CONVERTING-ENZYME-INHIBITOR IMPROVES FOREARM REACTIVE HYPEREMIA IN ESSENTIAL-HYPERTENSION

Endothelial function is known to be impaired in essential hypertensive patients. In this study, we examined whether antihypertensive drugs i mprove forearm vasodilatory response to reactive hyperemia in 26 patie nts with essential hypertension (62+/-2 years) without diabetes mellit us, hyperlipidemia, coronary heart disease, or cerebrovascular disease . Antihypertensive drugs were never given or were discontinued for at least 4 weeks before the study. Patients were treated with monotherapy of either temocapril (2 or 4 mg, n=15) or amlodipine (2.5 or 5 mg, n= 11) for 6 months. Forearm blood flow was measured by strain-gauge plet hysmography. Vasodilator response to the release of upper arm compress ion at 300 mm Hg for 5 minutes and to sublingual administration of nit roglycerin (0.3 mg) were assessed. Changes of forearm blood flow respo nse to reactive hyperemia were significantly less in hypertensive pati ents (99+/-18%) than in age-matched normotensive control subjects (150 +/-22%, P<.01, n=39). Blood pressure (mm Hg) was similarly decreased b y the treatment with temocapril (160+/-4/94+/-2 to 139+/-3/83+/-3, P<. 001) or amlodipine (165+/-5/94+/-3 to 141+/-4/82+/-3, P<.001). Respons e to nitroglycerin was not changed by either drug. Forearm vasodilator y response to reactive hyperemia was improved by temocapril (102+/-20% to 168+/-25%, P<.01) but not by amlodipine (97+/-16% to 114+/-14%, NS ). These results indicate that the treatment with the angiotensin-conv erting enzyme inhibitor temocapril improved forearm vasodilatory respo nse to reactive hyperemia, suggesting its beneficial effect on endothe lial function.