Treatment effects of Λ-receptor blocker on blood pressure and left ventricular diastolic function in essential hypertension

POSTERS: Antihypertensive

AJH-APRIL 1997-VOL. 10, NO. 4, PART 2

SH ORT-TER M A CE INHIBITO R T RE AT M ENT A N D STRUCTURAL

A N D FU N C TION A L C H A N GES O F T HE

HE A RT. A.S.Gallavltch*, G.M.Kam alov*,T.S.Glukhova and L.I.SaflulXna.Kazan M edlcalUniversity*, Kazan Cardlocentre, Rus.sJa. Effectsof short-termA C E Inhibltomtreatmentcm structureand functionof hypertensive heartwithleft ventricular hypertrophy(LVH) are controvetial. W e studiedshort-term(4 weeks)effectsof ena2aprll10-20 m glday on structural (LV dlmentionsand voIUroes, interventrlcular septum IVS and posterior wall thicknessP W T,leftventricular m ass LV M ) and functional(ejection fractionEF, fractional shorterYmgFS, diastolic filllng velocltyes E,A)Indices. Echocardlo,gam by widelyaccepted methods were obtainedin 14 good responderstc enalapril hypertensive subject.? (stage2, 3 by JN C-V) aged 28-63 years. Resultswere followlng: (before/after treatment)

Drug Treatment

TREATMENT EFFECTSOF& -RECEPROR BLOCKSR ON BLOOD PRESSURE AND LEFTVENTRICULARDIASTOLIC FUNCTIONIN ESSENTIALHYPERTENSION Liuxiaohui, H. Da-yi and He Yi-hua.Bei@gRed Cross ChanyangHospital, Capit?dUniversityof MedicafSciences,Beijing100020,”China. The studywas to evaluatethe effectsofd -receptorblockade on bloodpressure and letl ventriculardimtoficfunctionimessential hypeflension.Fo~-three patientswitl mifdto moderateessential h~ertension were randomfyditided intotwo groups.GroupA was receivedsnbhypertensivetherapywithd-blocker Ahnad (n=21), GroupBwas used as dme-conkol(n=22).Twenty-four-houblood pressuremeasurementssnd echocardiographicmeasurementof lefi venbi.ufar diastolicfunctionwere perfomedheforetiempy, atler 4 weeks oftieatment. .Mmsrlsignificantlyreduced in mean systolic/diastolicbloodpressure atter 4 weeks of therapyin GroupA(-15.1+8.3w -10.4i8.2nunH~respectively)(p<0.0001j. Diastoliclet?venbicuhr All@ was not increasedwiththe Ahnad (pO.05).Itw~ suggestedthat M-blOGkeriscapableof reducing systolic/diastolicbloodpressure significantlybut it doesn’taffected Iefiventricukwdiastolicfiction in hypertensivepatients.

LVED D =4,9/4,9. LVESD =3,3/3,3. LVED V=82,1/82,7. LVESV=32,3/34,0. IVS=l,3/1,3.P W T=l,3/1 ,3.LV M=ZJ+,2/ (p~ 0,05). 244,2.EF=60/58.ES=32/33.E/A ❑0,78/0,83. W e concludedthatin spiteof reductionof high bloodpressureshort-termenslapril treatmentdid not change structural and functional indicesof hypertensive heartwith LV H. Key Worda: enalapti,

structure,

left venhicular diastolicfuncdom echocsrdiography, d-receptor blocker,essendafhwerteodan,

function.

THERESULTSOF PROLONGEDTREATMENTOF PATIENTS WITHDIABETESMELLITUSANDARTERfAL HYPERTENS1ON WITHCAPOTEN. N.N.Kimhidze, M.A.Rogava, Institute of Clinicaland Experimental Therapy,Tbilisi,Georgia Weobserved78 patients(aged27 to 74 years)withDiabetes MeUitus(duration4 monthsto 15years)andarterialhypertension. 45 patients,including7 withunstableand38 withstable hypertension,formedthe 1stgroupof insulin-dependent patients.in the 2ndgroupof33 insulin-independent patients,6 hadunstableand 27 stablehypertension.Dailydoseofcapotenin eachgroupof patientsvariedfrom 12.5to 75 mg, reachingin somecases 1OO-I25 mgfor a shortperiodof time. Inbothgroupstherewastbe decrease of EDV,ESVandthe increaseof EFandE/A coefficients demonstratingimprovementof systolicanddiastolicfunctionof left ventricle.?le positiveeffectofprokmgedtreatmentwithcapoten during7 yearswas observedin 68.4%of the Ist groupand 54.5%in the 2ndgroupin patientswithstablehypertension(73.3%and72.7%, combined).Inbothgroupsvirtuallyall patientswithunstable hypertensionin additionto positivehemodynamicchangesshowed animprovement in microcirculatory parameters,wbereasin patients withstablehypertensionthesechangesshowedan independent character.Positivestablehemodynamicchangesbothpracticallyand statisticallywerenot relatedwithmicrocirculatorychanges.Our experienceshowsthatcapotenis a highlyeffectivedrugfor longtermandcontinuoususe,whicbinsuresan improvementand preservationof functionalstabilityof the cardiovascularsystemand normalizationof arterialpressure.Weconcludedthat capotencan be successtidlyusedas a preventivemeasureinjust earlystagesoftbe disease,improvingthe qualityof lifeand long-termprognosisin patientswiththis complexaad life-threateningdisease. diabetesmellitus,capoten,srteriaihypertension Key Words:

Key Words:

Is it a reason to use angiotensirrconverthtgenzyme inhibitorsin postmenopausalwomeu. Lubov1.Olbinskaya,SvetlasmA. Kbaritonova MoscowMedicalSechenovAcademy,Rusaia Itis estimated that many women in postmenopausal period are needed of the antihypertensive treatment. It is established that only antihypertensive drugs are not satisfied for blood pressure control. The main of the study was to try to treat arterial hypertension in postmenopausal women with combination antihypertensive drug and hormone replacement therapy (HRT). As the antihypertensive drug we used angiotensin converting enzyme(ACE) inhibitor trandolopril (T) (Krroll,Germany) and estradiol valerate (EV) + norgestrel(N) (Shering, Germany) as a HRT. This combination help to intensify the vasoprotective effects of estrogens and its peripherical vasodilated actions. T 2 mg or EV 2 mg + N 5 mg are used or as a monotherapy once daily or as a combination. Without special randomisation half of the women were started with T, half- with HRT. After 2 weeks in cases without satisfactory effects the dose of was increased and after 2month we added HRT if it well necessary. In group which we started with HRT after 2 month we added T if blood pressure became rather high. Monotherapy with T had antihypertensive effects in 68°/0, HRT monotherapy - 61°/0.The best results are notice in combination treatment cases. Conclusion: In postmenopausal women with mild or moderate arterial hypertension it is possibleto use ACE inhibitors or HRT as monotherapy. In part of such women combination of ACE inhibitors and HRT is more suitable. Key Words: postmenopausal women, arterial hyperten8ion, ACE inhibitors, hormone replacement therapy

139A