Cell growth and survival are potential therapeutic targets for the control of complications associated with
hypertension. In most cardiovascular disorders, cardiac fibroblasts and large-vessel smooth muscle cells can replicate and thus contribute to the disease. We propose that cardiovascular
hyperplasia may be reversed via therapeutic apoptosis induction with drugs that are safe and already used in the clinic. We first reported that, irrespective of the drug class, those drugs that are able to induce regression of cardiovascular
hypertrophy are also able to reverse cardiovascular
hyperplasia via apoptosis. Drugs active in this regard include inhibitors of the renin-angiotensin system,
calcium channel blockers, and beta-blockers. Moreover, the effects of these drugs on cell survival is not merely secondary to blood pressure reduction. Therapeutic apoptosis in the cardiovascular system of the spontaneously hypertensive rat is characterized by a rapid and transient onset following initiation of
antihypertensive treatment. Herein, the induction and termination of therapeutic apoptosis during drug treatment of
hypertension will be briefly reviewed and supported by novel data suggesting that reversal of cardiovascular
hyperplasia is associated with reduced cell growth and a resistance to further induction of therapeutic apoptosis, as shown in spontaneously hypertensive rats receiving an intermittent regime of
nifedipine therapy. We propose that the presence of a cell subpopulation with defective cell cycle regulation may determine organ susceptibility to undergo therapeutic apoptosis.