CORONARY BLOOD-FLOW IN RENOVASCULAR HYPERTENSION

We assessed the acute effects of 2.5 mg oral cilazapril on systemic an d coronary hemodynamics in seven renovascular hypertensive patients wi th a chronically overactive renin-angiotensin system (RAS), but with n o electrocardiographic or echocardiographic signs of left ventricular hypertrophy. Cilazapril resulted in a significant decrease in mean art erial pressure and coronary vascular resistance, together with a prolo nged increase in coronary sinus blood flow (CSBF). Post-cilazapril han d-grip resulted in larger increases in CSBF in response to a given inc rease in myocardial oxygen requirements. It is concluded that the chro nic activation of the RAS exerts an adverse influence on the control m echanisms of CSBF and that converting enzyme inhibition reverses the e ffects of angiotensin II on coronary hemodynamics. Converting enzyme i nhibitors may have a cardioprotective role in renovascular hypertensio n.