système rénine-angiotensine; bradykinine; inhibiteur de l'enzyme de conversion; fonction endothéliale; périndopril; Renin-angiotensin system; Bradykinin; Angiotensin converting enzyme inhibitor; Endothelial function; Perindopril
Abstract :
[en] The endothelium plays a vital role as part of the cardiovascular continuum. Risk factors such as hypertension and dyslipidemia unbalance angiotensin II - bradykinin homeostasis, leading to endothelial dysfunction and changes in vascular structure that promote atherosclerosis and thrombosis. When dealing with risk factors, treatment should focus on the prevention and restoration of endothelial function. Not all cardiovascular drugs are able to reverse vascular and structural endothelial dysfunction. Increasing levels of bradykinin is an effect of the use of angiotensin-converting enzyme inhibitors (ACE-Is), and also a fundamental part of their mode of action. The cardiovascular protection observed with ACE-I, and not with sartans, can be explained rationally by the specific effects of bradykinin on the endothelium. In the pharmacological class of ACE-Is, perindopril likely produces the strongest effects on bradykinin, which may explain, at least in part, the documented superiority of this drug in the prevention and treatment of cardiovascular disease. [fr] L’endothélium joue un rôle primordial en tant qu’élément du continuum cardiovasculaire. Les facteurs de risque comme l’hypertension et les dyslipidémies déséquilibrent l’homéostasie angiotensine II – bradykinine, ce qui entraîne une dysfonction endothéliale et des modifications
de la structure vasculaire favorisant l’athérosclérose et les thromboses. Le but du traitement des facteurs de risque doit être la prévention et la restauration de la fonction endothéliale, mais tous les médicaments à visée cardiovasculaire ne sont pas capables d’inverser la dysfonction
endothéliale et les anomalies structurelles vasculaires. L’augmentation des taux de bradykinine est un effet de la prise des inhibiteurs de l’enzyme de conversion (IEC), et représente un élément fondamental de leur mode d’action. La protection cardiovasculaire observée avec les IEC, et
non avec les sartans, peut s’expliquer rationnellement par les effets spécifiques de la bradykinine sur l’endothélium. Dans la classe pharmacologique des IEC, c’est probablement le périndopril qui produit les effets les plus puissants sur la bradykinine, ce qui peut expliquer, au moins en partie, la supériorité documentée de ce médicament dans la prévention et le traitement des maladies cardiovasculaires.
Disciplines :
Urology & nephrology General & internal medicine
Author, co-author :
Lancellotti, Patrizio ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation
ANCION, Arnaud ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Insuffisance cardiaque - Transplantation
D'ORIO, Vincenzo ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service des urgences
GACH, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Cardiologie interventionnelle
MARECHAL, Patrick ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Cardiologie multidisciplinaire et prévention
KRZESINSKI, Jean-Marie ; Centre Hospitalier Universitaire de Liège - CHU > Département de médecine interne > Service de néphrologie
Language :
French
Title :
Bradykinine et protection cardiovasculaire. Role du perindopril, un inhibiteur de l'enzyme de conversion de l'angiotensine.
Alternative titles :
[en] Bradykinin and cardiovascular protection. Role of perindopril, an inhibitor of angiotensin conversion enzyme
Publication date :
2018
Journal title :
Revue Médicale de Liège
ISSN :
0370-629X
eISSN :
2566-1566
Publisher :
Université de Liège. Revue Médicale de Liège, Liège, Belgium
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