The matrix metalloproteinases/tissue inhibitors of metalloproteinases
system is involved in the regulation of extracellular matrix metabolism,
which plays a crucial role with regards to maintenance of tissue
integrity. During the occurrence of vascular pathologies including
hypertension, the balance between proteases and their inhibitors is
temporally destroyed. Even though there are conflicting data in the
literature regarding the expression pattern of the vascular matrix
metalloproteinase system, the occurring extracellular matrix turnover
leads to the change of arterial mechanical properties. For example,
hypertension plays crucial role in the formation of cardiovascular
remodeling which seems to be characterized by an increase in
extracellular matrix. Changes in arterial stiffness, a predictor for
cardiovascular morbidity and mortality, are determined by alterations in
vascular extracellular matrix due to hemodynamic, genetic, or other
factors. It has become increasingly evident that blockade of the
renin-angiotensin-aldosterone system and other pharmacological
strategies, seem to be particularly effective in reducing vascular
stiffness and collagen content in human and animal models. However, the
relationship between extracellular matrix metabolism and the effects of
therapy in hypertensive patients needs to be further explored in larger
trials over a longer period of time