (OR [95% CI] = 1.14 [1.03-1.35], p = 0.042), lower in-hospital mortality (adjusted OR [95% CI] = 0.64 [0.54-0.75], p < 0.001), and lower 30-day mortality (adjusted OR [95% CI] = 0.62 [0.53-0.73], p < 0.001).</p><p><strong>Conclusion: </strong>This is the largest study investigating the prognostic impact and benefits of chronic RASI pre-treatment in STEMI patients undergoing PPCI, including those treated during the COVID19 pandemic. We found that chronic RASI treatment at hospital admission was associated with significant improvement in reperfusion and reduction in mortality, without any negative effect in SARS-CoV-2 positive patients. Results should be interpreted considering the retrospective, nonrandomized nature of the study.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Steps to Walk Out of, or Side Track, Cardiovascular Disease to Achieve Longevity.","authors":"Antonis A Manolis, Theodora A Manolis, Antonis S Manolis","doi":"10.2174/0115701611363987251012160135","DOIUrl":"https://doi.org/10.2174/0115701611363987251012160135","url":null,"abstract":"<p><p>Aging is a relentless process of gradual physio-biochemical non-reversible deterioration that significantly influences human health, leading to declining cellular function and increasing cellular damage; it is recognized as a major risk factor for atherosclerosis and cardiovascular (CV) disease (CVD), the leading cause of death worldwide. Although aging is inevitable, healthy aging is the key to well-being. Longevity is a desirable yet complex outcome influenced by a wide range of factors, including genetics, lifestyle choices, healthcare access, socio-economic conditions, and other environmental factors. The compromised efficiency of processes that counteract age-associated molecular damage affects CVD susceptibility and expedites the emergence of clinical disease. Recently recognized key resilience mechanisms related to aging may constitute new potential therapeutic targets. Geroscience focuses on the discovery and translation of methods and interventions to curtail or reverse age-related deficits that compromise quality of life for older individuals. The geroscience paradigm, increasingly acknowledged in medical specialties, renders possible the prevention of premature aging, the optimal treatment of geriatric diseases, the reduction of healthcare disparities and prejudices, and the extension of the population's health span. These important geroscience issues, including multimorbidity, frailty, tendency to frequent falls, cognitive and multisensory impairment, cardiac arrhythmias, coronary disease and heart failure, as well as undernutrition, sarcopenia and polypharmacy, are herein discussed, together with recent relevant medical advances. Emphasis is placed on boosting psychology and also on pharmacological and nonpharmacological interventions such as exercise and physical activity, healthy diets and lifestyle that target key components of aging, which might assist in both primary (geroprotection) and secondary prevention (gerotherapeutics) of CV and other diseases posing an enormous challenge in older age. The geroscience paradigm is increasingly recognized in medical specialties, enabling the prevention of premature aging, optimal management of geriatric ailments, reduction of health-care disparities and prejudices, and potential improvement of the population's health-span.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mast Cells and Cardiovascular Disorders.","authors":"Antonis A Manolis, Theodora A Manolis, Apostolos Vouliotis, Antonis S Manolis","doi":"10.2174/0115701611393333260511094916","DOIUrl":"https://doi.org/10.2174/0115701611393333260511094916","url":null,"abstract":"<p><p>Mastocytosis is a neoplasm characterised by clonal proliferation of mast cells (MCs) in the skin and other organs, including the heart, and symptoms produced by MC-derived mediators. MC activation syndrome (MCAS) relates to increased and inappropriate activation of MCs without clonal proliferation. Mast cells are tissue-resident immune cells strategically located in different cardiac sites, e.g., myocardium, pericardium, aortic valve, and close to nerves, and in atherosclerotic plaques. The mediators (e.g., histamine, tryptase, chymase, cytokines, and chemokines) have roles in inflammation, angiogenesis, tissue remodelling, and fibrosis. They activate different cardiac resident immune cells (e.g., macrophages) and structural cells (e.g., fibroblasts and endothelial cells). MCs participate in atherosclerosis and several cardiovascular diseases (CVD), comprising allergic angina, coronary syndromes, and arrhythmias, by destabilizing and promoting atherosclerotic plaque rupture with its attendant dire consequences. Furthermore, MCs stimulate fibrosis after a myocardial infarction. MCAS is increasingly appreciated as it affects many patients previously noted to have various apparently idiopathic chronic multisystem inflammatory and/or allergic diseases or dystrophisms. Symptoms resulting from mediator release comprise flushing, hypotension, urticaria, angioedema, headache, vomiting, and diarrhea. Diagnosis is rendered by skin and/or bone marrow biopsy. Considering the increasing incidence and prevalence of MC-related diseases, guidance is needed for clinicians or researchers to select efficacious MC stabilizers that could block external stimulus signals into cells, inhibit intracellular signalling pathways, and disrupt degranulation. These novel therapies may soon find their way into the clinical arena. All relevant data and important advances in this recently recognized clinical entity are herein reviewed.