Plasminogen Activator Inhibitor-1: A Novel Therapeutic Target for Hypertension?
Hypertension is the most common reversible risk factor for stroke, myocardial infarction, and heart failure, affecting greater than 60 million individuals in the United State alone and 1 billion globally1. According to the World Health Organization, hypertension is now the leading cause of preventable death worldwide2. Importantly, the prevalence and complications of hypertension increase significantly with age. However, despite the availability of many anti-hypertensive agents of distinct pharmacologic classes and evidence-based guideline recommendations for step-wise, multi-drug regimens, control of hypertension remains suboptimal with target blood pressure achieved in less than 50% of patients 1. Although patient non-compliance and sub-maximal dosing of anti-hypertensive agents contribute to lack of blood pressure control, there is an unmet need for new approaches for treatment of hypertension. In this issue of Circulation, Boe and coworkers3 report that pharmacological inhibition of plasminogen activator inhibitor-1 (PAI-1) is protective against the development of hypertension, cardiac hypertrophy, and periaortic fibrosis (i.e., arteriosclerosis) in mice treated with Nω-nitro-L-arginine methyl ester (L-NAME) to inhibit endothelial nitric oxide synthase (eNOS).
- plasminogen activator inhibitor-1
- hypertension, high blood pressure
- plasminogen activator
- protease inhibitor
- Received September 29, 2013.
- Accepted October 2, 2013.