ENALAPRIL DOES NOT IMPROVE LEFT-VENTRICULAR DIASTOLIC DYSFUNCTION IN YOUNG AND MILD HYPERTENSIVES WITHOUT CONCOMITANT HYPERTROPHY

The aim of the study was to determine whether enalapril monotherapy ca n improve left ventricular diastolic dysfunction (LVDD) in young and m ild hypertensive patients without concomitant left ventricular hypertr ophy (LVH). Fifty patients with hypertension less than or equal to 160 /100 mm Hg, aged less than or equal to 50 years, normal two-dimensiona l echocardiographic (2-D echo) measurements, and LVDD were enrolled in this study. The LVDD was defined as a transmitral early (E) to atrial (A) peak velocity ratio of 1. The mean documented hypertension was 6.3 years. The mean daily dose of enalapril was 13 mg. Baseline and 24-mo nth follow-up echocardiograms were evaluated. Thirty-eight age- and se x-matched healthy subjects served to establish the normal reference va lues of 2-D echo measurements. After treatment, peak early diastolic v elocity (E) (49 +/- 6 cm/sec v 48 +/- 10 cm/sec; P = not significant), peak atrial velocity (A) (62 +/- 9 cm/sec v 62 +/- 10 cm/sec; P = not significant), and E/A ratio (0.80 +/- 0.10 v 0.78 +/- 0.13; P = not s ignificant) remained unchanged. Moreover, early to atrial velocity-tim e integral ratio (1.24 +/- 0.08 v 1.23 +/- 0.11; P = not significant) did not change. The left ventricular mass index, relative wall thickne ss, left ventricular end-systolic diameter, left atrial diameter, frac tional shortening, heart rate, and body mass index did not show signif icant changes in all hypertensive patients. In conclusion, longterm an tihypertensive therapy with enalapril did not lead to an improvement o f LVDD in young and mild hypertension patients without concomitant LVH .