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational and Environment-Related Cardiovascular Disease: A Comprehensive Review of the Literature.","authors":"Antonis S Manolis, Antonis A Manolis, Theodora A Manolis, Apostolos Vouliotis","doi":"10.2174/0115701611431479260401102651","DOIUrl":"https://doi.org/10.2174/0115701611431479260401102651","url":null,"abstract":"<p><p>Work is a social determinant of Cardiovascular (CV) and general health and can both influence and be influenced by health. The type of work, working conditions, and work environment are fundamental social determinants of CV and general health status. Climate change presents an urgent and increasing threat to workers' health, via both direct exposure to environmental risks and the indirect worsening of social and health inequalities. Occupational health, which focuses on the promotion of mental and physical health and well-being of workers, and the avoidance of occupationrelated health risks, is a crucial but less discussed concern and component of human health. Relevant research at the intersection of climate change and occupational health remains scarce. Additionally, mitigation of climate change and adaptation efforts are driving forces for rapid transformations in the workplace, including shifts towards sustainability and circular economy models. These transitions are creating new occupational hazards, including those concerning renewable energy and the circular economy sectors. Investment in occupational health research and surveillance should be increased to address the evolving influences of both climate change and the green transition, to enhance and protect workers' CV and general health. Among the work-related factors that play an important role in patients with CVD, the following seem crucial: work participation, physical and mental work capability, appropriate work, support from and flexibility of the work environment, inter-personal communication, person-centered milieu, and interdisciplinary communication. A moderate leisure-time physical activity combined with moderate occupational physical activity may be a more plausible way to combine these two activities to sustain and/or improve CV health. Such an approach may be able to ameliorate workrelated outcomes in patients with CVD. Finally, lifestyle interventions targeting multiple behaviors are also most important to prevent CVD and attain cardiometabolic health. All these issues of occupational CVD are herein reviewed, and relevant meta-analyses are tabulated and discussed.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metalloproteinases 2 and 9 as Biomarkers in Acute Elevation of Blood Pressure.","authors":"Days Oliveira de Andrade, Doroteia Rossi Silva Souza, Moacir Fernandes de Godoy, Tatiana Palotta Minari, Marco Antonio Vieira-da-Silva, Luciana Neves Cosenso-Martin, Jose Fernando Vilela-Martin","doi":"10.2174/0115701611408430251124044623","DOIUrl":"https://doi.org/10.2174/0115701611408430251124044623","url":null,"abstract":"<p><p>Vascular remodeling, a common feature of hypertension and its complications, involves the reconstruction of blood vessel layers through mechanisms of vascular matrix degradation and reorganization. This process is an important step in development, morphogenesis, and tissue repair. Normally, it is regulated by physiological conditions, but when dysregulated, it may contribute to the pathogenesis of several diseases, such as arthritis, cancer, chronic ulcers, and fibrosis. Uncontrolled remodeling of the extracellular matrix (ECM) in the myocardium and vasculature is characteristic of cardiovascular diseases (CVDs). Matrix metalloproteinases (MMPs) have been highlighted as an important class of enzymes with cleavage capacity linked to remodeling processes in CVDs. These proteolytic enzymes are involved in collagen degradation, contribute to the formation and breakdown of various ECM proteins, and participate in cell migration and growth regulation. They are present in several cell types and tissues, including vascular smooth muscle cells, fibroblasts, endothelium, and inflammatory cells. Activation of the renin-angiotensin-aldosterone system affects vascular structure by promoting fibrosis and growth and is also an important regulator of inflammation and vascular remodeling. In this context, this review aims to provide insight into the biological role of MMPs (focusing on MMP-2 and MMP-9) and tissue inhibitors of metalloproteinases (TIMPs) in the development and progression of CVDs, as well as the severe implications of acute blood pressure elevations, such as eclampsia, stroke, and other related conditions, highlighting the varied roles of MMPs in vascular remodeling processes.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147971304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the Cardiovascular Risk Increased in Patients with Isolated Systolic Hypertension and Anemia?","authors":"Koracevic Goran, Micic Sladjana, Stojanovic Milovan, Zdravkovic Marija, Otasevic Petar, Lovic Dragan, Djindjic Boris, Otasevic Suzana, Jankovic Tomasevic Ruzica, Cvetkovic Predrag, Maricic Bojan","doi":"10.2174/0115701611427759260410142243","DOIUrl":"https://doi.org/10.2174/0115701611427759260410142243","url":null,"abstract":"<p><strong>Introduction: </strong>Isolated systolic hypertension (ISH) is important because of its very high prevalence. Anemia is also a highly prevalent non-communicable disease. The paper aims to answer the study questions: 1) Is there a relation between anemia and dBP?; 2) Is there a link between ISH and anemia?; 3) Are ISH and anemia important due to their prevalence?; 4) Is the cardiovascular risk increased in ISH patients with anemia?5) Is this recognized in HTN guidelines?</p><p><strong>Methods: </strong>Search 1 was done for 'isolated systolic hypertension' and 'anemia' in papers (excluding guidelines). Search 2 was performed for arterial hypertension (HTN) guidelines, to see if there is a part about 'isolated systolic hypertension' and about 'anemia', as well as about their relationship. We performed a SCOPUS, Springer Verlag, Elsevier, PubMed, and Google Scholar search.</p><p><strong>Results: </strong>Diastolic blood pressure is often decreased in anemia, due to abundant pathophysiological mechanisms. Moreover, dBP is often low in both ISH and anemia. Third, anemia and ISH are important due to their high prevalence, especially in the elderly.</p><p><strong>Discussion: </strong>The main result of the study is the identification of the important, clinically relevant, previously undefined problem: anemia in ISH. Cardiovascular risk is increased in ISH patients with anemia. The significance of anemia in ISH is not recognized in HTA guidelines, partially because they need to be concise.</p><p><strong>Conclusion: </strong>The overlooked problem of anemia in ISH needs recognition both in clinical practice, to avoid overzealous dBP reduct.</p>","PeriodicalId":11278,"journal":{"name":"Current vascular pharmacology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147940606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}