AMBULATORY BLOOD-PRESSURE AND LEFT-VENTRICULAR CHANGES DURING ANTIHYPERTENSIVE TREATMENT - PERINDOPRIL VERSUS ISRADIPINE

Using digitized M-mode echocardiograms and 24-h ambulatory blood press ure (BP) monitoring, we compared the effects on left ventricle (LV) an d BP of 6-month treatment with a calcium antagonist or an angiotensin- converting enzyme (ACE) inhibitor in 36 hypertensive patients with LV hypertrophy (group 1, 18 subjects treated with sustained-release israd ipine; group 2, 18 subjects treated with perindopril), At the basal ev aluation, the two groups had comparable BP and LV parameters. After tr eatment, both groups showed a similar and significant reduction in 24- h, day- and night-systolic and diastolic BP (SEP, DBP). The reduction in LV mass index was greater (p < 0.01) in group 2. In group 1, percen tage of decrease of LV mass correlated significantly with percentage o f decrease in 24-h and daytime BP; this was not true of group 2. Toget her with the reduction in LV hypertrophy, there was a significant incr ease of peak lengthening rate of LV diameter that was greater (p < 0.0 1) in group 1. Both drugs can reduce LV hypertrophy and improve diasto lic function. The reduction of hypertrophy induced by perindopril appe ars to be partly independent of BP decrease and therefore partly relat ed to a direct action of perindopril on the myocardium.