PERINDOPRIL AND PHYSIOLOGICAL-RESPONSES TO EXERCISE

Cardiovascular drugs have varying effects on hemodynamic, metabolic, a nd hormonal responses to exercise. To evaluate the effects of the nove l angiotensin-converting enzyme (ACE) inhibitor, perindopril on these exercise-related responses, we studied 9 healthy volunteers in a doubl e-blind, randomized, placebo-controlled trial. After a week of perindo pril 4 mg orally daily or placebo therapy, volunteers performed a trea dmill effort test; the sequence was repeated after a 1-week washout pe riod. Perindopril caused a significant reduction in mean resting systo lic and diastolic blood pressure (SBP, DBP) without increasing resting heart rate (HR); 15-min postexercise SBP was also significantly reduc ed. There were no significant differences between the perindopril and placebo effort tests with respect to metabolic indexes studied (serum K+, plasma glucose, plasma free fatty acids) or plasma hormonal concen trations measured (ACTH and cortisol, norepinephrine (NE) and epinephr ine (EPI), glucagon and insulin, growth hormone and prolactin, renin a ctivity). In the perindopril arm of the study, however, there were mod est but significant increases in mean serum K+ before exercise to imme diately after exercise (0.4 +/- 0.1 mM, p < 0.01) and mean plasma gluc ose from before exercise to 5 min (0.6 +/- 0.2 mM, p < 0.01) and 15 mi n (0.5 +/- 0.2 mM, p < 0.05) after exercise. These data show that peri ndopril does not impair the hormonal changes associated with exercise in healthy subjects but induces a more consistent increase in blood K and glucose concentrations.