EFFECT OF ANTIHYPERTENSIVE THERAPY WITH L ISINOPRIL AND METOPROLOL ONARTERIAL COMPLIANCE IN ESSENTIAL-HYPERTENSION

In a double-blind, randomized study the effect of lisinopril and of me toprolol on arterial distensibility was investigated in 40 patients wi th essential hypertension (age 47 +/- 7,1 years). After a placebo-run- in period the patients were randomly treated with metoprolol (50 mg, 1 00 mg or 200 mg) or lisinopril (5 mg, 10 mg or 20 mg) for 10 weeks and the diameter and the arterial distensibility of the common carotid ar tery were determined before and after 6 and 10 weeks of therapy. A mul ti-gate Doppler system was used to measure the vessel wall movements b y a Doppler analysis in M-Mode, blood pressure was recorded by finger- plethysmography. Neither lisinopril nor metoprolol influenced the end- diastolic diameter of the common carotid artery. In the lisinopril gro up a significant increase of the arterial distensibility after 6 and 1 0 weeks was observed (p <0.01 compared to the baseline value, p < 0.05 compared to the metoprolol group). The results show that lisinopril b ut not metoprolol improves the arterial distensibility in essential hy pertension. Pressure-independent effects of ACE inhibitors may be impo rtant modulators of adaptative changes in the arterial wall.