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Canadian Journal of Cardiology

Oxidative Stress and Human Hypertension: Vascular Mechanisms, Biomarkers, and Novel Therapies

Published:February 13, 2015DOI:https://doi.org/10.1016/j.cjca.2015.02.008

      Abstract

      Hypertension is a major cardiovascular risk factor. Of the many processes involved in the pathophysiology of hypertension, vascular damage due to oxidative stress (excess bioavailability of reactive oxygen species [ROS]) is particularly important. Physiologically, ROS regulate vascular function through redox-sensitive signalling pathways. In hypertension, oxidative stress promotes endothelial dysfunction, vascular remodelling, and inflammation, leading to vascular damage. Vascular ROS are derived primarily by nicotinamide adenine dinucleotide phosphate oxidases, which are prime targets for therapeutic development. Although experimental evidence indicates a causative role for oxidative stress in hypertension, human data are less convincing. This might relate, in part, to suboptimal methods to accurately assess the redox state. Herein we review current knowledge on oxidative stress in vascular pathobiology and implications in human hypertension. We also discuss biomarkers to assess the redox state in the clinic, highlight novel strategies to inhibit ROS production, and summarize how lifestyle modifications promote vascular health by reducing oxidative stress.

      Résumé

      L'hypertension est un facteur de risque cardiovasculaire majeur. Parmi les nombreux processus intervenant dans la physiopathologie de l'hypertension, les lésions vasculaires dues au stress oxydatif (biodisponibilité excessive des espèces réactives de l'oxygène [ERO]) sont particulièrement importantes. Physiologiquement, les ERO régulent la fonction vasculaire par les voies de signalisation sensibles à l’état redox. Dans l'hypertension, le stress oxydatif qui favorise la dysfonction endothéliale, le remodelage vasculaire et l'inflammation entraîne les lésions vasculaires. Les ERO vasculaires proviennent principalement des oxydases du nicotinamide-adénine-dinucléotide-phosphate, qui sont les cibles de choix du développement thérapeutique. Bien que les données probantes expérimentales montrent que le stress oxydatif joue un rôle causal dans l'hypertension, les données sur l’être humain sont moins convaincantes. Cela pourrait en partie avoir un lien avec les méthodes qui sont sous-optimales pour évaluer avec précision l’état redox. Ici, nous passons en revue les connaissances actuelles sur la pathobiologie vasculaire et les conséquences liées au stress oxydatif sur l'hypertension chez les êtres humains. Nous discutons également des biomarqueurs pour évaluer l’état redox en clinique, soulignons les nouvelles stratégies pour inhiber la production d’ERO et résumons comment les modifications au mode de vie favorisent la santé vasculaire en réduisant le stress oxydatif.
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