Left ventricular systolic function after marked reduction of ventricular hypertrophy induced by 5 years' enalapril treatment

To determine the effects of long-term treatment of essential hypertension with an angiotensin-converting enzyme inhibitor as regards arterial pressure at rest and during exercise, left ventricular mass and functional sequelae. Twenty-six patients with previously untreated essential hypertension took...

Full description

Saved in:

Bibliographic Details
Published in:	European heart journal Vol. 16; no. 12; p. 1981
Main Authors:	González-Juanatey, J R, Pose Reino, A, García Acuña, J M, Castelo Fuentes, V, Amaro Gendón, A, Calvo Gómez, C, Gil de la Peña, M
Format:	Journal Article
Language:	English
Published:	England 01-12-1995
Subjects:	Adult Angiotensin-Converting Enzyme Inhibitors - administration & dosage Angiotensin-Converting Enzyme Inhibitors - adverse effects Echocardiography - drug effects Enalapril - administration & dosage Enalapril - adverse effects Female Follow-Up Studies Hemodynamics - drug effects Hemodynamics - physiology Humans Hypertension - diagnostic imaging Hypertension - drug therapy Hypertrophy, Left Ventricular - diagnostic imaging Hypertrophy, Left Ventricular - drug therapy Long-Term Care Male Middle Aged Ventricular Function, Left - drug effects Ventricular Function, Left - physiology
Online Access:	Get more information
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	To determine the effects of long-term treatment of essential hypertension with an angiotensin-converting enzyme inhibitor as regards arterial pressure at rest and during exercise, left ventricular mass and functional sequelae. Twenty-six patients with previously untreated essential hypertension took enalapril 20 mg twice daily for 5 years. Cardiovascular parameters were determined by two-dimensionally guided M-mode echocardiography in a pre-treatment placebo phase, 8 weeks and 1, 3 and 5 years after the start of therapy, and 8 weeks after drugs were discontinued. Therapy reduced resting arterial pressure from 156/105 to 128/84 mmHg (P < 0.001) and arterial pressure during exercise from 205/113 to 172/94 mmHg (P < 0.0011). After 1, 3 and 5 years' therapy, left ventricular mass index had decreased by 15, 28 and 39% respectively (P < 0.001 in each case). Eight weeks after treatment was halted, arterial pressure at rest and during exercise had returned to pre-treatment values, but decreased left ventricular mass was maintained. Left ventricular pump function had improved after 5 years' treatment, and this improvement was maintained during the 8 weeks without treatment. Significant reductions in arterial pressure at rest and during exercise were achieved by 8 weeks' treatment with enalapril and maintained during 5 years' further treatment, while a marked reduction in left ventricular mass took place progressively throughout the 5 year period. Reduction of myocardial hypertrophy by enalapril appeared to be beneficial rather than detrimental to cardiac pump performance.
ISSN:	0195-668X
DOI:	10.1093/oxfordjournals.eurheartj.a060857