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Background  We have previously demonstrated that antihypertensive treatment with renin‐angiotensin system inhibitors restores the impaired endothelium‐dependent hyperpolarization ( EDH )–mediated responses in spontaneously hypertensive rats ( SHR s). Herein, we investigated whether the angiotensin  II  receptor–neprilysin inhibitor sacubitril/valsartan ( LCZ 696) would improve reduced  EDH ‐mediated responses and whether  LCZ 696 would exert additional effects on endothelium‐dependent and endothelium‐independent vasorelaxation compared with an angiotensin  II  type 1 receptor blocker alone during hypertension.    Methods and Results   SHR s were treated for 3 months with either  LCZ 696 or valsartan, from the age of 8 to 11 months. Age‐matched, untreated  SHR s and Wistar‐Kyoto rats served as controls. Membrane potentials and contractile responses were recorded from the isolated superior mesenteric arteries. Acetylcholine‐induced,  EDH ‐mediated responses were impaired in untreated  SHR s compared with Wistar‐Kyoto rats.  EDH ‐mediated responses were similarly improved in the  LCZ 696‐ and valsartan‐treated  SHR s. No difference was observed in acetylcholine‐induced, nitric oxide‐mediated relaxations among the 4 groups. Endothelium‐independent relaxations in response to a nitric oxide donor, sodium nitroprusside, and those to levcromakalim, an  ATP ‐sensitive K + ‐channel opener, were similar among the 4 groups; however, the sensitivities to levcromakalim were significantly higher in both  LCZ 696‐ and valsartan‐treated  SHR s.    Conclusions   LCZ 696 appears to be as effective as valsartan in improving the impaired  EDH ‐mediated responses during hypertension.  LCZ 696 and valsartan exert similar beneficial effects on endothelium‐independent relaxation via enhanced sensitivity of the  ATP ‐sensitive K +  channel. However, the dual blockade of renin‐angiotensin system and neutral endopeptidase with  LCZ 696 does not appear to provide additional benefit over valsartan alone on vasomotor function in mesenteric arteries of  SHR s.

Angiotensin II Receptor–Neprilysin Inhibitor Sacubitril/Valsartan Improves Endothelial Dysfunction in Spontaneously Hypertensive Rats