From Fiona Bailey

23 Sep 2024

Hi Paul,

As we postulate both central (SNS inhibition) and peripheral mechanisms underlying BP reductions we also have been assessing flow mediated dilation (FMD) and the potential for BP meds to impact shear stress as a factor promoting NO mediated vasodilation. 

Ca+ inhibitors certainly effect endothelial function but others also have noted changes in FMD with beta blockers and ACE inhibitors. I have an older reference for this — but its at home.

It's interesting if you think that CPAP also appears to negatively impact FMD - so presumably our OSA folks have CPAP + meds effects adding yet another layer of complexity.

Another reason perhaps to think of the elevated /hypertensive folks as a "cleaner" group that may provide mechanistic insight?

Fiona