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- Title
A095: Chronic treatment with ace-inhibitors induces left ventricular changes independently of blood pressure decrease.
- Authors
Grandi*, A.M.; Bertolini, A.; Santillo, R.; Imperiale, D.; Broggi, R.; Colombo, S.; Selva, E.; Jessula, A.; Guasti, L.; Venco, A.
- Abstract
Using 24-h ambulatory blood pressure monitoring (ABPM) and digitized M-mode echocardiography, we evaluated the left ventricular (LV) morpho-functional changes induced by chronic treatment with ACE-inhibitors (AECi) ineffective in reducing blood pressure (BP).After at least 18 months from the evaluation before treatment, we checked the essential hypertensives (H) (24-hour BP > 140 and/or 90 mmHg) lost at follow-up. Among them we found 21 H who have regularly taken the prescribed ACEi, but at the 2nd evaluation had BP not controlled and similar to pretreatment values. We evaluated: 24-h, day-time, night-time systolic, diastolic BP and heart rate, % nocturnal fall of BP, LV end-diastolic diameter (DD), LV mass index (LVMi), peak shortening (−dD/dt) and peak lengthening rate (+dD/dt) of LV diameter, peak thinning rate of LV posterior wall (dW/dt).Mean interval length between 1st and 2nd evaluation was 28 ± 7 months. BMI and heart rate (24-h, day, night) were unchanged, as were all BP parameters. LVDD and peak shortening rate of LV diameter, index of systolic function, were normal in all and did not change. At the basal evaluation 9 pts. had LV hypertrophy (LVMi > 130 g/m2 men, >110 g/m2 women) and 12 pts. had impaired diastolic function (+dD/dt < 3.6 sec−1 and/or dW/dt < 8.5 cm/sec); at the 2nd evaluation 4 pts had LV hypertrophy and 5 diastolic dysfunction. (See Table)The difference between 1st and 2nd evaluation as regards LV diastolic parameters lost the statistical significance after correction for LVMi values.In conclusion, despite the lack of BP decrease, chronic treatment with ACEi influences the LV, with reduction of LV mass and improvement of LV diastolic function. These effects of ACEi, not due to BP reduction, have therefore to be ascribed to a direct action of the drugs on the myocardium.Am J Hypertens (2000) 13, 146A-146A; doi:S0895-7061(00)00628-2
- Publication
American Journal of Hypertension, 2000, Vol 13, p146A
- ISSN
0895-7061
- Publication type
Article
- DOI
10.1016/S0895-7061(00)00628-2