Cyclosporine, Blood Pressure and Atherosclerosis
Abstract
Blood pressure rises soon after administration of immunosuppressive regimens using cyclosporin A, These changes lead to widespread vasoconstriction and increased risk for atherosclerosis. Changes in blood pressure are commonly associated with disturbed circadian regulation and may produce rapidly developing target injury, including intracranial hemorrhage, left ventricular hypertrophy and microangiopathic hemolysis. Mechanisms underlying this disorder are complex and include altered vascular endothelial function. Vasodilators such as prostacyclin and nitric oxide are suppressed, whereas vasoconstrictors, including endothelin, are increased. Changes in the kidney include vasoconstriction, reduced glomerular filtration and sodium excretion. When blood pressure effects are combined with the effects of glucocorticoids and weight gain, changes in cholesterol and triglycerides magnify the risk for atherosclerotic disease. Effective therapy depends upon rigorous blood pressure control and administration of vasodilating agents with attention to the interactions with cyclosporin A. Effective blood pressure control and lipid management is an important component in the long-term management of transplant recipients.
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Cyclosporine is associated with enhanced renal vasoconstriction leading to volume-dependent (low renin) hypertension.
“Cyclosporine is associated with enhanced renal vasoconstriction leading to volume-dependent (low renin) hypertension.219,220”
From Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association (2018) · cites this paper as [219]
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Carey, R. M., Calhoun, D. A., Bakris, G. L., Brook, R. D., Daugherty, S. L., Dennison-Himmelfarb, C. R., Egan, B. M., Flack, J. M., Gidding, S. S., Judd, E., et al. (2018) · Hypertension · doi:10.1161/hyp.0000000000000084 · Cited by 1,153 · see citing works
“is associated with enhanced renal vasoconstriction leading to volume-dependent (low renin) hypertension.(219,220) Cyclosporine-”
BackgroundSelf-citationOral cyclosporine decreases severity of neurotoxicity in liver transplant recipients
Wijdicks, E. F. M., Dahlke, L. J., & Wiesner, R. H. (1999) · Neurology · doi:10.1212/wnl.52.8.1708 · Cited by 33 · see citing works
Taler, S. J., Textor, S. C., Canzanello, V. J., et al. (2000) · American Journal of Hypertension · doi:10.1016/s0895-7061(99)00171-5 · Cited by 21 · see citing works
Self-citationSecondary Hypertension due to Drugs and Toxins
Gyamlani, G. G., & Geraci, S. A. (2007) · Southern Medical Journal · doi:10.1097/smj.0b013e318063c3e8 · Cited by 18 · see citing works
“Enhanced renal vasoconstriction with decreased excretion of salt and water produces volume-dependent (low renin) hypertension.(18) Blood pressure may be difficult to control when cyclosporine is continued, and although this typically decreases after drug discontinuation, it may not resolve completely.”
BackgroundExtending Myocardial Viability During Heart Preservation with Cyclosporine A
Masters, T. N., Fokin, A. A., Schaper, J., et al. (2010) · Journal of Cardiac Surgery · doi:10.1111/j.1540-8191.2000.tb01299.x · Cited by 14 · see citing works
Factores que influyen en la hipertensión arterial refractaria
de la Morena, J. S., Sien, C. C., & Urioste, L. M. R. (2002) · Hipertensión y Riesgo Vascular · doi:10.1016/s1889-1837(02)71260-9 · Cited by 4 · see citing works
Manolis, A. J. (2020) · Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature · doi:10.3410/f.734299250.793571584 · Cited by 1 · see citing works
- Authors
- TEXTOR, S. C., TALER, S. J., CANZANELLO, V. J., & SCHWARTZ, L.
- Affiliations
- Mayo Clinic (US)
- ORCID
- TALER, SANDRA J.
- Venue
- Cardiology in Review
- Published
- 1997-05
- Volume
- 5
- Issue
- 3
- Pages
- 141-151
- ISSN
- 1061-5377 (ISSN-L)
- OpenAlex
- W1969335966
- Cited by
- 7
- References
- 0
- Citations by year
- 2020: 1 · 2018: 1
- FWCI
- 0.48
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cardiology in Review (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Transplantation › Renal Transplantation Outcomes and Treatments
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Keywords
- cyclosporine, blood pressure, atherosclerosis, immunosuppressive therapy, vasoconstriction, circadian rhythm, endothelial dysfunction, intracranial hemorrhage, left ventricular hypertrophy, microangiopathic hemolysis, glucocorticoids, lipid control, transplant recipients, vasodilators, endothelin, prostacyclin, nitric oxide, renal vasoconstriction
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