ACE inhibitor lisinopril influence on left ventricular diastolic dysfunction and endothelial response in hypertensive patients with or without chronic heart failure

Abstract

In 20 patients with arterial hypertension (AH), ACE inhibitor lisinopril (dapril) was administered as monotherapy for 11, 6 weeks. Mean age of the participants was 56+/-9, 67 years. Group 1 included 8 patients with chronic heart failure (CHF) symptoms, Group 2 - 12 patients without CHF. In Group 1, mean dapril dose was 19, 38 mg/d, in Group 2 - 9, 85 mg/d. For 4 patients from Group 1 and 1 patient from Group 2, due to monotherapy inefficacy, hypothiazide (12, 5 mg/d) was added. The complex clinical examination included 24-hour blood pressure monitoring (24-hour BPM), left ventricular diastolic function assessment with Doppler echocardiography, endothelial response measurement by D. Celermayer method (1992), and quality-of-life evaluation by international scales. Among patients with AH and no CHF, dilapril monotherapy more effectively decreased systolic and diastolic BP levels, pressure load, in comparison to CHF group. A significant diastolic function improvement was observed in both groups. Endothelial response improved only in non-CHF patients. Quality-of-life improved susbstantially in both groups.

Keywords

• arterial hypertension
• chronic heart failure
• left ventricular dysfunction
• monotherapy
• ace inhibitors