The incidence of
hypertension, the major modifiable risk factor for
cardiovascular disease, is increasing. Thus, there is a pressing need for the development of new and more effective strategies to prevent and treat
hypertension. Development of these relies on a continued evolution of our understanding of the mechanisms which control blood pressure (BP). Resistance arteries are important in the regulation of total peripheral resistance and BP; changes in their structure and function are strongly associated with
hypertension.
Anti-hypertensives which both reduce BP and reverse changes in resistance arterial structure reduce cardiovascular risk more than
therapies which reduce BP alone. Hence, identification of novel potential vascular targets which modify BP is important.
Hypertension is a multifactorial disorder which may include a genetic component. Genome wide association studies have identified ATP2B1, encoding the
calcium pump
plasma membrane calcium ATPase 1 (PMCA1), as having a strong association with BP and
hypertension. Knockdown or reduced PMCA1 expression in mice has confirmed a physiological role for PMCA1 in BP and resistance arterial regulation. Altered expression or inhibition of PMCA4 has also been shown to modulate these parameters. The mechanisms whereby PMCA1 and 4 can modulate vascular function remain to be fully elucidated but may involve regulation of intracellular
calcium homeostasis and/or comprise a structural role. However, clear physiological links between PMCA and BP, coupled with experimental studies directly linking PMCA1 and 4 to changes in BP and arterial function, suggest that they may be important targets for the development of new pharmacological modulators of BP.