THE ARTERIAL-WALL - A NEW PHARMACOLOGICAL AND THERAPEUTIC TARGET

In recent years, two key concepts having numerous interrelationships w ere advanced for the understanding of various cardiovascular diseases: the ''endothelial dysfunction'' and the ''arterial remodelling''. Bot h endothelial dysfunction and arterial remodelling occur in various pa thologies including essential hypertension, heart failure, atheroscler osis, restenosis after angioplasty, and pulmonary hypertension, and ha ve modified the therapeutic approach by offering new pharmacological t argets: specific receptors not only at the site of the vascular smooth muscle cells but also on the endothelial cells, growth factors that s timulate proliferation of smooth muscle, and receptors and enzymes of the extra-cellular matrix. Among the various substances under research , the present review will discuss angiotensin II receptor antagonists, endothelin receptor antagonists, nitrates-NO donors, potassium channe l activators, and substances interfering with proteoglycans and other components of the extra-cellular matrix.