CHANGES OF THE LEFT-VENTRICULAR DIASTOLIC FUNCTION IN PATIENTS WITH ESSENTIAL-HYPERTENSION AFTER A COURSE OF ANTIHYPERTENSIVE TREATMENT

Patients with mild to moderate essential hypertension (n=29) were trea ted for 6 week by antihypertensive drugs in individually effective dos es. Eight patients received ebalapril, 8 - diltiazem, 7 - prazosin and 6 - nifedipine. None of the patients had signs of ischemic heart dise ase, disorders of cardiac rhythm or heart failure. There was no differ ence between four treatment groups in initial blood pressure and main hemodynamic parameters. All the patients had echo-doppIer signs of dia stolic dysfunction: isometric relaxation time and deceleration time of early filling were increased, the peak early to peak atrial velocitie s ratio was significantly decreased compared to values obtained in 15 healthy persons. In each of treatment groups therapy resulted in signi ficant lowering of systolic and diastolic blood pressures and in a ten dency to improvement of all echo-doppler characteristics of left ventr icular diastolic function. Moreover, enalapril and diltiazem significa ntly reduced isovolumic relaxation time while ebalapril also significa ntly lowered peak early to peak atrial velocities ratio. #either nifed ipine nor prazosine produced significant changes of left venrtcular di astolic function. Dynamics of echo-doppler parameters of left ventricu lar diastolic function during acute pharmacological test and during 6 weeks of treatment was not always identical. Peak to peak atrial ratio was the most reliable parameter for prediction of reaction of left ve ntricular diastolic function to course treatment. Its dynamics during acute drug test coincided with that during 6 weeks of treatment in 75% of cases.